Dr. Parjeet Kaur, Associate Director, Endocrinology & Diabetes, Medanta – The Medicity
Type 1 Diabetes Mellitus, previously known as juvenile diabetes, is a chronic autoimmune condition in which the pancreas loses its ability to produce insulin — a vital hormone responsible for regulating blood glucose levels in the body.
As per the latest estimates, Type 1 Diabetes affects more than 95 lakh people globally, with 9.4 lakh people in India alone. The number of cases is increasing rapidly, particularly in low- and middle-income countries, due to improved diagnosis and rising incidence rates. A report published in the Journal of the Association of Physicians of India notes that India currently records the highest incidence of new Type 1 Diabetes cases in the world. Another study found that India ranks second only to the United States in the total number of people living with Type 1 Diabetes, and has the highest number of patients under the age of 20 years.
The onset of Type 1 Diabetes is influenced by a combination of factors, including genetic predisposition and exposure to certain viral infections. Although it most commonly develops during childhood or adolescence, it can occasionally occur in adults as well. Interestingly, unlike most other autoimmune disorders, it is slightly more prevalent among males.
The condition develops when the immune system mistakenly attacks and destroys the insulin-producing beta cells of the pancreas. This destruction leads to elevated blood glucose levels. Type 1 diabetes often develops suddenly, especially in children or young adults. Common symptoms include excessive thirst, frequent urination, unexplained weight loss, and fatigue. Sometimes, a person can present with a serious condition called Diabetic Ketoacidosis (DKA).
If left uncontrolled, high blood glucose can cause severe long-term complications such as retinopathy, nephropathy, neuropathy, and coronary artery disease in adulthood. Acute Complications include Diabetic Ketoacidosis (DKA) which is a life-threatening emergency caused by insulin deficiency. Symptoms include nausea, vomiting, abdominal pain, fruity breath odour, rapid breathing, confusion and it requires urgent medical care. Other acute complication is Hypoglycemia (Low Blood glucose)
Despite the growing prevalence of this condition, awareness about Type 1 Diabetes in children remains limited. Many still mistake it for a lifestyle disease, when in fact, it is an autoimmune condition that requires lifelong management and commitment.
Managing Type 1 Diabetes
Currently, there is no known cure for Type 1 Diabetes, though scientists and researchers worldwide are working toward finding one. Fortunately, with early diagnosis, proper medical supervision, and a structured care plan, the condition can be effectively managed.
Insulin is the mainstay and essential medicine for treatment of Type 1 diabetes. With consistent care and emotional support, children and adolescents living with Type 1 Diabetes can lead long, active, and fulfilling lives. An effective management plan typically includes:
- Multiple daily insulin injections, or insulin pump therapy
- Regular blood glucose monitoring to maintain optimal blood glucose levels
- A balanced diet with controlled carbohydrate intake
- Routine physical activity to enhance insulin sensitivity
Technological advancements are also improving the quality of life for patients. For instance, Automated insulin pump also known as an artificial pancreas — a device that mimics the natural function of the organ — can automatically monitor glucose levels and deliver the required amount of insulin throughout the day. A Continuous Glucose Monitor (CGM) is a small wearable device that measures your blood glucose levels throughout the day and night and helps you make smarter daily decisions about insulin, meals, and activity.
In 2023, the U.S. FDA approved Lantidra, the first cell-based therapy for adults with Type 1 diabetes who struggle with severe and recurrent hypoglycemia. Lantidra works by infusing healthy islet cells from a donor pancreas into the patient’s liver. These cells can sense glucose and produce insulin naturally, restoring the body’s own ability to control blood glucose. In clinical studies, some patients became insulin-independent for several years, and most experienced fewer episodes of low blood glucose. However, because the therapy requires lifelong immunosuppressive drugs, it’s reserved for select patients — especially those with brittle diabetes not responding to standard treatments.
Similarly, another recent research on zimsislecel, a stem cell–derived islet cell therapy, has shown promising results: around 83% of participants who received the full dose no longer required insulin after one year. However, as the study had a small sample size, more extensive and long-term trials are necessary before its widespread use can be confirmed.
Persistent Challenges
Despite these advancements, several barriers continue to hinder effective management of Type 1 Diabetes in children:
- Lack of Awareness: Many still believe diabetes affects only adults. This misconception often delays diagnosis and treatment, increasing the risk of complications.
- Limited Access to Care: In rural and underserved regions, insulin, glucose monitors, and trained healthcare providers remain scarce, making consistent management difficult.
- Financial Constraints: The lifelong cost of insulin, testing supplies, and medical consultations can be overwhelming, leading some families to compromise on essential care.
- Psychosocial Impact: Beyond physical symptoms, children often face stigma, social isolation, and emotional distress, which can affect their overall well-being and self-esteem.
To strengthen the management of childhood diabetes in India, a comprehensive and coordinated approach is needed. Key strategies include:
- Enhancing Awareness and Education
- Expanding Access to Quality Care
- Financial Support and Policy Initiatives
- Psychosocial and Community Support
Type 1 Diabetes may be a lifelong condition, but with timely diagnosis, proper medical care, and strong community support, children living with it can lead healthy, fulfilling, and productive lives. With collective effort—from parents, healthcare professionals, policymakers, and society at large—we can create a future where every child with diabetes receives the care, understanding, and opportunity they deserve to thrive.
