Dramatic changes in the care of type 1 diabetes (T1D) have occurred in the last decades, which have improved metabolic control and changed the clinical profile of the associated complications of this condition. Recently, earlier puberty in boys with T1D compared with healthy boys has been reported, which has been linked to elevated serum testosterone in men with T1D. In girls, pubertal milestones are occurring within the normal range. Thelarche in girls with T1D is delayed only a couple of months, and this event is following the same secular trend toward an earlier onset that has been described in the general population. The age of menarche has decreased in the last four decades but is slightly delayed in those girls who have a premenarcheal onset of T1D. Currently, adolescents with T1D have to deal with complications related to excessive insulin daily doses as menstrual irregularities, hyperandrogenism, and weight gain.