According to statistics, the total number of children with diabetes accounts for about 5% of the total number of people with diabetes in China, and it is increasing by 10% every year. The International Diabetes Federation expects that the global incidence of type 2 diabetes in children will increase by more than 50% in the next 15 years. The prevention and treatment of diabetes should start with children and adolescents. In the past, children under 14 years of age with diabetes were largely type 1 diabetics. Today, the increase in type 2 diabetes in children, especially among obese children with a genetic predisposition to type 2 diabetes, is particularly pronounced. This is a very serious problem. The reason for this is that with the rapid economic development after the reform and opening up of China, it has brought great changes to people’s lifestyles. Now children’s lifestyles have changed a lot compared to before Most of them are only children, families are too spoiled, so children consume not only more food, but also high calories; filler learning makes children too nervous, children have more classes at school, more homework at home, no or less time for sports; in short, too many calories, lack of physical activity and mental tension. These three are important factors in the growth of diabetes in children. There are several types of diabetes in children, such as type 1 and type 2 and youth maturity onset type. 98% of them are type 1 diabetes. Type 1 diabetes is caused by the destruction of insulin B cells and absolute lack of insulin secretion, which must be treated with insulin, also known as insulin-dependent diabetes, with a higher incidence in preschool and adolescence. If diabetes in children is not well controlled, the microvascular and macrovascular complications associated with high blood sugar will put children at risk for blindness, stroke and kidney failure. Children and adolescents are young and have a long life ahead of them, so prevention and good glycemic control of diabetes are more important than in other age groups. Diabetes has many complications Lesions can occur in the eyes, heart, brain, kidneys, liver, nerves, blood vessels, and feet. The basic pathology of diabetes is to damage small and large blood vessels throughout the body with high blood sugar. The kidney is an organ that is easily damaged, and diabetic nephropathy is a common comorbidity of diabetes. Diabetic nephropathy is the leading cause of end-stage renal failure in the United States and the second leading cause of end-stage renal failure in Europe. The proportion of diabetic nephropathy in patients with end-stage renal failure in China has also increased to 15%. The rate of progression to end-stage renal failure in diabetic patients with diabetic nephropathy is faster than that in general kidney disease, about 14 times faster than other kidney diseases. Clinically, diabetic nephropathy is divided into 5 stages. Stage 1 mainly consists of increased glomerular filtration, increased renal blood flow, and clinical examination without urinary protein. Stage 2 may show positive protein in urine after exertion, which may disappear after rest. stage 3 may show urine microalbumin between 30-300mg/24h, but there are no obvious clinical symptoms. stage 4 shows manifestations of nephrotic syndrome such as massive proteinuria, swelling and low plasma protein. stage 5 diabetic nephropathy is more serious, also called uremic stage. In view of the insidious onset of diabetes in some children and its serious complications, parents should pay extra attention to obese children with a family history of diabetes, and it is best to take their children to the hospital regularly (every six months) to have their blood sugar tested. Not only fasting blood glucose but also 2-hour postprandial blood glucose should be checked, because the latter is more significant for early detection of diabetes than the former. Diagnosed children with diabetes should go to the hospital regularly to check micro urine protein, which helps diagnose early diabetic nephropathy. In the treatment of diabetic nephropathy in children, in addition to the control of sugar intake required by diabetes itself, it is also necessary to control the intake of protein, because a high protein diet can increase the burden on the kidneys, while a low protein diet can slow down the rate of kidney damage in diabetic patients, but the supply of nutrients necessary for the growth and development of children should not be ignored. For children with large amounts of proteinuria, edema and renal insufficiency, the intake of sodium and fluid should also be restricted. The next drug therapy includes insulin therapy and oral hypoglycemic drugs, etc. 90% of children with diabetes are type 1, which is insulin-dependent diabetes, and must be treated with lifelong exogenous insulin injections. The other 10% of children have type 2, or non-insulin-dependent diabetes. The pathogenesis is the same as that of adult diabetes, mainly caused by the relative lack of insulin secretion (that is, the patient’s pancreas can secrete insulin but cannot meet the patient’s needs), which can be treated with hypoglycemic drugs, but insulin should also be given because of the combined kidney damage. In addition, blood pressure should be controlled, renal anemia should be corrected, infection should be prevented, nephrotoxic drugs should be avoided and contrast agents should be applied when undergoing some imaging tests. If the disease progresses to the uremic stage of diabetic nephropathy, renal replacement therapy is required. Since the treatment of diabetes in children is lifelong, insulin injections, diet control and changes in lifestyle can cause a lot of pain and inconvenience and a great deal of mental burden to the child, psychosocial treatment is also essential to control diabetes in children. The theme of this year’s United Nations Diabetes Day is “Diabetes and Children and Adolescents”, and parents should work together with the whole society to prevent diabetes in children and adolescents and to prevent its progression to diabetic nephropathy.