According to the American Diabetes Association (ADA), approximately 352,000 Americans under the age of 20 have been diagnosed with either type 1 or type 2 diabetes. If not properly managed, diabetes can lead to serious and potentially life-threatening complications. In fact, in 2021, diabetes was the eighth leading cause of death in the United States (ADA, n.d.-f).
Understanding what diabetes is and the steps needed to manage it are essential to ensuring that your adolescents and children with diabetes receive the care and support they need to live healthy, full lives.
Understanding the Differences Between Type 1 and Type 2 Diabetes
The Hormone Insulin
Insulin is an essential hormone produced by beta cells in the pancreas. Insulin travels through the blood to your body’s cells and acts like a “key” to unlock the cells. When this happens, the glucose (sugar) can move from the blood into the cells. Once glucose is inside a cell, it can be used to make energy for your body (Cleveland Clinic, 2024).
In type 1 diabetes, the body’s autoimmune system mistakenly attacks and destroys these insulin-producing beta cells in your pancreas. As a result, the body can no longer produce insulin. Individuals with type 1 diabetes rely on external (exogenous) insulin, delivered through injections or an insulin pump, to maintain healthy blood glucose levels. Without insulin, blood glucose levels can rise to dangerous, potentially life-threatening levels (Cleveland Clinic, 2024).
Who Diabetes Affects
Type 1 diabetes was once commonly referred to as “juvenile diabetes” because it often develops in children and adolescents. However, this term is now used less frequently because type 1 diabetes can occur at any age, and more young people are now being diagnosed with type 2 diabetes (Perng et al., 2023).
In type 2 diabetes, the pancreas still produces insulin, but the body’s cells no longer respond effectively to insulin, a condition known as insulin resistance (Cleveland Clinic, 2024). Insulin resistance prevents insulin from transporting glucose into the cells, where it would normally be used for energy. As a result, glucose builds up in the bloodstream, causing blood sugar levels to rise above normal levels. Using the analogy where insulin acts like a key to unlock cells and allow glucose to enter, in type 2 diabetes, the key no longer reliably unlocks the cells.
If your child has type 2 diabetes, it means their body cannot use insulin efficiently. Unlike type 1 diabetes, where the body stops producing insulin entirely, individuals with type 2 diabetes may still produce insulin, but not enough to maintain normal blood glucose levels (ADA, n.d.-a).
Management of Type 2 Diabetes
Some individuals can control their blood glucose levels with oral medication, while others may eventually require insulin injections in addition to other treatments. Maintaining normal blood glucose levels is essential to reduce the risk of long-term complications, such as nerve damage, kidney damage, and vision problems. While the risk of developing type 2 diabetes increases with age, it can affect people of any age, including children and adolescents (ADA Professional Practice Committee [PPC], 2023).
Diabetes Symptoms
In adolescents and children, symptoms of diabetes may include:
- constant thirst
- frequent urination
- persistent hunger
- blurred vision
- delayed wound healing
- excessive fatigue
- unexplained weight loss despite increased appetite
Note that weight loss is more common in children with type 1 diabetes than in children with type 2 diabetes (Mayo Clinic Staff, 2023a, 2023b).
Treatment and Management of Diabetes in Childhood
Diabetes affects each child differently, and managing diabetes can be stressful for both the child and their caregivers. However, creating a clear care plan and understanding the available treatment options are essential steps toward successful management.
It’s important to know that caring for children and teens with diabetes is not the same as caring for adults. Children are still growing and changing physically, emotionally, and cognitively. Because of this, their diabetes care needs to be different. It should be adapted to their age, how they feel, and their family dynamics. A care plan that works for an adult may not work for a child (ADA PPC, 2023).
There are several strategies recommended for managing diabetes in children and youth.
Nutritious Eating
A healthy diet is key for your child to successfully manage and treat their diabetes and can also benefit the entire family. The ADA recommends starting with a balanced plate that focuses on nonstarchy vegetables, lean protein, whole fruits, and healthy fats (ADA PPC, 2023).
