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Type 1 diabetes: what families face and what comes next

TL;DR

What is type 1 diabetes?
In type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas, leaving the body with little or no insulin. People need insulin treatment because diet and exercise cannot replace the missing hormone.

How does type 1 diabetes differ from type 2 diabetes?
In type 1, the body loses its ability to make enough insulin; in type 2, the body has trouble using insulin and eventually cannot make enough. Lifestyle changes can help prevent or delay type 2 in some people, and some can achieve remission, meaning blood sugar stays below the diabetes range without diabetes medicine.

How has type 1 diabetes treatment changed?
Insulin first reached patients in 1922, giving children a chance to survive a disease that was usually fatal. Today, blood sugar sensors and pumps that adjust insulin doses can help families manage daily care.

What is daily life like for a child with T1D?
Daily care means giving insulin, checking blood sugar, and planning around meals, activity, and illness; even a pool trip or stomach bug can bring extra decisions. Families work with schools, keep supplies on hand and help children learn their care as they grow.

Which recent advances can help children now?
Blood sugar sensors, insulin pumps, and easier emergency treatments can help with daily care. Newer options include inhaled mealtime insulin for eligible children age six and older and Tzield, a medicine that can slow the disease in certain patients.

Could new treatments help people live without taking insulin?
Transplanted insulin-producing cells have allowed some adults in studies to stop taking insulin. Researchers still need to establish how safe and long-lasting these treatments are, especially before they could become an option for children.

Where can families find practical help?
Breakthrough T1D, the American Diabetes Association, TrialNet, and Beyond Type 1 offer help with school care, early testing, and insulin costs. Diabetes camp networks and camps such as South Carolina’s Camp Adam Fisher can help families find opportunities for children to meet peers who understand.

November is National Diabetes Month in the United States, often called Diabetes Awareness Month, and November 14 is World Diabetes Day. Type 1 diabetes has touched the lives of our loved ones and friends. We want to use this month to help others understand the disease, the work it takes to care for a child with it, and why families keep following the research.

One family close to us shared how their child’s diagnosis unfolded. It was summer. Their child was thirsty and making frequent trips to the bathroom, which seemed understandable in the heat. A child who usually loved sports seemed tired and less interested. The parent wondered what had happened to that familiar energy.

Then the weight loss became impossible to explain away. A blood sugar check led to the emergency room and a stay in the children’s intensive care unit. Their child had developed a dangerous buildup of acids in the blood, a condition called diabetic ketoacidosis. Looking back, the parent could see how the signs fit together. As they happened, each seemed to have another explanation.

The posts that followed described a family learning to care for their child, proud of how the child handled injections and grateful to everyone who helped them through the first weeks. There was also frustration when insurance delayed a pump their care team recommended. Those experiences help explain what families need from the science and from the people around them.

What type 1 diabetes is

The pancreas makes insulin, a hormone that helps sugar move from the blood into the body’s cells for energy. That sugar is also called glucose.

In type 1 diabetes, or T1D, the immune system mistakenly attacks the insulin-producing cells in the pancreas. Over time, the pancreas makes little or no insulin. Sugar then builds up in the blood because the body cannot use it properly. Doctors call T1D an autoimmune disease, meaning the body’s defenses attack its own healthy cells.

T1D can develop at any age. The most current CDC National Diabetes Statistics Report was updated in March 2026. It estimates that about 2.1 million Americans had diagnosed T1D, including 314,000 children and teens younger than 20. These estimates reflect 2023, since national health data take time to collect and analyze.

Eating too much sugar does not cause T1D. Genes can affect a person’s risk, and environmental factors may also play a role. Researchers are still trying to understand why one person develops it, and another does not.

Watch for unusual thirst, frequent urination, unexplained weight loss, and ongoing tiredness. These symptoms need prompt medical attention. Vomiting, stomach pain, unusual sleepiness, or fast, deep breathing can be signs of diabetic ketoacidosis, or DKA. DKA happens when too little insulin leads to a dangerous buildup of acids called ketones. It can be life-threatening and needs emergency care.

How type 1 differs from type 2

Type 2 accounts for about 90% to 95% of diabetes cases, according to the CDC. In type 2, the body’s cells struggle to respond to insulin. This is called insulin resistance. The pancreas tries to keep up by making more insulin, but over time it cannot make enough to control blood sugar.

