Type 1 diabetes in children is a condition where your child's body stops making insulin. Insulin is an important hormone that helps sugar from food enter the body's cells for energy. Sugar from food also is called glucose. Without insulin, the body can't work as it should. To stay healthy, your child needs to get insulin through injections or an insulin pump. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes.

Being told your child has type 1 diabetes can feel overwhelming, especially at first. You and your child, depending on their age, need to learn how to give insulin, count carbohydrates and check blood sugar levels regularly.

There's no cure for type 1 diabetes, but it can be managed. Thanks to new technology, it's easier than ever to track blood sugar and deliver insulin. These advances help children with type 1 diabetes live active, healthy lives.

Symptoms of type 1 diabetes in children typically come on quickly. Watch for symptoms such as:

• Feeling very thirsty.
• Needing to urinate often. This may include bed-wetting in a child who has already toilet trained.
• Feeling very hungry.
• Stomach pain, nausea or vomiting.
• Losing weight without trying.
• Feeling tired or low on energy.
• Mood changes or unusual behavior, such as irritability.
• Breath that smells fruity.

When to see a doctor

Contact your child's healthcare professional if you notice any of these symptoms. Getting a diagnosis and starting treatment right away can help prevent serious health issues.

The exact cause of type 1 diabetes isn't known. But in most people, the body's immune system — which typically protects against harmful germs — mistakenly attacks and destroys cells in the pancreas that make insulin. These cells are called islet cells or beta cells. Genetics and environmental factors, such as certain viruses, may raise the risk of this happening.

Once the islet cells of the pancreas are gone, your child's body makes little or no insulin. Insulin is important because it helps move sugar from the blood into the body's cells where it's used for energy. Sugar from food also is called glucose.

After you eat, sugar from food enters the bloodstream. Without enough insulin, that sugar builds up in the blood instead of reaching the cells. High blood sugar can lead to serious and even life-threatening health issues if not treated.

Type 1 diabetes typically begins in children, but it can start at any age. Several things may raise the risk of developing the condition:

• Family history. A child has a slightly higher risk if a parent or sibling has type 1 diabetes.
• Genetics. Some genes are linked to a higher chance of developing type 1 diabetes.
• Races and ethnic groups. In the United States, type 1 diabetes is more common in children who are white and not Hispanic than in children of other racial or ethnic groups.
• Infections caused by viruses. Exposure to certain viruses may play a role in triggering the immune system to attack the cells that make insulin in the pancreas.

Type 1 diabetes can affect many parts of the body. Keeping your child's blood sugar level as close to a healthy range as possible most of the time can greatly lower the risk of serious conditions related to diabetes. These conditions also are called complications.

Complications can include:

• Heart and blood vessel disease. Over time, diabetes can raise the risk of high blood pressure, narrowed blood vessels, heart disease and stroke. These issues typically develop later in life.
• Nerve damage. High blood sugar can damage the small blood vessels that supply blood to your child's nerves. This may lead to tingling, numbness, burning or pain, often in the hands and feet. Nerve damage tends to develop slowly over time.
• Kidney damage. Diabetes can harm the tiny blood vessels in the kidneys that filter waste from the blood. This may affect how well the kidneys work over time.
• Eye issues. High blood sugar can damage the blood vessels in the retina. The retina is the part of the eye that senses light. This damage can lead to vision changes or vision loss.
• Weaker bones, called osteoporosis. Diabetes may lessen bone strength, raising your child's risk of osteoporosis as an adult.

You can help protect your child's health by:

• Helping keep blood sugar levels in a healthy range as often as possible.
• Encouraging healthy eating and regular physical activity.
• Making sure to see the diabetes care team regularly for checkups and guidance.

Children with type 1 diabetes also are more likely to develop other autoimmune conditions, such as thyroid disease and celiac disease. Your child's healthcare professional may recommend testing for these conditions as part of ongoing care.

Right now, there's no proven way to prevent type 1 diabetes. But researchers are working hard to find a way to prevent the condition, and it's a very active area of study.

In children at high risk of type 1 diabetes, certain autoantibodies can be found months or even years before symptoms begin. A blood test can find these autoantibodies. They are a warning sign that the immune system is attacking the cells that make insulin in the pancreas. Researchers are working on:

• Finding ways to prevent or delay type 1 diabetes in people who are at high risk of developing the disease.
• Stopping further damage to the cells that make insulin in people who have just been diagnosed.

Many blood tests can help diagnose type 1 diabetes in children. These tests also are used to monitor the condition over time. Typical tests include:

• Random blood sugar test. This often is the first test done. A blood sample is taken at any time of the day. If your child's blood sugar is 200 mg/dL (11.1 mmol/L) or higher and they have diabetes symptoms, this result strongly suggests diabetes.
• A1C test, also called glycated hemoglobin test. The A1C test shows your child's average blood sugar over the past three months. An A1C level of 6.5% or higher on two different tests means your child is likely to have diabetes.
• Fasting blood sugar test. A blood sample is taken after your child hasn't eaten for at least eight hours or overnight. Going for a time without eating is called fasting. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher suggests diabetes.

Additional tests

If these tests show high blood sugar, your child's healthcare professional may do more blood tests to confirm the diagnosis. This also will show whether it's type 1 or type 2 diabetes. This may include tests for autoantibodies, which are usually present in type 1 diabetes but not in type 2. Knowing the type of diabetes is important because the treatment is different.

