Diabetes used to affect elderly individuals earlier, predominantly. However, now younger people are also developing diabetes. It can be any of the two types (type 1 or type 2). In type 1 diabetes, the pancreas does not produce enough insulin required for the body; while in type 2 diabetes, the secreted insulin does not act effectively on the target tissues.
The causes of diabetes include heredity, obesity, being physically inactive, improper diet, etc. Further, it is very common to see a poor metabolic control and management difficulties in adolescents, due to various reasons. Let us review some of these reasons one by one.
Issues related to the management of diabetes
The reasons that interfere diabetes control in young adults include:
# Body image and eating disorder: This is the commonest problem found in adolescents, especially girls. Teens are concerned about their body image due to peer pressure/their wish to follow a celebrity/conform to a body stereotype and weight. To protect their body image, they may do dieting, manipulate the insulin doses (in type 1 diabetes) to lose weight or avoid weight gain. All these can lead to poor/unstable sugar control and diabetes-related complications.
# Endocrine changes during puberty: Insulin resistance increases during puberty due to the secretion of growth hormone. Since this phenomenon occurs during night time, there is increased blood sugar levels (hyperglycaemia) in the morning hours.
# Poor adherence: To cope with the pubertal changes and accept the diagnosis of diabetes can be stressful to a teen. They may rebel against the diagnosis in the form of anger, sadness, denial, etc. Any suggestions given by parents, health care personnel or friends are not accepted. As they are reluctant to be supervised, they may miss monitoring their sugar levels and miss to take insulin on time. This poor adherence can lead to poor control of diabetes.
# Risky behaviour: Teens are impulsive to explore their abilities without thinking about the consequences. The risk-laden activities like absenteeism, fighting, speed driving, smoking, alcohol, using illegal drugs, unprotected sex, etc. can cause physical injuries, infections, and unwanted pregnancies, which can affect the blood glucose levels. One may require multiple conditions to be treated, and it is not surprising if they endanger themselves with early complications of diabetes.
# Social context: In schools, the need to check the glucose levels in a private place all alone and fear of the negative response from friends if they had to express that they have diabetes, may intensify teens concerns’ about the feeling of being different and hence they prefer to stay isolated. This medical need may leave the teen depressed, and depression is known to affect diabetes.
Therefore, all the above factors have to be kept in mind for efficient management of adolescents with diabetes.
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