New research has uncovered why type 1 diabetes progresses more aggressively in children, particularly those under seven, offering hope for future treatments that could delay the disease.
Type 1 diabetes is an autoimmune condition where the body attacks insulin-producing cells in the pancreas, disrupting blood sugar regulation.
While the disease can affect people of all ages, children diagnosed at a young age often experience more severe symptoms.
The study, published in Science Advances, shows that the pancreas is still developing in early childhood, making its beta cells—responsible for producing insulin—more vulnerable to immune attack.
Researchers at the University of Exeter examined pancreas samples from 250 donors, tracking how beta cells form and mature over time.
They found that in young children, beta cells exist as small clusters or individual cells. When the immune system attacks these immature cells, they are destroyed before they can mature into larger, more resilient structures known as Islets of Langerhans.
In contrast, beta cells in older children or adults form more durable clusters, allowing them to survive longer and produce some insulin, reducing the disease’s severity.
“This is a really significant finding for type 1 diabetes,” said Dr. Sarah Richardson of the University of Exeter. “It helps explain why the disease is more aggressive in young children and why new treatments could make a big difference.”
For families like the Nyes from Merseyside, the impact of early-onset type 1 diabetes is deeply personal. Eight-year-old Gracie was suddenly diagnosed in 2018 after a brief illness.
“The diagnosis remains the worst part of our life,” said her father, Gareth Nye. “Suddenly everything we took for granted was 10–20 times harder.”
Today, Gracie uses a glucose monitor and insulin pump and is “bossing diabetes,” her father adds.
The study also highlights promising new treatments. Immunotherapy drugs, such as the UK-licensed teplizumab, could protect beta cells long enough to mature, potentially delaying or preventing severe disease. While not yet available on the NHS, these therapies represent a significant step forward.
Rachel Connor from Breakthrough T1D described the findings as “a missing piece of the puzzle,” while Dr. Elizabeth Robertson of Diabetes UK emphasized that understanding the aggressive nature of type 1 diabetes in children “opens the door to developing new therapies that could give children more precious years without insulin therapy.”
With these breakthroughs, the future for children diagnosed with type 1 diabetes is looking brighter than ever.