Use the Diabetes Plate Method
This visual guide helps with meal planning and managing blood glucose. Use a 9-in. plate and fill half with nonstarchy vegetables, such as broccoli, carrots, eggplant, jicama, onions, celery, or greens. Fill one quarter of the plate with proteins such as chicken, fish, tofu, or eggs. In the last quarter of the plate, include nutritious carbohydrate-containing foods such as fruits, whole grains, starchy vegetables (such as corn or peas), or dairy products. Drink water or a zero-calorie beverage (Nutrition & Wellness Team, 2025).
Read Food Labels
The ADA recommends using nutrition fact labels to determine the serving sizes and total carbohydrate content in foods that your child eats. This information is included on the nutrition facts label on most packaged foods (ADA, n.d.-c). Managing both the amount of carbohydrates and the timing of carbohydrate intake helps maintain steady blood glucose levels.
Get Professional Support
If possible, schedule an appointment with a registered dietitian nutritionist (RDN) to help identify the best food choices for your child’s needs.
Glucose Monitoring in Children
Monitoring blood glucose levels is a key part of helping your child manage their diabetes successfully. This involves checking their blood glucose levels several times before and after meals, during and after physical activity, and whenever symptoms of high or low blood glucose appear. Be sure to follow your child’s healthcare provider’s instructions for when and how often to check their blood sugar.
Glucose levels can be measured using a traditional blood glucose meter or with a continuous glucose monitor (CGM), which tracks glucose levels in real time throughout the day and night. It is important that your child understands how and when to use these devices.
In addition to daily checks, your child’s healthcare provider may order a hemoglobin A1C test to assess average glucose levels over the past 2 to 3 months and help determine how well their diabetes is being managed over time (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2020).
Insulin Treatment for Children
Insulin therapy plays a vital role in managing diabetes. There are five main types of insulin, categorized by how quickly they start working and how long they last in the body. These include:
- rapid acting
- short acting (regular)
- intermediate acting
- long acting
- ultra long acting
These types of insulin are prescribed on a schedule to manage blood glucose levels throughout the day and night. The specific insulin regimen your child needs will depend on their diabetes type, how well their blood glucose is controlled, and other individual health factors.
There is no one-size-fits-all insulin treatment. It must be tailored to your child’s unique needs. That’s why it is important to work closely with your child’s healthcare provider to develop a personalized medication plan. They can help determine whether insulin is needed, what type is best, and how it should be administered—whether by syringe, insulin pen, pump, or other delivery method (NIDDK, 2022).
Physical Activity in Children with Diabetes
Regular physical activity is a key part of managing diabetes in children. The ADA recommends that children and adolescents with diabetes engage in at least 60 min of moderate to vigorous physical activity each day, including muscle and bone-strengthening activities at least three times a week.
Daily movement helps regulate blood glucose levels, supports a healthy body weight, and improves overall well-being. It also promotes social interaction and builds self-esteem, which are important benefits for growing children.
Exercise doesn’t have to be intense: activities like walking, biking, dancing, or playing outside all count. What matters most is consistency and enjoyment. Encourage your child to find activities they enjoy and can stick with.
- Talk to your child’s healthcare provider to develop a physical activity plan with your child and help them set their goals (ADA PPC, 2023).
- Keep a fast-acting carbohydrate (like juice or glucose tablets) nearby in case of low blood glucose.
- Make sure your child stays hydrated and wears proper footwear to prevent injury.
- Educate your child’s caregivers, including teachers or coaches, on your child’s glucose management before, during, and after physical activity.
Even small amounts of movement throughout the day can make a big difference. The goal is to build healthy habits that your child can enjoy and maintain over time (ADA, n.d.-d).
Optimism and Family Management
Living with diabetes can be challenging, not just for the child but for the entire family. That’s why maintaining an optimistic attitude and a strong family support system is so important.
Children and adolescents need to know that diabetes does not define them. With the right care and encouragement, they can still do everything their peers can and more. Parents and caregivers play a key role in modeling this mindset. When adults show confidence and optimism, children are more likely to feel empowered and capable.
