The peak incidence of type 1 diabetes in boys is between the ages of twelve and fourteen, when puberty is up and running. The hormonal changes that accompany puberty actually increase insulin resistance in both boys and girls, which compounds the problem of insufficient insulin production in those with type 1 diabetes.

Insulin resistance may also be accompanied by increased resistance to growth hormone in boys, and poor control has the potential to affect the speed and course of the “growth spurt” that normally occurs at puberty.

A Turbulent Time

Puberty is a time of separation from parents and a growing emphasis on social relationships — creating a separate social identity is paramount. Boys who may have depended on their parents for guidance on diabetes care may start taking more responsibility for their own care. Likewise, parents must learn to hand over the reins of diabetes control, at least partially, to allow their child to mature emotionally as well as physically.

However, the social pressures of puberty can also push young men in the opposite direction of ignoring their diabetes for the sake of being more like their peers. Drug and alcohol use — experimental or otherwise — can also become a problem during this time of life.

American adolescent males are statistically more likely to drink alcohol and take illicit drugs than are girls of a similar age. In 2006, 21.3 percent of boys between the ages of 12 and 20 reported recent binge drinking, and 7.9 percent considered themselves heavy users of alcohol.

Because alcohol can impair treatment judgment and trigger a potentially dangerous hypoglycemic episode, it's important that boys (and girls) with diabetes are educated about the special risks they face with alcohol and drug use. Even though “Just Say No” is good advice, realistically, many youths may not follow it. Especially during adolescence, kids need to know what precautions are necessary if they do drink.