Puberty as an accelerator for diabetes complications

Pediatr Diabetes. 2014 Feb;15(1):18-26. doi: 10.1111/pedi.12112. Epub 2014 Jan 20.


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.

Keywords: adolescent diabetes; androgens; insulin resistance; puberty; vascular complications.

Publication types

  • Review

MeSH terms

  • Adiposity
  • Adolescent
  • Age of Onset
  • Albuminuria / etiology
  • Child
  • Child, Preschool
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Retinopathy / etiology
  • Female
  • Glycated Hemoglobin / metabolism*
  • Human Growth Hormone / metabolism
  • Humans
  • Insulin Resistance
  • Insulin-Like Growth Factor I / metabolism
  • Male
  • Obesity / complications
  • Polycystic Ovary Syndrome / etiology
  • Puberty / blood*
  • Sexual Maturation


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Human Growth Hormone
  • Insulin-Like Growth Factor I