1. International Diabetes Federation. IDF Diabetes Atlas — 8th edition. Diabetes Atlas http://www.diabetesatlas.org (2017).

2. Mayer-Davis, E. J. et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. N. Engl. J. Med. 376, 1419–1429 (2017).

3. Patterson, C. C. et al. Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study. Diabetologia 62, 408–417 (2019).

4. Secrest, A. M. et al. Cause-specific mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes. Diabetes 59, 3216–3222 (2010).

5. Bjornstad, P., Donaghue, K. C. & Maahs, D. M. Macrovascular disease and risk factors in youth with type 1 diabetes: time to be more attentive to treatment? Lancet Diabetes Endocrinol. 6, 809–820 (2018).

6. Barrett, E. J. et al. Diabetic microvascular disease: an Endocrine Society Scientific Statement. J. Clin. Endocrinol. Metab. 102, 4343–4410 (2017).

7. Patterson, C. C. et al. Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989. Diabetologia 50, 2439–2442 (2007).

8. Livingstone, S. J. et al. Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008–2010. JAMA 313, 37–44 (2015).

9. Petrie, D. et al. Recent trends in life expectancy for people with type 1 diabetes in Sweden. Diabetologia 59, 1167–1176 (2016).

10. Huo, L. et al. Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study. Diabetologia 59, 1177–1185 (2016).

11. Gregg, E. W. et al. Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data. Lancet 391, 2430–2440 (2018).

12. Rawshani, A. et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet 392, 477–486 (2018).

13. Cameron, F. J. & Wherrett, D. K. Care of diabetes in children and adolescents: controversies, changes, and consensus. Lancet 385, 2096–2106 (2015).

14. Cameron, F. J. et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes in adolescence. Pediatr. Diabetes 19, 250–261 (2018).

15. Marcovecchio, M. L., Tossavainen, P. H. & Dunger, D. B. Status and rationale of renoprotection studies in adolescents with type 1 diabetes. Pediatr. Diabetes 10, 347–355 (2009).

16. Sauder, K. A. et al. Co-occurrence of early diabetes-related complications in adolescents and young adults with type 1 diabetes: an observational cohort study. Lancet Child Adolesc. Health 3, 35–43 (2019).

17. Diabetes Control and Complications Trial Research group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N. Engl. J. Med. 329, 977–986 (1993).

18. Subramanian, S. & Hirsch, I. B. Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes mellitus. Endocrinol. Metab. Clin. North Am. 47, 65–79 (2018).

19. Diabetes Control and Complications Trial Research group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J. Pediatr. 125, 177–188 (1994).

20. American Diabetes Association. 13. Children and adolescents: standards of medical care in diabetes — 2019. Diabetes Care 42, S148–S164 (2019).

21. Donaghue, K. C. et al. ISPAD Clinical Practice Consensus Guidelines 2018: microvascular and macrovascular complications in children and adolescents. Pediatr. Diabetes 19, 262–274 (2018).

22. National Institute for Health and Care Excellence. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICE https://www.nice.org.uk/guidance/ng18 (2015).

23. Wherrett, D. K. et al. Type 1 diabetes in children and adolescents. Can. J. Diabetes 42, S234–S246 (2018).

24. Tauschmann, M. & Hovorka, R. Technology in the management of type 1 diabetes mellitus — current status and future prospects. Nat. Rev. Endocrinol. 14, 464–475 (2018).

25. Prahalad, P. et al. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes. Diabet. Med. 35, 419–429 (2018).

26. Hovorka, R. et al. Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial. Lancet 375, 743–751 (2010).

27. Bekiari, E. et al. Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis. BMJ 361, k1310 (2018).

28. National Paediatric Diabetes Audit & Royal College of Paediatrics and Child Health. National Paediatric Diabetes Audit 2016–17 — care processes and outcomes. RCPCH https://www.rcpch.ac.uk/sites/default/files/2018-07/npda_annual_report_2016_-_2017_april_2018_final_updated_3.pdf (2018).