People with T1D need insulin to replace what their bodies can no longer make. They usually take it by injection or with a pump. With injections, long-acting insulin provides background coverage between meals and overnight, while rapid- or short-acting insulin covers meals and helps correct high blood sugar. Pumps generally use rapid-acting insulin, delivering small amounts throughout the day and extra doses for meals. Some people can use inhaled insulin at meals alongside background insulin. Type 2 treatment can include changes to food and activity, other medicines and insulin, depending on the person.

Lifestyle changes can help prevent or delay type 2 in some high-risk people. Some people who already have type 2 can achieve remission after substantial, lasting weight loss, including through supervised nutrition programs or weight-loss surgery. Remission means blood sugar stays below the diabetes range without diabetes medicine. Blood sugar can rise again, so people still need follow-up care. No one can promise a permanent cure, and remission isn’t possible for everyone.

This is where advice about the two diseases can get confused. Healthy eating and exercise support health in T1D, but they cannot replace insulin or reverse the immune system’s attack. Diet and exercise have not been shown to prevent T1D. Some treatments can delay disease progression in certain patients, as we explain below.

Children with T1D can still eat carbohydrates, including foods that contain sugar. A birthday celebration does not have to mean sitting out the cake. Families learn to plan insulin around food with their diabetes team, while making room for balanced nutrition and the child’s needs. Assuming a child simply needs to avoid sugar misses much of what managing T1D involves.

Children can develop type 2, and adults can develop type 1. Age and appearance alone cannot tell you which disease someone has. Both can cause serious health problems, and neither diagnosis is a judgment about someone’s character or effort.

A century of treatment progress

Before insulin, children with T1D often survived only briefly. Families sometimes relied on severe diets intended to keep a child alive a little longer. Research in Toronto in 1921 led to insulin treatment for 14-year-old Leonard Thompson in January 1922. It changed what a diagnosis could mean for a child’s future.

Early insulin came from animal pancreases. In 1982, the FDA approved the first human insulin made through genetic engineering. Later insulin types gave doctors more ways to cover the body’s needs between meals and manage the rise in blood sugar after eating.

A major 1993 study, the Diabetes Control and Complications Trial, showed that keeping blood sugar closer to normal reduced damage to the eyes, kidneys, and nerves. Follow-up research found that the benefits of earlier blood sugar control lasted for years.

Home blood sugar testing, insulin pens, and pumps gave families more information and more ways to give insulin. Wearable sensors added frequent readings and showed whether blood sugar was rising or falling. In 2016, the FDA approved the first commercial system that used sensor readings to help a pump adjust insulin automatically. It still needed input from the user.

A blood sugar reading on a phone or a pump working during the school day draws on decades of research. Each improvement can change how a family manages an ordinary afternoon, even while the search for a cure continues.

What an ordinary day asks of a child and family

Breakfast can mean checking blood sugar, estimating carbohydrates in food, and giving insulin while getting everyone out the door. At school, a child may need help treating low blood sugar, permission to use a phone linked to a medical device, or trained adults available during a field trip.

Exercise adds uncertainty. The father in the family whose experience we shared described seeing blood sugar drop during basketball and rise during football, when adrenaline could play a part. Another child, or another day, may look different. Activity, insulin already working in the body, and the direction blood sugar is moving all affect the plan. Families prepare with their diabetes team, keep treatment for lows available, and make sure coaches know how to help.

Devices can reduce some of this work. They also need charging, replacement sensors, and backup plans. Pump users need to care for the spot where insulin enters the skin. Parents may monitor readings remotely while working or sleeping. Children can feel self-conscious about a device or frustrated by another alarm. Research on children with T1D has documented effects on their emotional health and their families’ well-being.

That father also described how wearing pumps and sensors can feel overwhelming for a child, even when those tools help. A trip to the neighborhood pool brings more to think about than grabbing a towel. They have supplies to bring, blood sugar to monitor, and a plan to follow. The child still wants to jump in with friends.

He pointed to something many people would never think about: a stomach bug. A parent is trying to comfort a sick child while also watching blood sugar, preventing dehydration, and figuring out what the child can keep down. If food comes back up after mealtime insulin has been given, that insulin can keep working, and blood sugar may fall. Illness can also raise blood sugar and lead to ketones.

