Researchers discover why type 1 diabetes is far more severe in young children

Scientists say they have finally uncovered the reason type 1 diabetes is so severe in young children, explaining why the condition progresses faster and becomes harder to manage when the disease begins early in life. The discovery reveals that the pancreas is still developing during childhood and is particularly vulnerable under the age of seven, leaving young patients with far less protection against the immune system attack that defines the disease.

Type 1 diabetes occurs when the immune system mistakenly destroys cells in the pancreas that control blood sugar levels. The new research shows that children’s pancreases are still forming these vital beta cells, which makes them easier to wipe out before they can mature and strengthen. Scientists say newly developed drugs may be able to slow the disease and buy time for the pancreas to grow properly before damage becomes severe.

Around four hundred thousand people in the United Kingdom live with type 1 diabetes. Among them is Gracie, now eight years old, from Merseyside. She became seriously ill on Halloween in 2018. What began as a minor cold turned into a life-threatening emergency. Her father, Gareth, said she went from being a joyful one-year-old to almost dying in less than forty-eight hours. He describes the diagnosis as the worst moment of their lives and said that everything the family once found simple suddenly became ten to twenty times harder.

The Nye family adapted quickly as they learned to check blood sugar levels constantly and administer insulin to help Grace’s body absorb sugar from her blood. She now uses a glucose monitor and an insulin pump, and her father proudly says she is bossing diabetes.

For years, doctors did not fully understand why children diagnosed very young often face a tougher form of the illness. The new study published in the journal Science Advances offers the clearest answer yet. Researchers at the University of Exeter examined pancreas samples from two hundred and fifty donors. Their work allowed them to track how beta cells form in healthy people and how they appear in people with type 1 diabetes.

Beta cells are responsible for releasing insulin when blood sugar rises. Early in life, they are found as small clusters or even as single cells. As people age, these cells multiply and develop into larger groups called Islets of Langerhans. When the immune system begins its attack in a young child, the smallest clusters are destroyed first. They are fragile and have not yet had the chance to mature. Larger islets in older patients can partly withstand the attack, allowing them to keep producing at least some insulin, which softens the severity of their condition.

Dr Sarah Richardson from the University of Exeter said the findings are highly significant. She believes the future is much brighter for children diagnosed with type 1 diabetes today. She pointed to new possibilities, including screening children before the disease develops and using new immunotherapy drugs to delay the onset.

One such drug is teplizumab, already licensed in the United Kingdom. The treatment can stop the immune system from attacking beta cells and may give them valuable time to mature. It is not yet available on the NHS, but scientists hope that will change in the coming years.

The research forms part of the Type One Diabetes Grand Challenge organised by the Steve Morgan Foundation, Diabetes UK and Breakthrough T1D. Rachel Connor from Breakthrough T1D said the findings provide a missing piece of the puzzle. Dr Elizabeth Robertson from Diabetes UK agreed, saying the study opens the door to creating new treatments that could delay or even prevent the need for insulin therapy in some children.

The discovery marks a major step toward understanding why young patients face a tougher disease and offers hope that future treatments could protect them for far longer.