P-302: Puberty and type 1 diabetes
N Lemkimel, Z ImaneAbstract
Introduction
Type 1 diabetes is the most common chronic endocrine disease among children and adolescents. Puberty, marked by significant hormonal changes, represents a critical stage characterized by metabolic instability that complicates management and increases the risk of glycemic imbalance.
Objectives
To assess the metabolic impact of type 1 diabetes on puberty, analyze its clinical and glycemic evolution, examine the influence of the family and psychosocial context, and study the impact on academic performance.
Methods
A retrospective descriptive and analytical study was conducted at the Pediatric Endocrinology and Diabetology Department of CHU Ibn Sina, Rabat, between 2020 and 2024. Forty-five adolescents aged 14 to 18 years with type 1 diabetes were included. The studied variables included HbA1c (before and during puberty), acute complications, rehospitalizations, pubertal parameters, and the psychosocial, familial, and educational context.
Results
The mean age was 15.3 ± 1.2 years, with an average diabetes duration of 3.4 ± 0.5 years. The mean HbA1c during puberty was 8.6 ± 1.5%, significantly higher in rehospitalized adolescents (p = 0.0079). Pubertal delay affected 13% of patients, correlated with higher HbA1c (p = 0.019). The mean menarche age was 13.05 ± 0.7 years, delayed in poorly controlled patients (p < 0.001). Unfavorable family settings and lack of psychological support were associated with poorer metabolic control and school difficulties (p < 0.001).
Conclusions
Puberty is a period of vulnerability in the course of type 1 diabetes. Glycemic control, pubertal development, and school success are closely interrelated and influenced by family and psychosocial factors. A multidisciplinary approach is essential to optimize adolescent diabetes management.