The barrage of hormones, social turmoil, fashion crises, and other adolescent dramas that spells puberty can also spell trouble for your teen's (or preteen's) diabetes control. Issues of poor self-image and of wanting to fit in with peers by acting and eating as they do may raise glucose levels, either through noncompliance with treatment or as a stress response. Hormonal changes, which magnify all of the preceding and can increase the need for insulin, compound the problem.

Girls going through puberty will have an increased need for insulin as estrogen and progesterone production rev up with menarche (the first menstrual period). It's not surprising, then, that the peak age for type 1 diabetes diagnosis for girls is between the ages of 10 and 12, when puberty is often in full bloom.

At Risk for Eating Disorders

Eating disorders are more than twice as common in teenage girls with diabetes than in those without. Girls with eating disorders may skip their insulin dosage — a practice called insulin manipulation, or diabulimia — in an effort to lose weight. They are also at a higher risk for developing diabetic ketoacidosis (DKA) and poor long-term control (as measured by A1C levels).