29. Phelan, H. et al. The Australasian Diabetes Data Network: first national audit of children and adolescents with type 1 diabetes. Med. J. Aust. 206, 121–125 (2017).

30. Miller, K. M. et al. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care 38, 971–978 (2015).

31. Amin, R. et al. Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 336, 697–701 (2008).

32. Cho, Y. H. et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006. Pediatr. Diabetes 12, 682–689 (2011).

33. Dunger, D. B. Banting Memorial Lecture 2016 Reducing lifetime risk of complications in adolescents with Type 1 diabetes. Diabet. Med. 34, 460–466 (2017).

34. Hietala, K. et al. Age at onset and the risk of proliferative retinopathy in type 1 diabetes. Diabetes Care 33, 1315–1319 (2010).

35. Hovind, P. et al. Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study. BMJ 328, 1105 (2004).

36. Cho, Y. H., Craig, M. E. & Donaghue, K. C. Puberty as an accelerator for diabetes complications. Pediatr. Diabetes 15, 18–26 (2014).

37. Lane, P. H. Diabetic kidney disease: impact of puberty. Am. J. Physiol. Physiol. 283, F589–F600 (2002).

38. Amin, R. et al. Increasing urine albumin excretion is associated with growth hormone hypersecretion and reduced clearance of insulin in adolescents and young adults with type 1 diabetes: the Oxford Regional Prospective Study. Clin. Endocrinol. 62, 137–144 (2005).

39. Nadeau, K. J. et al. Insulin resistance in adolescents with type 1 diabetes and its relationship to cardiovascular function. J. Clin. Endocrinol. Metab. 95, 513–521 (2010).

40. Cree-Green, M. et al. Delayed skeletal muscle mitochondrial ADP recovery in youth with type 1 diabetes relates to muscle insulin resistance. Diabetes 64, 383–392 (2015).

41. Bjornstad, P. et al. Insulin sensitivity is an important determinant of renal health in adolescents with type 2 diabetes. Diabetes Care 37, 3033–3039 (2014).

42. Bjornstad, P. et al. Metformin improves insulin sensitivity and vascular health in youth with type 1 diabetes mellitus. Circulation 138, 2895–2907 (2018).

43. Benitez-Aguirre, P. et al. Sex differences in retinal microvasculature through puberty in type 1 diabetes: are girls at greater risk of diabetic microvascular complications? Invest. Ophthalmol. Vis. Sci. 56, 571–577 (2015).

44. Amin, R. et al. Low IGF-I and elevated testosterone during puberty in subjects with type 1 diabetes developing microalbuminuria in comparison to normoalbuminuric control subjects: the Oxford Regional Prospective Study. Diabetes Care 26, 1456–1461 (2003).

45. Codner, E. & Cassorla, F. Puberty and ovarian function in girls with type 1 diabetes mellitus. Horm. Res. Paediatr. 71, 12–21 (2009).

46. Costacou, T. et al. Dietary patterns over time and microalbuminuria in youth and young adults with type 1 diabetes: the SEARCH Nutrition Ancillary Study. Diabetes Care 41, 1615–1622 (2018).

47. Parving, H.-H., Persson, F. & Rossing, P. Microalbuminuria: a parameter that has changed diabetes care. Diabetes Res. Clin. Pract. 107, 1–8 (2015).

48. Viberti, G. C. et al. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet 1, 1430–1432 (1982).

49. Deckert, T. et al. Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia 32, 219–226 (1989).

50. Rossing, P. et al. Predictors of mortality in insulin dependent diabetes: 10 year observational follow up study. BMJ 313, 779–784 (1996).

51. Orchard, T. J. et al. In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population: a report from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetologia 53, 2312–2319 (2010).

