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Achieving optimal diabetic control in adolescence: the continuing enigma.
E M McConnell1, R Harper, M Campbell
1Diabetes Unit, Ulster Hospital, 700 Upper Newtownards Road, Dundonald, Belfast, Northern Ireland BT16 1RH, UK.
Diabetes/Metabolism Research and Reviews
|March 10, 2001
Summary
Adolescents with type 1 diabetes face challenges like poor glycaemic control due to puberty and autonomy desires. Psychological support is crucial for managing eating disorders and complex behaviours in type 1 diabetes care.
Area of Science:
- Endocrinology
- Adolescent Medicine
- Psychological Medicine
Background:
- Adolescence is a critical transition period marked by hormonal changes and a drive for autonomy.
- Type 1 diabetes management during adolescence presents unique challenges impacting glycaemic control.
- Puberty-related hormonal shifts and psychological development can significantly affect diabetes self-management.
Observation:
- Poor glycaemic control is common in adolescents with type 1 diabetes.
- Increased prevalence of eating disorders is noted due to heightened focus on diet and weight.
- Patients may manipulate diabetes management for body image, exacerbating hyperglycaemia and weight loss.
Findings:
- Needle phobia, fear of hypoglycaemia, and risk-taking behaviours complicate management.
- Lack of parental support and adverse life events negatively impact glycaemic control.
- Four illustrative cases highlight these complex psychosocial and behavioural issues.
Implications:
- Close collaboration between psychological medicine and diabetes teams is essential.
- Integrated care models are needed to address the multifaceted needs of adolescents with type 1 diabetes.
- Early psychological intervention can mitigate long-term complications and improve patient outcomes.