What Is Type 1 Diabetes?

Created: 03.07.2026  ·  Last Updated: 03.07.2026  ·  Category: Pediatric Endocrinology / Pediatrics  ·  Prepared by the Academic Hospital Web and Editorial Board.

Type 1 diabetes is an important metabolic disease that can be seen in childhood and requires regular follow-up. Blood glucose rises due to insulin deficiency; early diagnosis, correct insulin use, a nutrition plan, activity balance and family education form the basis of treatment.

Warning:

  • If excessive thirst, frequent urination, weight loss, vomiting, rapid breathing or a fruity smell on the breath is present, the child should be evaluated urgently.
  • In type 1 diabetes treatment, insulin dose, nutrition and exercise plans must be individualized by the physician and diabetes care team.

What Is Type 1 Diabetes?

Type 1 diabetes is a disease that occurs as a result of insulin deficiency and progresses with an increase in blood sugar (glucose). Insulin is a hormone secreted from the pancreas in our body and enables the sugar in the blood to be used by body cells. Normally, the cells in our body obtain the energy they need to continue their lives and functions by using the sugar in the blood almost like a fuel. Just as a car cannot run without enough gasoline, cells cannot perform their duties when they cannot use sugar.

Carbohydrates we take in with food are converted into simple sugars in the intestines, absorbed and mixed into the blood. When blood sugar starts to rise after eating, insulin secretion from the pancreas increases in people who do not have diabetes, and as a result, the sugar that enters the blood is used or stored by the cells. In people with diabetes, because insulin secretion is insufficient, the sugar passing from the intestines into the blood cannot be used by the cells and blood sugar rises.

In healthy people, according to the level of sugar in the blood during feeding or fasting, the body automatically adjusts the amount of insulin secretion and keeps blood sugar within normal limits. However, in a child with diabetes, because the pancreas cannot produce insulin, blood sugar is continuously high and rises even more after meals.

Important Information: Type 1 diabetes in children usually requires insulin therapy. Treatment is planned not only to lower blood glucose but also to help the child safely maintain growth, development, school life, nutrition and activity routines.

How Does Type 1 Diabetes Develop?

Diabetes develops as a result of the destruction of the insulin-producing cells of the pancreas due to various environmental and constitutional causes. When enough insulin cannot be produced, the sugar in the blood cannot be taken up and used by the cells, and the unused sugar accumulates in the blood, causing blood sugar to rise. Blood sugar rising above normal is called HYPERGLYCEMIA. Normally, in people without diabetes, blood sugar levels are between 70-110 mg/dl. In people with diabetes, blood sugar rises far above these values. When blood sugar rises above 170-180 mg/dl, some of the sugar in the blood also passes into the urine and sugar begins to appear in the urine. We can detect sugar in the urine by the color change on a urine test strip. As the amount of sugar in the urine increases, water is also excreted along with sugar, so the amount of urine the child produces begins to increase. The child may urinate frequently or start wetting the bed at night. To replace this water loss through urine, the child also starts drinking a lot of water. Thus, excessive thirst and frequent urination begin. These are symptoms of hyperglycemia.

In children with diabetes, because the sugar in the blood cannot be used due to insulin deficiency, the starving cells begin to break down fats and proteins to provide energy. As a result, weight loss occurs. In addition, during the use of fats for energy production, acidic substances called KETONES are released. Ketones cause nausea and vomiting. In order to remove these acidic substances from the body, rapid breathing also begins. Ketones are also excreted in the urine. Whether there are ketones in the urine can be easily understood with a urine test strip. If ketones are present in the urine, the light color on the test strip turns dark pink-purple. If diabetes is not diagnosed during this period and the necessary treatment is not started, the child may enter the severe condition we call diabetic ketoacidosis and coma may develop.

Emergency warning:

  • Diabetic ketoacidosis can be a life-threatening condition in children.
  • If vomiting, abdominal pain, rapid breathing, fruity breath odor, confusion or marked drowsiness is present, emergency medical support should be sought without delay.

Symptoms of Diabetes in Children

  • Drinking a lot of water
  • Urinating frequently
  • Bedwetting at night or getting up to urinate at night
  • Excessive eating
  • Inability to gain weight or weight loss
  • Weakness, fatigue, desire to sleep
  • A rotten apple smell in the mouth
  • Abdominal pain
  • Nausea and vomiting
  • Rapid breathing
Symptom Group How It May Be Noticed
Fluid and urination changes Excessive thirst, frequent urination, bedwetting or getting up at night to urinate may be seen.
Energy and weight changes Inability to gain weight, weight loss, weakness, fatigue and a desire to sleep may be noticed.
Ketoacidosis findings A fruity smell on the breath, abdominal pain, nausea-vomiting and rapid breathing may develop.

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How Is Type 1 Diabetes Treated?