52. Groop, P.-H. et al. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes 58, 1651–1658 (2009).

53. Fox, C. S. et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet 380, 1662–1673 (2012).

54. Matsushita, K. et al. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. 3, 514–525 (2015).

55. Abdelhafiz, A. H., Ahmed, S. & El Nahas, M. Microalbuminuria: marker or maker of cardiovascular disease. Nephron Exp. Nephrol. 119, e6–e10 (2011).

56. Schalkwijk, C. G. & Stehouwer, C. D. A. Vascular complications in diabetes mellitus: the role of endothelial dysfunction. Clin. Sci. 109, 143–159 (2005).

57. Schultz, C. J. et al. Risk of nephropathy can be detected before the onset of microalbuminuria during the early years after diagnosis of type 1 diabetes. Diabetes Care 23, 1811–1815 (2000).

58. Dunger, D. B. et al. Can we identify adolescents at high risk for nephropathy before the development of microalbuminuria? Diabet. Med. 24, 131–136 (2007).

59. Marcovecchio, M. L. et al. Reduced endogenous secretory receptor for advanced glycation end products (esRAGE) in young people with Type 1 diabetes developing microalbuminuria. Diabet. Med. 26, 815–819 (2009).

60. Marcovecchio, M. L. et al. Prevalence of abnormal lipid profiles and the relationship with the development of microalbuminuria in adolescents with type 1 diabetes. Diabetes Care 32, 658–663 (2009).

61. Marcovecchio, M. L. et al. Ambulatory blood pressure measurements are related to albumin excretion and are predictive for risk of microalbuminuria in young people with type 1 diabetes. Diabetologia 52, 1173–1181 (2009).

62. Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial Research Group. Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT). BMC Pediatr. 9, 79 (2009).

63. Marcovecchio, M. L. et al. ACE inhibitors and statins in adolescents with type 1 diabetes. N. Engl. J. Med. 377, 1733–1745 (2017).

64. National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. 1.15 — Managing complications. NICE https://www.nice.org.uk/guidance/ng17/chapter/1-recommendations#managing-complications (2016).

65. Marcovecchio, M. L. et al. Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): urinary screening and baseline biochemical and cardiovascular assessments. Diabetes Care 37, 805–813 (2014).

66. Benitez-Aguirre, P. Z. et al. The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes. Diabetologia 61, 968–976 (2018).

67. Cho, Y. H. et al. Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT (Adolescent Type 1 Diabetes Cardio-Renal Interventional Trial). Diabetes Care 38, 676–681 (2015).

68. Maftei, O. et al. Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes: Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT). Diabetes Care 37, 3069–3075 (2014).

69. Marcovecchio, M. L. et al. Renal and cardiovascular risk according to tertiles of urinary albumin-to-creatinine ratio: the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT). Diabetes Care 41, 1963–1969 (2018).

70. ACE Inhibitors in Diabetic Nephropathy Trialist Group. Should all patients with type 1 diabetes mellitus and microalbuminuria receive angiotensin-converting enzyme inhibitors? A meta-analysis of individual patient data. Ann. Intern. Med. 134, 370–379 (2001).

71. Wiegman, A. et al. Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA 292, 331–337 (2004).

72. de Boer, I. H. et al. Albuminuria changes and cardiovascular and renal outcomes in type 1 diabetes: the DCCT/EDIC Study. Clin. J. Am. Soc. Nephrol. 11, 1969–1977 (2016).

73. Rapoff, M. Adherence to Pediatric Medical Regimens (Kluwer Academic/Plenum Publishers, 1999).

74. Benitez-Aguirre, P. Z. et al. Top tertile urinary albumin creatinine ratio (ACR) doubles the risk of 3-step progression of diabeticretinopathy: the adolescent type 1 diabetes cardio-renal intervention trial (AdDIT) [abstract P150]. Pediatr. Diabetes 19 (Suppl. 27), 98 (2018).

75. Vuorio, A. et al. Statins for children with familial hypercholesterolemia. Cochrane Database Syst. Rev. 7, CD006401 (2017).