Diabetes is a disorder of metabolism. Metabolism is the way the body uses digested food for growth and energy. What happens during the process of metabolism? The food people eat, at least most of it, is broken down into glucose. Glucose is the form of sugar in the blood. It is the main source of fuel for the body.

Diabetes is a nasty disease which affects an estimated 246 million people worldwide and each year a further 7 million people join the ranks. What can you do about it? The simple prescription is to get started on a proper exercise program and eat right because each reduces insulin resistance.

Adolescence is the period of transition from childhood to adulthood. It is a time of physical and mental growth as well as sexual maturation. Teenagers tend to become sensitive to the way they look and act, and highly aware of all their body changes.

Adolescence is often seen as a stormy period; conflicts arise because of teenagers? need to break away from their parents yet finding, infuriatingly, that they are still very dependent upon them. This can give rise to unpredictable behavior, veering from the mature to the childish.

Dr Jill Challener, a consultant pediatrician in Cambridgeshire, UK, has made a special study of diabetes and teenagers. She concludes that the condition inevitably affects the normal processes of development - teenagers with diabetes may have delayed sexual and physical maturation and lack self-esteem because of the need for regular check-ups, injections and blood tests. Independence from parents is generally slower in coming because of prolonged parental concern, and teenage battles tend to be fought over diabetes rather than the usual teenage problem areas.

Teenagers with diabetes may also direct their anger towards the health-care team looking after them - it is really their way of fighting back at the disease which marks them out as different from their friends. There may be difficulty accepting all the rules of diabetes care, especially food management and regular injections. Boundaries will be tested to the limit; your child may even ignore all you and others have said about diabetes, especially if he is feeling fine.

Dr Challener's research has shown that teenagers need clear, simple, visual guidance in order for them to appreciate and understand the importance of good control. It is far easier for them to relate to a graph of their blood sugar levels than a number. She believes they need special handling, without abstract notions or warnings about 'the future? but with plenty of practical, sympathetic and above all simple advice on how to maintain their health and promote their independence.

The following shows the problems a teenager with diabetes might encounter.

Physical and sexual maturation:

1. Delayed sexual maturation

2. Small stature

3. Invasion of privacy

4. Frequent examinations

Conformity with peer group:

1. Meals must be eaten on time

2. Injections and blood tests

Self-image

1.Hypos which expose the difference

Self-esteem

1. Defective body image

Independence from parents

1. Parental concern

2. Battles over diabetes

Economic independence

1. Discrimination by employers