[Diabetes mellitus in childhood and adolescence (Update 2026)].

In contrast to adults, type 1 diabetes mellitus (T1D) is the most frequent form of diabetes in childhood and adolescence (94.2%) in Austria. After diagnosis the management of children and adolescents with T1D should take place in highly specialized pediatric units experienced in pediatric diabetology. The lifelong substitution of insulin is the cornerstone of treatment whereby modalities need to be individually adapted for patient age and the family routine. In this age group the use of diabetes technology (glucose sensors, insulin pumps and automated insulin dosage, AID) is recommended. An optimal metabolic control right from the start of treatment is associated with an improved long-term prognosis. Diabetes education is essential for youth with diabetes and their families and needs to be performed by a multidisciplinary team consisting of pediatric diabetologists, diabetes counsellors, dieticians, psychologists and social workers. The Austrian working group for pediatric endocrinology and diabetes (APEDÖ) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommend a metabolic goal of glycated hemoglobin (HbA1c) ≤ 7.0% (International Federation of Clinical Chemistry and Laboratory Medicine, IFCC < 53 mmol/mol) or ≤ 6.5 rel % (IFCC 48 mmol/mol) for those who have access to advanced diabetes technologies, such as AID and a time in range (TIR) of > 70% for all pediatric age groups without the occurrence of severe hypoglycemia. Appropriate age-related physical, cognitive and psychosocial development, screening for associated diseases, avoidance of acute diabetes-related complications (severe hypoglycemia, diabetic ketoacidosis) and prevention of diabetes-related late complications to ensure high quality of life are the main goals of diabetes treatment in all pediatric age groups.