CE: Diabetes and puberty: a glycemic challenge.

As children with diabetes enter adolescence, the physical and psychological changes of puberty add to the challenges of disease management. This often leads to increased stress for both parent and child and to poor overall glucose control with potential short- and long-term complications. During this period of transition, nurses play a central role in teaching patients and their families about the effects of puberty on insulin sensitivity and glucose metabolism, and in discussing how the emotional and behavioral changes associated with this challenging time can affect diabetes management.