Our daughter is nine years old and has had diabetes for five years. What are the concerns and precautions with diabetes and puberty? Are children more at risk during this stage of their life? If so what precautions should be taken?

The main problem with puberty is that control is much more challenging, as when hormones are released during puberty, these can affect the insulin making it less effective.

You are quite right in saying that if a child has had diabetes for a long time, it is the additional effects of puberty that can increase the risk of complications. However, it is important to stress that this is in the context of poor control, with high readings. A child going through puberty with good control has a significantly lower risk of developing problems. However, it is still unlikely that these problems occur during puberty, but if they are to occur, are more likely to occur later on in adult life.

JS