Risk factors for very high or low blood sugar levels in a child with type 1 diabetes include:

• Age. Very young children and boys of all ages are at the greatest risk for very low blood sugar.²
• Tight blood sugar control. Although keeping your child's blood sugar level tightly within a normal or near-normal range is important, this puts him or her at risk for frequent low blood sugar levels.³
• Persistent high blood sugar levels. Children who have persistent high blood sugar, indicated by higher hemoglobin A1c test results, are at greater risk for diabetic ketoacidosis than children with lower levels.²
• Puberty. Growth spurts and changing hormone levels that occur during puberty make it difficult to keep a child's blood sugar level within a target range.
• Psychiatric conditions. Children with depression, anxiety disorder, panic disorder, or eating disorders are at increased risk for frequent high and low blood sugar levels.²

Although children are protected from developing complications from diabetes (eye, kidney, heart, blood vessel, and nerve disease) during childhood, they are at risk for developing these diseases in adulthood. Risk factors for these complications include:

• Persistent high blood sugar over time. The higher your child's blood sugar levels and the longer they remain high, the greater his or her risk of developing complications in early adulthood.
• Length of time having the disease. The longer your child has diabetes, the more likely complications will develop, even if blood sugar levels are controlled.
  • Eye damage from diabetes, called diabetic retinopathy, is the most frequent cause of new cases of blindness in adults ages 20 to 74.⁴
  • Kidney damage, diabetic nephropathy, eventually occurs in 20% to 40% of all people with diabetes.⁵ Children who develop nephropathy usually show the first signs of the condition after puberty.
  • Nerve disease. Most people with diabetes develop some diabetic neuropathy over the years, but only about 13% to 15% have noticeable symptoms.⁶
• Having one complication. In adulthood, if children develop one complication, they are at risk for developing others.
• Smoking, high blood pressure, high cholesterol, and a family history of diabetic complications.