Changing needs of the patient with diabetes mellitus during the teenage years

Abstract
The Diabetes Control and Complications Trial has established the role of chronic hyperglycemia in the development of retinal, renal, and neuropathic complications of insulin-dependent diabetes mellitus. This paper discusses the special physiologic and developmental considerations that affect glycemic control in adolescents. We also review the prevalence of eating disorders and insulin omission in this age group as well as nutritional, gynecologic, and contraceptive issues. We emphasize the importance of family support, promotion of self-esteem, and the setting of realistic and attainable goals in improving long-term care for teenage patients with this disease.