Pediatric Type 1 Diabetes

Type 1 diabetes results from autoimmune destruction of pancreatic beta cells. The pancreas can no longer make enough insulin to move glucose from the bloodstream into muscle and fat cells. Blood glucose rises, but the cells are still starved for usable fuel. Without insulin, the body breaks down fat for energy. The liver converts fatty acids into ketones, which are acidic. This explains why untreated type 1 diabetes can progress from polyuria and weight loss to diabetic ketoacidosis (DKA): hyperglycemia causes osmotic diuresis and dehydration, while ketone accumulation causes metabolic acidosis. A child with type 1 diabetes needs insulin every day. Insulin is not simply a correction for a high glucose reading; it replaces a hormone the body cannot produce adequately.