Last spring, I flew home for ten days to take care of my nieces while my sister and her husband took a much-deserved trip to celebrate their twentieth wedding anniversary. I had an amazing time with my three nieces and it was a lovely opportunity to spend time together and connect. But, it was also one of the most stressful periods I have experienced in a long time because my youngest niece is nine years old and lives with type 1 diabetes.
As a pediatrician, the medical facts of this disease are not new to me. It is an autoimmune condition where the pancreas stops making insulin, and care involves counting carbohydrates and giving insulin with meals. On paper, it can sound almost manageable, it’s just math and medicine. What I learned during those ten days is that life with type 1 diabetes is anything but simple.
There is no pause button. Every snack, every sports practice, every moment of play is shaped by blood sugar levels and what they might do next. It’s sometimes unpredictable and what works one day might not work the next. Continuous glucose monitors sound alarms in the middle of the night and the question is always the same: is she dropping, rising, or somehow both? Should she eat something? Should we correct it with insulin? Can we wait and see? Families learn to sleep lightly and wake quickly because diabetes does not care if it is two in the morning.
My niece is lucky: she has been able to access resources and support systems that many families do not have. My niece uses a continuous glucose monitor and an insulin pump. She has a wonderful team at school who know how to help keep her safe. My sister has spent years advocating for her, writing care plans, training teachers and coaches, and making sure her daughter can participate fully in the world around her. Even with those tools and with that support it is hard. And the reality for many children globally is much harder.
Millions of children and adolescents live with type 1 diabetes around the world. Their safety and long-term health depend on consistent access to insulin and the technology that keeps blood sugar in a safe range. Unfortunately, access to resources such as continuous glucose monitors and insulin pumps is far from equal. In many countries these devices are available only to families who can afford private care, and there is also a scarcity of providers who know how to use them. Diabetes-related complications contribute to millions of deaths each year and many of those losses could be prevented through earlier diagnosis, adequate medical care, and reliable access to the right tools.
Children with type 1 diabetes deserve the same opportunities as all children. They can and should be able to run, learn, play, and engage in activities that bring them joy. Around the world, children with type 1 diabetes are discriminated against and excluded from school and social activities because of ignorance and fear. Families like my sister’s put enormous effort every day into making childhood feel normal. They should not have to fight so hard for safety, equity, and the chance for their child to simply be a child.
This Diabetes Awareness Month, I want to recognize the courage and determination that children with type 1 diabetes demonstrate every single day. I want to honor the caregivers who show up with strength even when they are exhausted. And I want to acknowledge the teachers, coaches, friends, and neighbors who learn, listen, and support.
Type 1 diabetes is not just about numbers and insulin. It is about real children trying to enjoy their childhood while managing a demanding condition. It is about families who carry a daily responsibility that is both essential and exhausting. When we pay attention, when we advocate, and when we care, we can ease that burden.
