Janet H. Silverstein, MD

Adolescence is a time when adherence to the diabetes treatment regimen is poor and HbA1c values are higher than at any other time of life. There are many reasons for this, including the normal psychological need for teens to become more independent, to question and often defy authority, and to be accepted by their peers. They feel invulnerable and may participate in risk-taking behaviors, including not doing the diabetes-related tasks necessary to succeed with their disease management.

Childhood overweight has increased at an alarming rate over the past two decades, with 17% of children and adolescents having BMI >95% and approximately one-third of all youth having BMI >85%.

Janet Silverstein

There are more fellows in pediatric endocrinology training than there have been in a decade. The number of first-year fellows increased from 32 to 80 between 1997 and 2003, and the number of fellows in all years of training increased from 96 to 213 between 1997 and 2005. Despite these reassuring numbers, pediatric endocrinology is experiencing a workforce shortage of crisis proportions, mainly driven by the increase in patient volume.