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Type 1 diabetes is characterized by autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Glucagon, cortisol, and growth hormone are not deficient; in fact, they often counteract insulin action, contributing to hyperglycemia.

Respiratory distress syndrome (RDS) is common in preterm infants due to inadequate surfactant production, which leads to alveolar collapse and impaired gas exchange. Surfactant normally reduces surface tension, allowing the lungs to expand. Without it, preterm infants experience respiratory failure. NEC, hypoglycemia, and hyperbilirubinemia are other preterm complications but not specifically due to surfactant deficiency. Administration of exogenous surfactant and antenatal corticosteroids are preventive and therapeutic measures.

Children with cystic fibrosis require a high-calorie, high-fat diet to meet increased energy needs due to malabsorption and higher metabolic demands. Pancreatic enzyme replacement therapy (PERT) is necessary to aid fat digestion. A low-fat or low-protein diet is inappropriate, and a gluten-free diet is only indicated for celiac disease.

Type 1 diabetes mellitus (T1DM) is the most common type of diabetes diagnosed in children and adolescents. It results from autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Clinical presentation often includes polyuria, polydipsia, weight loss, and sometimes diabetic ketoacidosis (DKA). Type 2 diabetes (T2DM), once rare in pediatric populations, has been increasingly diagnosed in adolescents due to rising obesity rates. However, T1DM remains predominant worldwide in younger children. MODY is a rare monogenic form of diabetes, while gestational diabetes is specific to pregnancy. Management of pediatric T1DM requires lifelong insulin therapy, dietary planning, blood glucose monitoring, and psychosocial support. Nutrition plays a critical role in balancing carbohydrate intake with insulin dosing, preventing hypoglycemia, and supporting normal growth. Education of caregivers and patients about carbohydrate counting, glycemic index, and consistent meal planning is essential in the management of pediatric diabetes.

Folate deficiency leads to megaloblastic anemia, characterized by large red blood cells, fatigue, and growth delays. Microcytic anemia is usually due to iron deficiency. Rickets results from vitamin D deficiency, while scurvy is caused by vitamin C deficiency.