Principles of treatment for special diabetes Special diabetes refers to special stages and special conditions of diabetes, including childhood and juvenile diabetes, gestational diabetes, geriatric diabetes, and perioperative diabetes and diabetes co-infection. The principles of treatment and research progress for childhood and juvenile diabetes, gestational diabetes, and geriatric diabetes are highlighted here. Diabetes in children and adolescents Diabetes in children and adolescents should include different types including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and other special types of diabetes mellitus (such as MODY, etc.). Due to their different etiologies and pathogenesis, the treatment principles and methods are different. Although T1DM and T2DM are most types of diabetes mellitus in children and adolescents, the practical problem with the concept and diagnostic typing of diabetes mellitus in children and adolescents is that there are not a few children with diabetes mellitus that are difficult to be typed. According to Beijing Children’s Hospital, in recent years, 5% of patients need to be followed up because of incomplete diagnosis at the initial diagnosis in the hospital. Despite the prevalence of T1DM in children, the chances of T2DM in children and adolescents are increasing in recent years, such as the Shanghai Luwan District Middle School Screening, which showed a prevalence of T2DM in children and adolescents of 4.79 per 10,000. The 2007 edition of the “Guidelines for the Prevention and Treatment of Type 2 Diabetes in China”, referring to the joint statement of the American Diabetes Association (ADA) and the American Academy of Pediatrics (AAP), states The main points of differentiation between type 1 and type 2 diabetes in adolescents, but in practice the differentiation from clinical manifestations still lacks more reliability. Due to the limitation of pediatric medication, those patients who cannot be clearly diagnosed are usually treated with insulin and should be re-evaluated after 1 or 5 years to avoid unnecessary long-term insulin application as much as possible. Early clarification of diagnostic staging is necessary to guide clinical treatment as early as possible. Treatment of T1DM in children and adolescents Since there is no previous report of T2DM in children, the occurrence of diabetes mellitus in children was almost all considered to be T1DM in the past, and therefore the research data on the treatment of T1DM are more abundant and in-depth, so we will not repeat the conventional treatment here. It is worth mentioning that improvements in insulin dosage forms, injection equipment, and monitoring tools have made good glycemic control easier to achieve, such as the use of ambulatory glucose monitoring (CGMS) and insulin pumps (CSII), which significantly improve glycemic control without significantly increasing hypoglycemia and weight gain. However, the DCCT told us that mean glycated glucose protein (HbA1c) was 1% higher in the adolescent group compared to the adult group and that short-term adverse events occurred more frequently.