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Living with Diabetes

Diabetes and puberty

7/2/2019 by Jessica Schmidt-Herzel

Diabetes and puberty

Sooner or later, puberty happens to everyone. It’s a natural part of life.Unfortunately, you can’t put puberty on hold, which can be a real pain in the rear for people with diabetes. Puberty comes with its own set of special challenges when it comes to diabetes management. Keep on reading to find out exactly how puberty affects bodies with diabetes.

Blood sugar roller coaster in puberty - but why?

Puberty typically happens between 9 and 17 years old, boys usually a little later than girls.

When puberty starts, estrogen (in girls) and testosterone (in boys) start releasing in varying concentrations (pulsatile). These hormones cause a decrease in insulin sensitivity. Due to the different hormone levels, insulin sensitivity fluctuates, which explains the wild swings and stubborn blood sugars.

Most girls feel this as soon as their period starts. It usually looks like this: In the first half of the cycle, insulin requirements are generally lower, and in the second half of the cycle more insulin is needed. About five days before menstruation, insulin requirements increase again due to the increase in estrogen and progesterone.

Another hormone is also important: the growth hormone. It's responsible, as the name implies, for the growth that happens throughout adolescence. It is released early in the morning and thus leads to increased blood sugar levels in the morning. This is also called the dawn phenomenon, which can be a problem not only in puberty but also for many adults. These hormones can increase insulin requirements by 1.5  – this is entirely normal and happens with everyone!

It is normal, important, and necessary to adjust insulin settings during these crazy adolescent years. Also, your growing teen might suddenly have a much bigger appetite during puberty and start eating huge portions! As a diabetes educator in practice, I am often amazed by how much these growing people can eat, and how much insulin is needed! But their body needs fuel  to grow and that's where the calories are needed.

Brain process - curse and blessing at the same time

It’s not only the hormones and their fluctuations affecting blood sugar levels during puberty! The maturing of the brain is happening too.

Teenagers experience massive mood and emotional swings within minutes of one another h. Of course, this makes it even more challenging to respond calmly to fluctuating or inexplicably high sugar levels or annoying questions from worried parents. And don’t forget the ringing pump, meter, and CGM alerts.

Young people will want to start becoming more independent as a result of puberty. For children or adolescents with diabetes, this might mean a push back when they’re asked for their blood sugar or sensor values over and over ​​again.

What they want is to manage their diabetes alone, hang out with their friends, and chill out. And it’s a delicate balance for parents and caregivers to help them do it safely while taking on more responsibilities.

Of course, it’s vital to teach your teen how to nail the essentials – no skipped insulin or medications, not ignoring too many alarms, and remembering to change pump sites regularly. And try not to be frustrated by high values! Do the best you can, together. Correct and carry on.

Exchange and peer support

For adolescents with diabetes, there is also a lot to be said about resources from your clinics: there are often training programs, teenage camps, and, as uncool as it sounds, "self-help groups." Any of these may help your teen to be more self-confident and independent when it comes to  dealing with their diabetes.

Also, regular appointments with your child’s endocrinologist and diabetes educator to review and adjust the insulin dosage or discuss specific situations are indispensable. Teamwork is the order of the day!

Things get exciting again when your teen officially becomes an adult! Switching from pediatric diabetes care to adult diabetes care can be scary for them, especially if they’ve grown up with that pediatric provider. Ask your current provider for help with the transition.

Better together

It is essential for children and their parents to be involved in diabetes therapy together from the get-go. It helps enormously if the growing teen can make safe insulin adjustments, count and calculate carbs, or change their own sensor or infusion site. And it allows parents to let go, trust, and encourage independence.

The mySugr website does not provide medical or legal advice. mySugr blog articles are not scientific articles, but intended for informational purposes only.
Medical or nutritional information on the mySugr website is not intended to replace professional medical advice, diagnosis or treatment. Always consult a physician or health care provider with any questions you may have regarding a medical condition.

Jessica Schmidt-Herzel

Jessica is a state-approved dietician and certified diabetes educator for DDG (German Diabetes Society). You may have read her articles for our blog, including topics such as diabetes and puberty or diabetes and menopause. Jessica has supported many people living with diabetes offline as well. She cares for patients at a children’s clinic in Berlin and organizes sporting and vacation activities for children with diabetes throughout the year. Apart from taming diabetes monsters, she is very committed to her annual half-marathon training or harvesting vegetables in her garden.