Childhood diabetes care (Diabetes (type 1 and type 2) in children and young people)

What is childhood diabetes care?

Diabetes means the blood sugar (glucose) is too high because the body cannot make enough insulin, or cannot use it properly. Most children with diabetes have type 1, where the body stops making insulin and lifelong insulin treatment is needed. Type 2 diabetes, linked to insulin not working well, is less common in children but is increasing. Childhood diabetes care covers diagnosing diabetes and then managing it safely every day.

A new diagnosis of type 1 diabetes is often urgent. The symptoms — being very thirsty, weeing a lot (including a previously dry child wetting the bed), tiredness and losing weight, remembered as the '4 Ts': Toilet, Thirsty, Tired, Thinner — usually come on over just days or weeks. If you notice these, your child needs to be seen the same day, because untreated type 1 diabetes can quickly lead to a dangerous emergency called diabetic ketoacidosis (DKA).

Day-to-day care is led by a specialist children's diabetes team and built around insulin (for type 1), checking glucose levels, balancing food and activity, and learning to handle high and low blood sugar safely. What this guide cannot do is replace your child's diabetes team or their personalised plan — it is here to help you understand the condition, ask good questions, and recognise emergencies fast.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Hypo vs DKA — what to look for

If you are ever unsure whether it is a hypo or DKA, treat for a hypo first if your child can swallow safely, and get urgent help. Follow your team's written plan.

Preparing for your treatment

• If you suspect new diabetes (the 4 Ts), do not wait — arrange same-day assessment; this is often an emergency, not a routine appointment.
• For ongoing care appointments, bring your child's glucose readings or download from their meter, pump or sensor.
• Bring the insulin and devices your child uses, and a list of doses.
• Note any recent hypos, high readings, illnesses or changes in routine, appetite or activity.
• Write down questions about school, sport, sleepovers, growth or puberty, which all affect diabetes.
• Bring details of how diabetes is managed at school and any support already in place.

What happens

If diabetes is newly suspected, a child usually has an immediate finger-prick blood glucose test and a urine or blood check for ketones. A high glucose level means same-day referral to the paediatric team. Many children with new type 1 diabetes are admitted to hospital to start insulin, treat any DKA, and begin learning how to manage the condition with the diabetes team.

At diagnosis and afterwards, the specialist children's diabetes team — including paediatricians, diabetes nurses and dietitians — teaches the family how to give insulin, check glucose, count or match carbohydrate, recognise and treat hypos, and follow 'sick-day rules' when the child is ill. Children and families are supported to take on more of this over time.

At routine reviews, the team checks glucose patterns and long-term control (including the HbA1c blood test), adjusts insulin, reviews devices such as pumps and sensors, checks growth and wellbeing, and screens over time for diabetes-related complications. Care is planned around school, activity and family life.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The two emergencies to know cold are severe low blood sugar and DKA. A hypo needs fast-acting sugar and then a snack; if your child is unable to swallow, drowsy or fitting, it is a 999 emergency. DKA — tummy pain, vomiting, fast or deep breathing, fruity-smelling breath, drowsiness or confusion, usually with high glucose and ketones — is life-threatening and needs 999. Insulin should never be stopped during illness; follow your team's sick-day rules and seek help early.

Published figures to discuss

How childhood diabetes affects a particular child depends on the type, age, how quickly it was diagnosed, day-to-day control and access to support and technology. A notable proportion of children are still diagnosed only once they have developed DKA, which is exactly why early recognition of the 4 Ts matters. Long-term complication risk relates strongly to glucose control over many years. Because these figures vary by population and care setting, this guide describes risks in cautious, qualitative terms rather than quoting specific percentages.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Diabetes is a lifelong condition rather than something to recover from, but symptoms usually improve quickly once insulin and treatment start. 'Afterwards' is really about learning to manage diabetes confidently day to day, with the specialist team's support, and fitting it around normal childhood.

• Thirst, tiredness and frequent weeing improving within days of starting treatment.
• A learning curve for the whole family in the first weeks.
• Day-to-day ups and downs in glucose readings — perfect numbers are not the aim.
• A temporary fall in insulin needs early on in type 1 (the 'honeymoon' phase).
• Adjusting the plan around illness, growth, exercise and changing routines.

Aftercare

• Give insulin as prescribed and never stop it during illness — follow your team's sick-day rules.
• Check glucose (and ketones when advised) as your plan sets out, especially when your child is unwell.
• Always carry fast-acting sugar and a follow-up snack to treat hypos.
• Keep an emergency plan and, if prescribed, glucagon for severe hypos, and make sure carers know how to use it.
• Balance carbohydrate, activity and insulin with help from your dietitian and team.
• Make sure school has an up-to-date care plan and trained staff.
• Attend all clinic reviews, including blood tests and complication screening.
• Watch for and act fast on emergency signs of hypo and DKA, and know when to call 999.