There is currently no widely used treatment that will completely remove type 1 diabetes from the body, in other words, that will enable the body to produce its own insulin again. However, by giving the insulin the body needs externally by injection, it is possible to lower blood sugar to the desired levels and reverse the negative developments listed above. Type 1 diabetes seen in children is different from type 2 diabetes seen in adults. Since insulin production of the pancreas continues in most adult patients with diabetes, their treatment with diet or oral diabetes medications may be possible. However, in type 1 diabetes, this is not possible because the insulin-producing cells of the pancreas are completely or almost completely destroyed. Therefore, children with diabetes need to receive insulin externally by injection. When insulin is given orally, it is broken down in the stomach and becomes ineffective. Therefore, it must be administered by injection.

With insulin as well as a balanced nutrition and activity plan in diabetes treatment, children can live a completely normal and active life.

Therefore, there are three main elements in diabetes treatment.

These are:

  1. Insulin,
  2. Nutrition plan,
  3. Activity and exercise.

Achieving the desired control of diabetes depends on establishing a good balance between these three elements. Among these, insulin and activity lower blood sugar, while nutrition has an effect that raises blood sugar.

Treatment note: In type 1 diabetes treatment, insulin, nutrition, exercise and blood glucose monitoring are evaluated together. Insulin dose or the treatment plan should not be changed without a physician’s recommendation.

Target Blood Glucose Levels in Diabetes

In people without diabetes, blood glucose levels are between 70-110 mg/dl. In people with diabetes, we want to keep blood glucose levels as close to normal as possible with treatment. The blood glucose levels we target in people with diabetes according to age and fasting-postprandial status are shown below:

Age Group Fasting After Meals Before Bedtime
0-1 year 90 - 170 mg/dl 120 - 200 mg/dl 110 - 170 mg/dl
Preschool age 80 - 160 mg/dl 110 - 190 mg/dl 110 - 150 mg/dl
School-age child and adolescent 80 - 130 mg/dl 110 - 170 mg/dl 110 - 130 mg/dl

In a child with diabetes, it is inevitable that blood sugar will occasionally go outside these limits. However, the important thing is to ensure that most blood glucose values remain within these limits. This is achieved through good diabetes education, measuring blood glucose as frequently as possible, and establishing a good balance between insulin, nutrition and exercise.

Important Information: Blood glucose targets should be individualized according to the child’s age, risk of hypoglycemia, duration of disease, treatment method and physician assessment. Therefore, the values in the table do not replace the recommendation of the treating physician.

When Should You See a Doctor?

If your child has symptoms such as excessive thirst, frequent urination, bedwetting, unexplained weight loss, fatigue or a fruity smell on the breath, an evaluation by pediatrics or pediatric endocrinology is needed. In children diagnosed with diabetes, the care team should be contacted in cases of low blood glucose, high blood glucose, ketone positivity, vomiting, inability to eat or drink, or deterioration in general condition.

Situations that may require urgent evaluation:

  • Persistent vomiting or inability to take fluids
  • Rapid and deep breathing
  • Rotten apple / fruity smell on the breath
  • Confusion, drowsiness or fainting
  • Detection of ketones in urine or blood together with high blood glucose

Do Not Delay Diabetes Symptoms in Children

You can book an appointment with Academic Hospital specialists to evaluate your child’s symptoms and create a personalized follow-up plan.

Frequently Asked Questions

What symptoms can type 1 diabetes cause in children?
Excessive thirst, frequent urination, bedwetting, weight loss, fatigue, nausea-vomiting and rapid breathing are among the important symptoms of type 1 diabetes. A fruity smell on the breath and drowsiness may require urgent evaluation.
Is type 1 diabetes a temporary condition?
Type 1 diabetes is generally a chronic condition that requires lifelong follow-up and insulin therapy. With treatment, blood glucose can be controlled and children can maintain an active life.
Why is insulin necessary in type 1 diabetes?
In type 1 diabetes, the pancreas cannot produce enough insulin. Without insulin, glucose in the blood cannot be used by the cells and blood glucose rises.
Which symptoms may suggest diabetic ketoacidosis?
Abdominal pain, nausea, vomiting, a fruity smell on the breath, rapid breathing, marked fatigue and drowsiness may require urgent assessment for diabetic ketoacidosis.
Can children with type 1 diabetes exercise?
Yes. Children with type 1 diabetes can be physically active with appropriate insulin use, nutrition planning and blood glucose monitoring. The activity plan should be arranged with the child’s care team.
Are target blood glucose values the same for every child?
No. Target blood glucose values should be individualized according to age, duration of diabetes, hypoglycemia risk and the treatment plan. Therefore, targets should be planned specifically for the child by the treating physician.
Academic Hospital note: You can book an appointment to receive expert evaluation for type 1 diabetes symptoms, blood glucose monitoring and treatment planning in children.

References

The general information in this article about type 1 diabetes, symptoms in children, diabetic ketoacidosis, insulin treatment and follow-up approach is supported by the authoritative health sources below.

  1. Centers for Disease Control and Prevention, "About Type 1 Diabetes", cdc.gov
  2. National Institute of Diabetes and Digestive and Kidney Diseases, "Type 1 Diabetes", niddk.nih.gov
  3. American Diabetes Association, "Children and Adolescents: Standards of Care in Diabetes—2026", diabetesjournals.org
  4. Mayo Clinic, "Type 1 diabetes in children", mayoclinic.org