Adolescents and Diabetes Mellitus
The risk of developing type 1 diabetes is higher than virtually all other severe chronic diseases of childhood.
Peak incidence occurs during puberty, around 10 to 12 years of age in girls, and around 12 to 14 years of age in boys.
The symptoms for type 1 diabetes can resemble the flu in children.
Type 1 diabetes tends to run in families. Brothers and sisters of children with type 1 diabetes have about a 10 percent chance of developing the disease by age 50.
The identical twin of a person with type 1 diabetes has a 25 to 50 percent chance of developing type 1 diabetes.
Diabetes mellitus is a metabolic disorder characterized by a failure to secrete enough insulin, or, in some cases, the failure of the cells to respond appropriately to the insulin that is produced. Because insulin is needed by the body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood. Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, malnutrition, infections, viruses, or other illnesses.
The three main types of diabetes--type 1, type 2, and gestational (during pregnancy only)--are all defined as metabolic disorders that affect the way the body metabolizes, or uses, digested food to make glucose. Glucose is the main source of fuel for the body.
Type 2 diabetes is commonly preceded by prediabetes. In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDKK). Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent development of type 2 diabetes.
Prediabetes affects 79 million people in the U.S., according to the CDC and the National Diabetes Information Clearinghouse.
According to the American Diabetes Association and the National Diabetes Education Program, about 215,000 people under the age of 20 have diabetes. Most of them have type 1 diabetes. However, type 2 diabetes, a disease that used to be seen primarily in adults over age 45 and older, has become more common in younger people, primarily due to increasing rates of obesity in children and adolescents.
Although the teenage years can be a challenge for any child as he/she goes through sexual and emotional changes, it can be especially trying for adolescents with diabetes. Adolescents inherently want to "fit in." Being different in any way from his or her peers can be emotionally stressful, especially for the teenager.
The teen who previously complied very well with his or her diabetes management plan may now become rebellious and refuse to comply. A teen may also experience denial of the disease, or display increasingly aggressive behavior in reaction to the stress of managing diabetes, during a time in life that is challenging enough already.
One aspect of diabetes management, blood sugar control, is especially hard during adolescence. Researchers believe the growth hormone produced during adolescence to stimulate bone and muscle growth may also act as an anti-insulin agent. Blood sugar levels become harder to control, resulting in levels that swing from too low to too high. This lack of control over blood sugar levels can be very frustrating for your teenager.
Open communication between you and your teenager with diabetes is important during these years. You should recognize that your teenager wants to be treated as an adult, even if that means letting him or her take charge of his or her own diabetes management plan. Parents should also recognize that teenagers need the following:
- Spontaneity. Adolescence is a time of spontaneity, such as stopping for pizza after school. However, the teenager with diabetes also needs to realize that managing his or her diabetes successfully will give him/her the flexibility that is craved.
- Control. Teenagers want to be in charge of their own lives and create their own identities. To achieve this control, the teenager will test limits. However, a teenager with diabetes can learn that, by exerting control over his or her diabetes, he or she is learning to gain control over other parts of life.
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Online Resources of Adolescent Medicine