What to know about managing diabetes and puberty

Diabetes and puberty both emerge from the endocrine system, requiring extra attention to navigate the impact of hormonal shifts that occur at this time. Accordingly, the tween and teen years bring with them a host of changes and challenges.

For those who live with type 1 diabetes (t1d) — as well as their caregivers — puberty can create a few hurdles for effective management of the condition. However, it's entirely possible for young adults to live full, vibrant lives during this time. Here's what you need to know to shepherd your child through this season of life.

Does diabetes affect puberty, or does puberty affect diabetes?

The answer is both. Diabetes can affect puberty, and in turn, puberty often impacts diabetes management as well.

If your child's blood sugar is rollercoastering on a regular basis, puberty may be delayed. Their weight may not be regulated in the same way, and menstruation may begin later and on an irregular basis. Paying close attention to diabetes management and working toward in-range blood glucose levels is the best way to lessen the impact of t1d on puberty.

A study in the Indian Journal of Endocrinology and Metabolism shows that when diabetes is managed in a way that maintains a majority of time-in-range and/or reflects in-range A1Cs, the likelihood of timely puberty and normal growth increases, and the risk of long-term complications reduces.

When puberty begins, the hormones that surge during this time can also cause significant insulin resistance. Sex hormones like estrogen and testosterone and stress hormones like cortisol can impact your child's blood glucose levels, leading to fluctuations that may have previously been out of the norm. Typically, your child's insulin needs will increase, and their blood sugar can go up and down in a way that requires more flexibility in their approach to treatment.

How can you care for t1d and puberty?

• Stay on top of endocrinology visits. As you begin to see hormonal changes taking place, your child's endocrinology team can recommend dosing changes and other strategies to take control of the situation as it's evolving.
• Look for patterns and make adjustments. At home, keep an eye out for emerging blood glucose patterns, and use that information to make any necessary tweaks to keep your child safe and healthy.
• Utilize tools to help. If your child isn't already using a continuous glucose monitor (CGM), this would be a great time to get started. A CGM can make the search for patterns easier as the wealth of data it provides can help you and the care team make necessary changes.
• Track the menstrual cycle (if applicable). Period tracker apps like MagicGirl (designed especially for tweens and teens) can help keep track of the cycle itself as well as symptoms that can help unearth patterns when overlayed with CGM data.
• Communicate with your child. It's important to take a non-accusatory approach to discussions about diabetes during this time. It's already tough for kids in this age range, so remind them that you're always here to discuss what they're going through and work together to ride the wave of emotions and blood sugar during this time.
  
  

Stay calm and do your best, together

Puberty is a notoriously difficult time for caregiver and child relationships, and adding diabetes to the mix can make it more challenging. But it also opens the door to better communication and collaborative decision-making, which can increase your child's independence in their care as they grow through this stage of diabetes and puberty. Use all of the tools at your disposal to help manage blood glucose levels and remember to breathe through it all! Also, always consult with your child's diabetes healthcare team before making any changes or adjustments in their management.

Curious about how hormonal changes can impact the body in puberty and beyond? Check out this article about hormones and diabetes on the Edgepark Health Insights blog.