[Interdisciplinary management of the diabetic adolescent. "Between two balances"]

Insulin-dependent diabetes mellitus (IDDM) is difficult to live with as well as difficult to treat among adolescents. The physiological and psychological changes, that characterize the transition from childhood to adulthood, are often accompanied with deterioration in glucose control. This disequilibrium is linked, on the one hand, with the hormonal phenomena caused by puberty and, on the other hand, with behavioral factors. The strict way of living together with the daily constraints imposed by the treatment become hardly in keeping with the fundamental needs of freedom and self-sufficiency of the adolescent. The treatment of the diabetic adolescent requires a good insight in the specificities of adolescence as well as a good knowledge of diabetes at this period of life. The objective of the treatment and the approach of the patient will have to be adapted to this age and not simply modeled on the diabetological practices commonly used with children or adults. For every patient suffering from a chronic disease, and even more so for adolescents, the treatment of the disease in its biomedical aspects is necessary but not sufficient. The interactions between the adolescent patient, his illness, his treatment and his environment work in such a way that they can only be taken into account globally. Only a close cooperation and atmosphere of give and take between this adolescent, who is in fact the principal agent of his treatment day after day, and the different persons taking care of him, can prove effective. In practice, this can be really achieved by the medical team only if their indispensable technical competence is combined with an all-important approach centered on the patient as an individual.