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American Diabetes Association
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DOI: 10.2337/9781580405317
Library of Congress Cataloging-in-Publication Data
Harris, Michael A. (Michael Avram), author.
Teens with diabetes : a clinician’s guide / Michael A. Harris, Korey K. Hood, Jill Weissberg-Benchell.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58040-531-7 (alk. paper)
I. Hood, Korey K., author. II. Weissberg-Benchell, Jill, author. III. American Diabetes Association, issuing body. IV. Title.
[DNLM: 1. Diabetes Mellitus--psychology. 2. Adolescent Development. 3. Adolescent. 4. Parent-Child Relations. 5. Self Care. WK 810]
RJ420.D5
616.4’6200835--dc23
2013042491
eISBN: 978-1-58040-577-5
Contents
1. Developmental Demands of Adolescence
2. Adjustment to Diagnosis During Adolescence
5. Parent-Teen Relationships and Diabetes
Diabetes is the second most prevalent chronic disease in childhood, occurring in about one of every 400–500 people below the age of 20 years in the United States. The prevalence of diabetes in this age-group is second only to that of asthma. Diabetes is a lifelong disease, and children with diabetes become adolescents with diabetes and then adults with diabetes. In adults, diabetes is a leading cause of new-onset blindness (due to diabetic retinopathy), renal failure (resulting in the need for dialysis or renal transplantation), nontraumatic amputations, and macrovascular disease (contributing to cerebrovascular [stroke] or coronary artery [heart attack] disease). According to the Centers for Disease Control and Prevention, in 2012, diabetes was the seventh leading cause of death in the U.S. and was a major contributor to the first (heart disease), fourth (cerebrovascular disease), and eighth (renal disease) leading causes. Therefore, overall, diabetes is a devastating disorder.
Metabolic control of diabetes (mostly, but not exclusively, glycemic/glucose control) is clearly associated with the long-term outcomes of diabetes. Better glycemic control, as determined by hemoglobin A1C, when started relatively early in the course of diabetes (even during adolescence), reduces the subsequent risks of retinopathy, nephropathy, neuropathy, and macrovascular disease. Although this fact has been clearly demonstrated for type 1 diabetes by the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study and for type 2 diabetes by the U.K. Diabetes Prospective Study (UKPDS), morbidity and mortality associated with long-term diabetes complications still occur at an unacceptable rate.
Despite advancing knowledge over recent decades, the physiology of glucose metabolism and the pathophysiology of diabetes are not completely understood. Even after more than 90 years since the discovery and initial use of insulin to treat diabetes by Banting and Best, normalization of metabolic control remains an elusive goal for most people with type 1 and many with type 2 diabetes. For type 1 diabetes, which most commonly starts during childhood and depends on insulin replacement as the mainstay of treatment, the development of improved insulins and insulin analogs, self-monitoring of blood glucose (SMBG), and continuous glucose monitoring (CGM) and insulin pumps (continuous subcutaneous insulin infusion [CSII]) has significantly improved long-term outcomes and quality of life. However, normalization of metabolic control is still not a reality for most.
Managing diabetes