Even choosing a drink takes thought. Gatorade, Pedialyte, and similar drinks are not automatically off-limits because they contain sugar. Depending on blood sugar and what the child can eat, the plan may call for carbohydrate-containing fluids; at other times, sugar-free fluids may fit. Families need a sick-day plan covering fluids, insulin, and blood sugar and ketone checks. Children with T1D still need insulin when they are sick. Vomiting or trouble keeping fluids down requires prompt contact with the diabetes team; signs of DKA require emergency care.

In the family account shared with us, an early source of comfort came from the emergency doctor, who also lived with T1D. The doctor showed the child a pump and blood sugar monitor and talked about camping and backpacking. The parent recalled how quickly that encouragement helped their child settle. It offered a picture of life beyond the hospital, with activities still to enjoy and new responsibilities to learn.

Soon, their child was learning to give insulin injections. The parent wrote with pride about how the child was handling it, even as the family still absorbed the diagnosis. Learning a care task can feel like an accomplishment, but having to do it again can still be frustrating.

The parent’s gratitude was specific: neighbors brought meals, a relative stayed with the other children so both parents could go to the hospital, and friends covered rides. Someone with diabetes experience answered questions when blood sugar readings were difficult. A school wanted to help, and a teacher with T1D reached out.

After the diagnosis, the family also discovered that adults they already knew were living with T1D. People began sharing experiences the family had never heard before. A disease that had felt unfamiliar suddenly had familiar faces, and the family had more people who understood.

That support gives a family people to turn to while they learn. As children grow, they can take on more of their care, with adults staying involved as needs and readiness change.

What recent innovations can offer children

A continuous glucose monitor, or CGM, is a wearable sensor that tracks blood sugar by measuring sugar in fluid just beneath the skin. It gives frequent readings and shows whether levels are rising or falling. Some systems send alerts and share readings with caregivers. Dexcom and Abbott’s FreeStyle Libre are examples of CGM brands. Age limits and features vary by product.

An automated insulin delivery system connects a sensor to a pump. Software uses the readings to adjust the insulin the pump delivers. The American Diabetes Association’s 2026 guidelines recommend offering these tools to children and teens who can use them safely, either themselves or with caregivers. Age limits and other requirements vary by system. Families still need training, meal input, and backup plans.

Different designs can fit different routines. Omnipod 5 uses a wearable patch pump controlled through a compatible smartphone or its controller. Tandem’s t:slim X2 delivers insulin through tubing connected to the body. Beta Bionics’ iLet reduces the need for calculations by using meal announcements, such as whether a meal has the usual amount of carbohydrates, more or less, rather than an exact carb count. It still needs the person to announce meals and manage the device. These tools can handle some decisions while leaving others to the child and family.

Emergency treatment has also become easier to give. Glucagon is a rescue medicine that raises blood sugar during a severe low. Nasal sprays and ready-to-use injections can reduce the preparation needed in an emergency. Each product has its own age limits and instructions.

Hospital care has advanced, too. Glytec’s Glucommander software helps medical teams calculate insulin doses using blood sugar readings and patient information. It is FDA-cleared for adults and children ages two through 17, and has been studied in children receiving hospital treatment for DKA. Doctors and nurses review its recommendations and give the insulin, adjusting care as the patient’s needs change. For a family facing a hospital stay, technology can also support the team caring for their child.

Two newer treatments bring other choices:

  • Insulin taken through an inhaler: Afrezza’s U.S. approval expanded in May 2026 to include children age six and older. It supplies insulin around meals; people with T1D still need background insulin between meals and overnight. Its label warns about sudden breathing problems in people with lung disease, and people with asthma should not use it. Lung testing is required. Its trial in children failed to show blood sugar control was no worse than with injected mealtime insulin. Families need to weigh that evidence and the safety requirements with their diabetes team.
  • Medicine that slows the disease: Tzield (teplizumab) acts on the immune system. It can delay the need for insulin treatment in eligible people age one and older with Stage 2 T1D. At this stage, blood tests show multiple diabetes-related antibodies, signs of an immune attack, and blood sugar is already abnormal. The person has not yet reached clinical diabetes. A separate June 2026 approval covers slowing insulin loss in certain children ages eight to 17 diagnosed within the previous eight weeks.

