Nutrición en el desarrollo puberal. Necesidades energéticas y valoración clínica de su cumplimiento en el paciente diabético

The diet of the child and the adolescent with diabetes must be balanced and similar to that of those of the same age group, gender and family and social environment. During adolescence, changes occur in life style and in dietary habits. Adolescents are consuming high-calorie diets with a clear excess of fats and a lack of fibre and vitamins. Nutritional needs have to be personalized and they vary depending on the subject's stage of growth, gender and weight-height percentile. While the female gender grows from the beginning of puberty in parallel with breast development, reaching her maximum peak when she reaches menarche, boys chronologically start later and they do not do so with the beginning of testicular development, which marks the beginning of puberty, but they grow later. The examples of two adolescents are given: on the one hand, a 14 year-old school adolescent who is administered a slow analogue as basal insulin in the morning and one at night, and a rapid-acting analogue bolus in the doses that do not need either as much food or as much insulin. On the other hand, an adolescent of a similar age who goes to the surgery with poorly controlled glycaemia (HbA1c, 10.5%) and a low weight velocity in relation to his growth velocity, undoubtedly due to an insufficiently insulinised intake. Adolescence is a risky time from the nutritional point of view, for, due to the pubertal spurt, a tendency to acquire wrong eating habits is added to the nutrient needs.