Managing type 1 diabetes takes effort every day, around the clock. It involves big changes to daily routines. But careful management of type 1 diabetes helps your child stay healthy and lowers the risk of serious complications.

As your child grows, help them learn how to take care of themselves. This includes:

• Taking a more active role in managing diabetes.
• Understanding that diabetes care is lifelong.
• Learning how to check blood sugar and take insulin.
• Making healthy food choices.
• Staying active and moving every day.
• Building a good relationship with their diabetes care team.
• Wearing a medical ID that shows they have diabetes.

These healthy habits will help your child stay strong and active for years to come.

School and diabetes

Work with your child's day care, school nurse and teachers so they know how to help with diabetes care. This includes knowing the signs of low or high blood sugar. And it includes knowing when to check blood sugar levels and when to give insulin.

Under federal law, children with diabetes have the right to support at school. Schools must make reasonable adjustments to help children learn safely and fully participate in school activities.

Ask your child's healthcare professional

Don't wait for your next appointment to ask for help if you have questions or concerns. Reach out to your child's healthcare professional, certified diabetes care and education specialist, or registered dietitian. They can help you troubleshoot challenges and adjust the care plan as needed.

Managing your child's diabetes can feel overwhelming, and that's OK. Some days will go smoothly, and other days will be frustrating. No one can manage diabetes perfectly all the time. What matters most is doing your best and knowing that your efforts make a big difference. And remember, you don't have to do this alone. Your child's diabetes care team is here to help.

Your child's emotions

Diabetes doesn't just affect the body, it can affect emotions too.

• When blood sugar is too high or too low, it can cause mood swings or irritability.
• Kids may feel different from their peers because they have to check blood sugar and take insulin.
• Connecting with other children who have diabetes can help your child feel less alone and more confident. Ask your child's care team about local meetups or diabetes camps in your area.

Mental health and risky behaviors

Children and teens with diabetes are more likely to experience anxiety, depression, and diabetes burnout or frustration. That's why some diabetes specialists regularly include a mental health professional, such as a social worker or psychologist, who can support your child emotionally.

Watch for signs of mental health concerns, especially in teens, such as feeling sad most of the time. Also watch for changes in sleep, appetite, friendships and school performance. If you see signs that worry you, talk to your child's care team about screening for depression or other issues.

Rebellion also may be an issue, especially for teens. A child who has been good about sticking to their diabetes treatment plan may rebel in the teen years by ignoring diabetes care.

Also, be aware that the use of alcohol, drugs or tobacco products can be more risky for young people with diabetes compared to those who don't have the condition. Talk openly with your child or teen about these dangers and offer support through this stage of life.

Support groups and counseling

It helps to talk with others who understand what you're going through. Support groups for both children and parents can offer connection, encouragement and practical tips.

• Children's support groups help kids feel understood and less alone.
• Parent support groups give caregivers a space to share their concerns and learn from others.
• Talking to a counselor or therapist also can help you or your child cope with the emotional impact of diabetes.

Ask your child's care team for recommendations, or explore support through these websites:

• American Diabetes Association (ADA). Offers resources and support for children and teens with diabetes.
• Juvenile Diabetes Research Foundation (JDRF). Provides support, education and community programs.

Looking ahead

It's normal to worry about the long-term effects of diabetes. But when you and your child work together with your child's diabetes care team and follow a treatment plan, you prepare your child to lead a full, healthy and active life. You're building skills and habits that help your child now and in the future.

Your child's regular healthcare professional likely will be the one to diagnose type 1 diabetes. Your child may need to stay in the hospital to get blood sugar under control if it's very high.

After the diagnosis, your child will most likely be cared for by a doctor who specializes in children's diabetes care, called a pediatric endocrinologist. Your child's diabetes care team also typically includes a certified diabetes care and education specialist, a registered dietitian, and a social worker. These experts help you and your child learn how to manage diabetes and adjust to your new routines.

What you can do

Before your appointment take these steps:

• Make a list of any concerns you have about your child's health and diabetes care.
• Bring a family member or friend along. Managing diabetes involves a lot of information. Having someone else with you can help you remember everything.
• Make a list of questions to ask your child's healthcare professional. Ask for a referral to a certified diabetes care and education specialist and a registered dietitian. They can give you more support and help you create a care plan that works for your family.

Topics you may want to talk about:

• How and when to check your child's blood sugar.
• Using a continuous glucose monitor (CGM).
• Insulin, such as types, how much to give and when.
• Giving insulin, such as using a syringe, pen or pump.
• How to treat low blood sugar.
• How to manage high blood sugar.
• Testing for ketones and what to do if they're high.
• Healthy eating and how different foods affect blood sugar.
• How to count carbohydrates.
• How to adjust insulin or food for exercise.
• How to handle diabetes at school, daycare, sleepovers, holidays and during illness.
• How often to see healthcare professionals.

What to expect from your doctor

Your child's healthcare professional will ask you a number of questions to better understand your needs. These might include:

• How comfortable are you with managing your child's diabetes?
• How often does your child have low blood sugar episodes?
• What does your child typically eat in a day?
• How often does your child get physical activity?