Deteriorating diabetes control during adolescence: physiological or psychosocial?

Area of Science:

• Endocrinology
• Adolescent Medicine
• Metabolic Disorders

Background:

• Pubertal metabolic control often deteriorates in individuals with type 1 diabetes mellitus (DM).
• This decline is linked to the transition towards greater autonomy and adolescent psychosocial development.
• Emerging disordered eating behaviors in some female teenagers further complicate management.

Purpose of the Study:

• To review the physiological and psychosocial impacts of puberty on type 1 DM.
• To highlight current treatment strategies addressing these pubertal changes.
• To propose further interventions for evaluation in managing type 1 DM during adolescence.

Main Methods:

• Literature review focusing on physiological and psychosocial changes during puberty in type 1 DM.
• Analysis of treatment strategies addressing insulin resistance and behavioral factors.
• Identification of areas for future research and intervention.

Main Results:

• Pubertal insulin resistance presents a significant, often under-recognized, challenge for adolescents with type 1 DM.
• Psychosocial shifts, including autonomy seeking and disordered eating, negatively affect metabolic control.
• Current strategies focus on adapting treatment to pubertal physiology and psychosocial needs.

Conclusions:

• Effective management of type 1 DM during puberty requires addressing both physiological insulin resistance and psychosocial development.
• Interventions should support adolescent autonomy while mitigating risks associated with behavioral changes.
• Further research is needed to optimize therapeutic approaches for this vulnerable population.