The global COVID-19 pandemic has urgently necessitated the widespread use of protective face masks, including N95 respirators, to mitigate viral transmission (Udwadia & Raju, 2020). These masks effectively reduce the spread of airborne infectious diseases, particularly in healthcare and high-risk settings (Collins et al., 2021). While the effectiveness of N95 masks in preventing infection is well-documented, their impact on specific populations, particularly children with chronic conditions such as T1DM, remains underexplored (Heshmati, 2024; Udwadia & Raju, 2020). Workers and residents using N95 masks during debris removal operations in earthquake-prone areas can significantly reduce asbestos exposure (Belackova et al., 2024). These masks help prevent asbestos-related diseases by effectively preventing inhalation of asbestos fibers released during debris cleanup (Belackova et al., 2024). Exposure to environmental toxins such as asbestos can negatively impact overall health and contribute to the development of chronic diseases (Dabravolski et al., 2021; Matsuzaki et al., 2012). Asbestos exposure may indirectly play a role in the development of type 1 diabetes (T1DM) by exacerbating chronic inflammation (Dabravolski et al., 2021; Matsuzaki et al., 2012). Type 1 diabetes mellitus is an autoimmune condition characterized by the destruction of insulin-producing beta cells in the pancreas, leading to chronic hyperglycemia. Managing T1DM mellitus in children is complex, requiring constant monitoring of blood glucose levels, administration of insulin, and careful attention to dietary and physical activity patterns (DiMeglio et al., 2018).

The COVID-19 pandemic and the unique challenges posed by the earthquake have introduced additional variables to managing T1DM in children (Heshmati, 2024; Li et al., 2020). Among these, N95 masks, known for their superior filtration efficiency, have raised questions regarding their potential impact on the clinical outcomes of children with diabetes (Heshmati, 2024; Li et al., 2020). The physiological and psychological effects of long-term mask use, especially in a vulnerable population such as children with T1DM, require comprehensive and comprehensive research (Heshmati, 2024; Li et al., 2020).

N95 masks are designed to filter at least 95 % of airborne particles, providing high respiratory protection (İpek et al., 2021). However, the increased respiratory effort required while wearing these masks could influence metabolic processes and glycemic control by altering oxygen consumption, respiratory rate, and stress responses (İpek et al., 2021). Furthermore, the psychological stress associated with mask-wearing, coupled with the existing burden of T1DM management, might exacerbate anxiety and affect glycemic variability (Nguyen et al., 2022).

This study aims to investigate the impact of N95 mask use on clinical outcomes in children with T1DM. Specifically, we will examine changes in blood glucose levels, the frequency of hypoglycemic and hyperglycemic episodes, and any reported physical and physiological effects of prolonged mask usage. By addressing these questions, we aim to provide evidence-based recommendations for the safe and effective use of N95 masks in this vulnerable population. This study contributes to pediatric diabetes management by examining how protective measures like N95 masks interact with chronic disease care. This research will fill a critical gap in understanding how protective measures against COVID-19, such as N95 mask usage, intersect with chronic disease management in pediatric populations. Through a comprehensive approach and rigorous analysis, we aim to elucidate the broader implications of mask usage on the clinical and psychosocial well-being of children living with T1DM.