Family involvement is essential to successful diabetes management. Caregivers should be familiar with how to:
- administer insulin,
- recognize and respond to low and high blood glucose,
- adjust food and insulin intake,
- create and follow a care plan, and
- communicate with school staff and healthcare providers.
According to the NIDDK, managing diabetes in children requires a team approach that includes the adolescent, family, and healthcare providers and school staff (2017). Diabetes must be managed around the clock, including during school hours, field trips, summer camp, and any extracurricular activities.
Schools should have trained staff who can monitor blood glucose, provide care as needed, and respond in emergencies (ADA, n.d.-b). It is also essential that students with diabetes have an individualized Section 504 plan in place. This plan, developed under the Rehabilitation Act of 1973, outlines accommodations and services the school should provide to ensure the student’s medical safety and equal access to education.
It includes provisions such as allowing blood glucose monitoring in the classroom, access to snacks and water, permission to leave class for diabetes care, and for school staff (including teachers, coaches, and bus drivers) who interact with the child to complete training to recognize and respond to low and high blood glucose levels (ADA, n.d.-e).
Childhood diabetes is manageable. With teamwork, education, and a positive attitude, your children can thrive. Work closely with your child’s healthcare team to create a plan that supports their health and their goals.
References
American Diabetes Association. (n.d.-a). About diabetes: Understanding type 2 diabetes. Retrieved July 1, 2025, from https://diabetes.org/about-diabetes/type-2
American Diabetes Association. (n.d.-b). Advocacy: Safe at school. Retrieved July 2, 2025, from https://diabetes.org/advocacy/safe-at-school-state-laws
American Diabetes Association. (n.d.-c). Diabetes and food: Reading food labels. Retrieved July 1, 2025, from https://diabetes.org/food-nutrition/reading-food-labels/making-sense-food-labels
American Diabetes Association. (n.d.-d). Fitness: Get started safely. https://diabetes.org/health-wellness/fitness/getting-started-safely
American Diabetes Association. (n.d.-e). Safe at school: Section 504 plan. Retrieved July 2, 2025, from https://diabetes.org/advocacy/safe-at-school-state-laws/section-504-plan
American Diabetes Association. (n.d.-f). Statistics about diabetes. Retrieved July 1, 2025, from https://diabetes.org/about-diabetes/statistics/about-diabetes
American Diabetes Association Professional Practice Committee. (2023). 14. Children and adolescents: Standards of care in diabetes—2024. Diabetes Care, 47(Supplement_1), S258–S281. https://doi.org/10.2337/dc24-S014
Cleveland Clinic. (2024, January 17). Insulin. Retrieved July 1, 2025, from https://my.clevelandclinic.org/health/body/22601-insulin
Mayo Clinic Staff. (2023a, September 2). Type 1 diabetes in children. Mayo Clinic. Retrieved July 1, 2025, from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/symptoms-causes/syc-20355306
Mayo Clinic Staff. (2023b, November 18). Type 2 diabetes in children. Mayo Clinic. Retrieved July 1, 2025, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes-in-children/symptoms-causes/syc-20355318#
National Institute of Diabetes and Digestive and Kidney Diseases. (2017, 20 Dec). Parents, teens, and diabetes: It’s a balancing act. National Institutes of Health. Retrieved July 2, 2025, from https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/balancing-act
National Institute of Diabetes and Digestive and Kidney Diseases. (2020, May). Helping the student with diabetes succeed. National Institutes of Health. https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/diabetes/helping-student-diabetes-succeed-guide-school-personnel
National Institute of Diabetes and Digestive and Kidney Diseases. (2022, March). Insulin, medicines, and other diabetes treatments. National Institutes of Health. Retrieved July 1, 2025, from https://www.niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments
Nutrition & Wellness Team. (2025, January 15). What is the diabetes plate? American Diabetes Association, Diabetes Food Hub. Retrieved July 1, 2025, from https://diabetesfoodhub.org/blog/what-diabetes-plate
Perng, W., Conway, R., Mayer-Davis, E., & Dabelea, D. (2023). Youth-onset type 2 diabetes: The epidemiology of an awakening epidemic. Diabetes Care, 46(3), 490–499. https://doi.org/10.2337/dci22-0046
