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Titolo:
Achieving optimal diabetic control in adolescence: the continuing enigma
Autore:
McConnell, EM; Harper, R; Campbell, M; Nelson, JK;
Indirizzi:
Ulster Hosp, Diabet Unit, Belfast BT16 1RH, Antrim, North Ireland Ulster Hosp Belfast Antrim North Ireland BT16 1RH , Antrim, North Ireland
Titolo Testata:
DIABETES-METABOLISM RESEARCH AND REVIEWS
fascicolo: 1, volume: 17, anno: 2001,
pagine: 67 - 74
SICI:
1520-7552(200101/02)17:1<67:AODCIA>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
GLYCEMIC CONTROL; EATING DISORDERS; PSYCHIATRIC-DISORDERS; ANOREXIA-NERVOSA; METABOLIC CONTROL; INSULIN OMISSION; NEEDLE PHOBIA; FOLLOW-UP; MELLITUS; IDDM;
Keywords:
adolescence; diabetic control;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
59
Recensione:
Indirizzi per estratti:
Indirizzo: Nelson, JK Ulster Hosp, Diabet Unit, 700 Upper Newtownards Rd, Belfast BT16 1RH, Antrim, North Ireland Ulster Hosp 700 Upper Newtownards Rd Belfast Antrim North Ireland BT16 1RH
Citazione:
E.M. McConnell et al., "Achieving optimal diabetic control in adolescence: the continuing enigma", DIABET M R, 17(1), 2001, pp. 67-74

Abstract

The transition from childhood through adolescence to adulthood is a difficult stage, particularly for patients with type 1 diabetes. The yearning forautonomy and independence, as well as the hormonal changes around the timeof puberty, can manifest in poor glycaemic control. The focus on diet and weight increases the prevalence of eating disorders, compounding the difficulties in supervising diabetes patients. This can be exacerbated by the realisation that hyperglycaemia induces weight loss and the use of this knowledge to further manipulate diabetes control to gain a desired body image. The management of adolescents with type 1 diabetes is therefore challenging and requires close collaboration between psychological medicine and diabetesteams. This review describes the difficulties frequently encountered, witha description of four cases illustrating these points. Case 1 demonstratesthe problem of needle phobia in a newly diagnosed patient with type 1 diabetes leading to persistent hyperglycaemia, the recognition of weight loss associated with this and the development of bulimia. The patient's overall management was further complicated by risk-taking behaviour. By the age of 24 years, she has developed diabetic retinopathy and autonomic neuropathy and continues to partake in risk-taking behaviour. Case 2 illustrates how thelack of parental support shortly after the development of type 1 diabetes led to poor glycaemic control and how teenagers often omit insulin to accommodate lifestyle and risk-taking behaviour. Case 3 further exemplifies the difficulty in managing patients with needle phobia and the fear of hypoglycaemia. Case 4 adds further weight to the need for parental support and the impact of deleterious life events on glycaemic control by manipulation of insulin dosage. Copyright (C) 2001 John Wiley & Sons, Ltd.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 22:22:05