The FDA granted that newer Tzield use through its accelerated approval process. The decision was based on C-peptide, a blood marker of how much insulin the body makes. Further studies must confirm the treatment’s benefits. Tzield is given through infusions into a vein and requires monitoring. Its label includes a serious warning about previously inactive viruses becoming active again. A child just diagnosed and a teenager who has lived with T1D for years may have very different treatment options.

Access belongs in this discussion, too. The parent whose account we shared described being denied a recommended pump because the child had not lived with diabetes long enough to meet the insurer’s rule. The parent was already managing injections and learning a new routine. Challenging a coverage decision added another job at a difficult time.

What researchers are trying next

Some research aims to help the body keep making its own insulin for longer after diagnosis. Studies involving children or teens have found that medicines called verapamil, low-dose antithymocyte globulin, and ustekinumab slow the loss of insulin production. Researchers are still studying these medicines for T1D, and each has different risks and monitoring needs.

How long the benefit lasts matters. An August 2026 follow-up of a trial of another medicine, baricitinib, found that benefits faded after treatment stopped. Continued treatment may be needed. A good result in a study raises more questions about long-term use.

Other researchers are replacing insulin-producing cells. The FDA approved Lantidra in 2023 for certain adults who keep having severe low blood sugar despite intensive diabetes care. It uses cells from donated pancreases. Patients need medicines that weaken the immune system to protect the transplanted cells.

Growing replacement cells in a lab could help overcome the shortage of donated cells. In a small adult study of Vertex’s treatment, zimislecel, 10 of 12 people who received the full dose no longer needed to take insulin at one year. Researchers made these replacement cells from stem cells that can develop into different cell types. The published early analysis included 14 adults with at least one year of follow-up.

The risks need equal attention. Participants took medicines that weakened their immune systems. Three developed seriously low levels of infection-fighting white blood cells. Two deaths were reported, from a serious fungal infection and worsening of a brain condition present before the study. More people and longer follow-up are needed to understand the benefits and risks. The current trial is for adults ages 18 to 65. The reviewed trial record gives no date when children could receive the treatment.

Researchers are also trying to protect replacement cells without weakening the whole immune system. In March 2026, Sana reported that gene-edited donor cells were still producing insulin after 14 months in one adult who did not take immune-suppressing drugs. Gene editing changes a cell’s DNA, in this case to help the cells avoid immune attack. This low-dose study did not show that the person could stop taking insulin, and it cannot establish safety for children.

Another approach is insulin designed to change its activity as blood sugar changes. A candidate called NNC2215 showed this could work in animal experiments published in 2024. Researchers still need to establish whether it works safely in people.

Parents reading these findings deserve clear answers. Who might a treatment help? What are the risks? Is it available now, or still being tested? For children, researchers also need to understand what happens as they grow and live with a treatment for many years.

Resources for individuals and families

Families need different help at different points. These resources focus on the United States, with links collected below:

  • School care and advocacy: The American Diabetes Association’s Safe at School program and Breakthrough T1D’s school guide help families and school staff plan care. A Diabetes Medical Management Plan explains the child’s medical needs. A 504 plan can document the support and changes a child needs to participate fully at school.
  • Early testing and research: TrialNet offers free testing for eligible relatives and certain other people. Testing can find T1D before symptoms appear and help families discuss follow-up care or research opportunities.
  • Help paying for insulin: Beyond Type 1’s Get Insulin resource helps people find assistance based on their situation. Each program has its own rules.
  • Camps and connection: The Diabetes Education & Camping Association has a camp directory. Camp Adam Fisher in Summerton, South Carolina, offers a summer camp for children with T1D. Camp Sweeney in North Texas is another option. Families can ask about current age limits, medical support, cost and financial help, and whether the experience suits their child. Camp is one way to find connection.
  • Daily care and emotional support: A child’s diabetes team can help families learn daily care, develop a sick-day plan, and connect them with nutrition and mental-health support. A parent’s stress and a child’s frustration deserve attention alongside blood sugar readings.

The family whose experience informed this article remembered the people who showed up: the relative who stayed with the other children, the friends who took over rides, and the adults who helped their child feel understood. For someone wondering how to help, those are good places to begin. Ask what needs covering this week, learn what the child’s care plan requires of you, and follow through.

Sources: Medical and regulatory information checked through October 27, 2026. Treatment indications discussed are U.S. indications. Family experiences were supplied privately and paraphrased without identifying details.

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