• Insulin, devices and spare supplies always stocked
• Glucose meter and/or sensor, plus ketone testing, ready
• Fast sugar and snacks carried at all times
• Glucagon kit (if prescribed) and carers trained to use it
• A written sick-day plan and emergency plan
• An up-to-date school diabetes care plan
• The diabetes team's contact and out-of-hours numbers saved

⚠ Get urgent help if…

• DKA emergency — tummy pain, vomiting, fast or deep breathing, fruity (acetone) smelling breath, drowsiness or confusion, usually with high glucose and ketones — call 999.
• A severe hypo — your child is drowsy, unable to swallow safely, having a fit, or unconscious — call 999 and use glucagon if prescribed and trained.
• Repeated vomiting in a child with diabetes, especially with high glucose or ketones — seek urgent advice and do not stop insulin.
• At first presentation: extreme thirst, lots of weeing (or a previously dry child wetting the bed), weight loss and tiredness — see a doctor the same day.
• Glucose that stays very high despite extra insulin, or rising ketones — contact your team urgently.
• A possible insulin pump failure with high glucose and ketones — follow your backup-insulin plan and seek advice.
• Signs of another illness alongside diabetes that is making glucose hard to control.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Once treatment starts, the immediate result is rapid relief of symptoms — thirst, tiredness and frequent weeing settle as glucose comes under control. With ongoing care, the aim is steady, in-range glucose most of the time, good growth and wellbeing, and a full, active childhood, judged partly by the HbA1c blood test and time-in-range from sensors.

Good control reduces the long-term risk of complications affecting the eyes, kidneys, nerves and heart, but it cannot guarantee none will ever occur, and 'perfect' numbers are neither realistic nor the goal. Type 1 diabetes is lifelong; there is currently no cure, and the priority is safe, sustainable management that fits the child's life.

Type 1 diabetes is a lifelong condition with no current cure, so management continues for life and evolves as the child grows, goes through puberty and becomes more independent. Type 2 diabetes in children is also long-term and managed over years. The care plan is reviewed regularly because insulin needs, devices, routines and goals all change over time, and young people are eventually supported to move to adult diabetes services.

Related tests, treatments or support

Diabetes care is coordinated with everyday life — school, sport, sleepovers and travel all need planning. Because type 1 diabetes can occur alongside other autoimmune conditions, children are checked over time for problems such as coeliac and thyroid disease. Emotional and psychological support is an important part of care, given the daily demands of the condition.

Follow-up & long-term care

Children with diabetes are followed up regularly by their specialist paediatric diabetes team, with clinic reviews that check glucose patterns, HbA1c, growth, devices and wellbeing, plus annual checks and, after some years, screening for diabetes-related complications. Families have access to the team between appointments and to urgent advice out of hours.

• Keep insulin and supplies in date and stocked, with backups for pump or device problems.
• Replace and rotate injection, pump and sensor sites to keep skin healthy.
• Renew glucagon and emergency kit before they expire and keep carers trained.
• Keep the school care plan and emergency plans up to date as your child grows.
• Attend all reviews and complication-screening checks.
• Update the plan around growth, puberty, new activities and travel with your team.

Repeat, follow-on and what comes next

• Insulin regimens are adjusted frequently — around illness, growth, puberty, activity and changing routines.
• Treatment may switch between injections and a pump, or monitoring may move to a continuous sensor, as needs and preferences change.
• For type 2 diabetes, treatment is often stepped up over time if glucose control is not maintained.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A named specialist diabetes team with clear contact routes, including urgent out-of-hours advice.
• Written hypo, DKA and sick-day plans, and an up-to-date school care plan.
• Regular reviews of glucose patterns, HbA1c, growth, devices, wellbeing and complication screening.
• Access to dietetic and psychological support, and a planned move to adult services in time.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether care is through the NHS specialist team (the standard route) or private appointments alongside it.
• The length and frequency of appointments and reviews.
• Devices used — insulin pumps and continuous glucose monitors — and their consumables.
• Insulin and other medicines, and ketone and glucose testing supplies.
• Laboratory tests such as HbA1c and complication screening.
• Dietitian, psychology and specialist nurse input.

• What any private appointment includes and how it links to the NHS diabetes team.
• Whether devices, consumables, insulin and testing supplies are included or charged separately.
• Which laboratory tests are included, and their fees.
• Whether dietitian, psychology and out-of-hours support are available.
• What happens in an emergency and who provides urgent and ongoing care.
• What you receive in writing, and the cancellation policy.

On the NHS? Childhood diabetes care is provided by specialist NHS paediatric diabetes teams, including insulin, devices and education; private input is usually supplementary, and ongoing care should remain linked to a specialist team.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Which type of diabetes does my child have, and how will it be treated?
• Exactly how do we recognise and treat a hypo and DKA, and when do we call 999?
• What are our sick-day rules, and who do we contact out of hours?
• Would an insulin pump or continuous glucose monitor suit my child?
• How will diabetes be managed safely at school and during sport?
• What long-term checks will my child have, and when do they start?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for childhood diabetes care

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG18 — Diabetes (type 1 and type 2) in children and young people Diabetes UK — Symptoms of diabetes in children (the 4 Ts) NHS — Diabetic ketoacidosis (DKA) Diabetes UK — Diabetic ketoacidosis (DKA) NHS — Type 1 diabetes in children RCPCH — National Paediatric Diabetes Audit (NPDA)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.