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Diabetes mellitus in childhood and adolescence is no longer a narrowly defined or uncommon condition. It represents a diverse group of metabolic disorders unified by persistent hyperglycemia but distinguished by unique pathophysiologic mechanisms and clinical trajectories. The World Health Organization now recognizes six categories of diabetes: type 1 diabetes, type 2 diabetes, hybrid forms, other specific types, unclassified diabetes, and hyperglycemia first detected during pregnancy, reflecting the growing heterogeneity of this disease. In pediatrics, this diversity is even more striking. Autoimmune β-cell destruction in type 1 diabetes; the interplay of insulin resistance and β-cell stress in youth-onset type 2 diabetes; β-cell toxicity in cystic-fibrosis–related diabetes; monogenic β-cell defects in MODY; and neurodegenerative mechanisms in Wolfram syndrome all illustrate the expanding spectrum encompassed by “pediatric diabetes.” Simultaneously, pediatric endocrinology is undergoing a profound transformation driven by rapid scientific discovery, emerging technologies, and novel therapeutics. The field is evolving faster than many clinicians can easily follow. Type 1 diabetes is now conceptualized as a staged condition, paving the way for disease-modifying interventions such as teplizumab during its preclinical phases. Automated insulin delivery systems have shifted our attention from hemoglobin A1c alone to continuous glucose monitoring metrics that more precisely reflect glycemic quality. New pharmacotherapies, including glucagon-like peptide-1 receptor agonists, are reshaping management strategies for youth-onset type 2 diabetes, obesity, and the increasingly recognized “double diabetes” phenotype. Precision-medicine approaches are redefining how we diagnose and treat monogenic, atypical, and rare forms of diabetes. The accelerated pace of scientific advancement makes it challenging for endocrinologists, general practitioners, trainees, and even highly engaged families to remain current. This volume was created to meet that need. It synthesizes cutting-edge science and emerging concepts that will guide clinical practice and research for years to come.