Adolescence

• The transitional phase of development between childhood and adulthood which incorporates the biological changes of puberty imposes unique challenges to the individual with diabetes and the diabetes care team
• Although the majority of adolescents adapt well to the difficult challenges of puberty, it must be recognized that their health care and emotional needs are distinctly different from those of younger children or older adults

Special facilities in the diabetes service should be made available for adolescents and young adults

• The major risks to the adolescent with diabetes include

• Persistent or progressively unsatisfactory metabolic control
• Risk-taking behavior
• Recurrent DKA
• Acceleration of microvascular complications
• Failure of attendance at clinics particularly at the time of transition from pediatric to adult diabetes service

• The deteriorating metabolic control in adolescence may be a consequence of

• Inadequate insulin dose increments in response to accelerating growth and body weight
• Hormonal changes associated with puberty
• Psychological and social difficulties
• Missed insulin injections
• Inappropriate eating behavior or eating disorders