Puberty as an accelerator for diabetes complications

Authors

  • Yoon Hi Cho,

    1. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
    2. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
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  • Maria E Craig,

    1. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
    2. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
    3. School of Women's and Children's Health, The University of New South Wales, Sydney, New South Wales, Australia
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  • Kim C Donaghue

    Corresponding author
    1. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
    2. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
    • Corresponding author: Prof. Kim Donaghue,

      Institute of Endocrinology and Diabetes,

      The Children's Hospital at Westmead,

      Locked Bag 4001, Westmead, NSW 2145,

      Sydney, New South Wales,

      Australia.

      Tel: 61-2-9845 3172;

      fax: 61-2-9845 3170;

      e-mail: kim.donaghue@health.nsw.gov.au

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Abstract

Much is written about how difficult it is to deal with diabetes during adolescence, and rightly so. Less is understood as to how puberty may be an accelerator of vascular complications. With the increase in childhood diabetes, complication risks need to be revisited in relation to puberty and the secular increase in adiposity. Recent data suggest greater risk for severe vascular complications in those with diabetes during puberty, compared with young people who develop diabetes after puberty. It is also widely recognized that higher hemoglobin A1c (HbA1c) results are often seen during the pubertal period. This article will review complication outcomes in relation to puberty and examine mechanisms by which puberty may modify risk above glycemic exposure, and possible gender disparities in the risk of complications in the adolescent period.

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