Deteriorating diabetes control during adolescence: physiological or psychosocial?
Metabolic control often worsens during the pubertal years in individuals with type diabetes mellitus (DM). This may be due in part to the developmental transition from dependency on parents to a more autonomous lifestyle. Adolescence is also marked by challenging of authority figures and previous ways of thinking, experimentation, and, in some female teenagers, emergence of disordered eating attitudes and behaviors. The insulin resistance of puberty may be particularly maladaptive for the teenager with type 1 DM and is likely under-recognized. In this review, we examine the impact of physiological and psychosocial changes during puberty in type 1 DM, highlight treatment strategies aimed at modifying these factors, and suggest further interventions that warrant evaluation.
Hamilton
Jill
J
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada.
Daneman
Denis
D
D000293:Adolescent; D001007:Anxiety; D001519:Behavior; D003863:Depression; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D004032:Diet; D005190:Family; D001068:Feeding and Eating Disorders; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D019382:Human Growth Hormone; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I; D010349:Patient Compliance; D011627:Puberty
D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D007328:Insulin; D007334:Insulin-Like Growth Factor I