Diabetes Care

UI Health Care Stead Family Children’s Hospital’s pediatric diabetes and endocrinology specialists are experts in the diagnosis and treatment of diabetes in children and adolescents, helping your child manage their symptoms and lead a healthy, active life.

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Diabetes is a condition in which your body is not able to regulate the amount of glucose, or sugar, in your blood. Glucose (sugar) is your body's main source of energy. Insulin is a hormone made by your pancreas to move the glucose from your blood into your cells so it can be used to create energy.

Depending on the type of diabetes your child has, their body either can’t make its own insulin, or the insulin does not work in the body like it should. This causes glucose levels to get too high and, over time, can lead to serious health conditions.

Excellence in pediatric diabetes care

University of Iowa Health Care has a long history of excellence in pediatric diabetes research, education, and clinical care. Our specialists have played a pivotal role in shaping the way diabetes is treated today. That’s why Stead Family Children’s Hospital’s pediatric diabetes and endocrinology program is nationally ranked by U.S. News & World Report as one of the nation’s best for pediatric diabetes care.

Types of diabetes

There are two main types of diabetes that affect children:

Type 1 diabetes. If your child has type 1 diabetes, their pancreas makes little to no insulin of its own. Since there is no insulin to move the glucose from the blood to the cells, the glucose stays in the blood and elevates
While many believe genetics plays a role, no one knows for sure why some people develop type 1 diabetes and others don’t. While you can develop type 1 diabetes at any age, it is most diagnosed in children, teens, and young adults.
Type 2 diabetes. If your child has type 2 diabetes, their pancreas still makes insulin, but it doesn’t work well in the body. This occurs when the cells stop responding normally to insulin, causing the pancreas to make more insulin to try and get the cells to respond. Over time, their body will not be able to make enough insulin, and it will elevate their blood sugar levels. Insulin and other types of medications may be needed for the treatment of type 2 diabetes.

What causes diabetes?

Type 1 diabetes is an autoimmune disease and is the result of the body’s own immune system destroying the cells in the pancreas that make insulin. While the immune system is designed to fight off infections to keep the body healthy, it sometimes attacks the body’s own cells.

While many believe genetics plays a role, no one knows for sure why some people develop type 1 diabetes and others don’t. While many While you can develop type 1 diabetes at any age, it is most diagnosed in children, teens, and young adults.

Type 2 diabetes is often due to some combination of genetics, being overweight, and not exercising. While type 2 diabetes is more common in adults, younger people can develop the condition.

What are the symptoms of diabetes?

The symptoms of type 1 diabetes and type 2 diabetes are similar, with a few differences.

Type 1 diabetes symptoms:

Being very thirsty and drinking a lot
Urinating a lot
Feeling very hungry
Losing weight without trying
Feeling tired a lot of the time

Type 2 diabetes symptoms

Drinking a lot
Urinating a lot
Feeling tired a lot of the time
Blurry vision
Dark skin that looks like dirty skin in areas such as the arm pits, around the neck, or inside the elbows

How is diabetes diagnosed?

Either type of diabetes can be diagnosed with a blood test. Tests your child may receive to diagnose and monitor their blood sugar include:

Fasting blood glucose test. This test is completed after your child has fasted for at least eight hours for the most reliable results. If their blood sugar level is high, even after fasting, it may indicate diabetes.
Random plasma glucose test. This test is completed at a random time, without fasting, to check blood sugar levels. If your child has symptoms of diabetes, but your provider does not want to wait eight hours for them to fast, they may order this test.
Glycated hemoglobin (A1C) test. This test measures your child’s average blood sugar level over the past three months. This can be used to help diagnose diabetes and see how well it is managed.

How is diabetes treated in children?

Managing your child's diabetes requires an individualized approach that encourages their growth and development and helps them stay healthy. While treatment strategies differ between type 1 diabetes and type 2 diabetes, both aim to help your child maintain healthy blood sugar levels and prevent complications.

Type 1 diabetes treatment

Treatment for type 1 diabetes focuses on replacing insulin and managing blood glucose levels through:

Insulin therapy. Children with type 1 diabetes need insulin every day, delivered via injections or an insulin pump. The goal is to mimic the body’s natural insulin production as closely as possible.
Blood glucose monitoring. Frequent checks using a glucose meter or continuous glucose monitor help determine how much insulin they need and can help when making decisions about what to eat.
Nutrition. A balanced diet with consistent carbohydrate intake is important to help maintain a steady blood sugar level.
Physical activity. Regular exercise is encouraged and can improve insulin sensitivity. However, physical activity can affect your child's blood sugar levels. Insulin and food intake may need to be adjusted to prevent low blood sugar during activity.
Education and support. Ongoing diabetes education helps children and families manage daily care and prepare for transitions such as school or sports.

Type 2 diabetes treatment

Treatment for type 2 diabetes focuses on managing blood glucose levels through lifestyle changes in combination with blood glucose level monitoring and medication. Treatment typically includes:

Lifestyle changes. The most important thing when managing type 2 diabetes is to commit to a healthy diet and increased physical activity. These changes can significantly improve blood sugar control and overall health.
Medications. Most children start with metformin, which helps lower blood sugar by improving insulin sensitivity. If blood sugar levels are very high at diagnosis or not controlled with oral medications, insulin or other medications may also be prescribed.
Monitoring. Regular blood glucose checks and follow-up visits help track progress and adjust treatment as needed.
Family involvement. Because lifestyle changes affect the whole household, family support is important for long-term success.

What are the complications of diabetes?

When managed properly, children with diabetes can lead healthy, active lives. However, both type 1 diabetes and type 2 diabetes can lead to serious complications if blood sugar levels are not controlled. These complications can affect various parts of the body and may develop over time:

Hypoglycemia (low blood sugar). This can occur when insulin or medication doses are too high, meals are missed, or after intense physical activity. Symptoms include shakiness, sweating, irritability, dizziness, and fatigue.
Hyperglycemia (high blood sugar). This can occur if there is too little insulin, during illness, or with a high carbohydrate intake. Symptoms include excessive thirst, frequent urination, fatigue, and blurred vision.
Diabetic ketoacidosis (DKA). More common in type 1 diabetes, DKA is a life-threatening condition caused by a lack of insulin, leading to a buildup of ketones in the blood. Symptoms include nausea, vomiting, abdominal pain, fruity-smelling breath, and confusion.
Eye problems. Children with diabetes are at increased risk for conditions like diabetic retinopathy, cataracts, and glaucoma, which can lead to vision loss if not monitored and treated.
Kidney damage. High blood sugar can damage the kidneys over time, potentially leading to kidney failure.
Nerve damage. This can cause tingling, numbness, or pain, especially in the hands and feet.
Mental health challenges. Managing a chronic condition can be stressful. Children with diabetes may experience anxiety, depression, or diabetes-related distress.

Family-centered diabetes support

Our providers are committed to supporting families at every step of diabetes care. We offer personalized meal planning and nutritional counseling to help create healthy, sustainable habits. Families also receive hands-on education about insulin use and blood sugar monitoring, helping them to manage care confidently at home. And for urgent needs, our pediatric endocrinologists are available 24/7 for questions and concerns.

A team approach to diabetes care

We take a comprehensive, team-based approach to managing diabetes in children and adolescents. Our multidisciplinary team includes pediatric endocrinologists, diabetes nurse educators, dietitians, and social workers who work together to address every aspect of your child’s well-being. From medical management and nutritional guidance to emotional support and education, our coordinated care offers the expertise and support you need, all in one place.