Pediatric endocrinology is the medical subspecialty which involves the diagnosis, treatment, and management of metabolic and growth disorders in children. The most common pediatric metabolic disorder treated by endocrinologists is type 1 diabetes. Pediatric endocrinologists also treat growth disorders, pubertal disorders, and other problems related to the thyroid, adrenal, or pituitary glands. The Pediatric endocrinologist at Endocrinology Associates of Dallas (EAD) and Plano treats patients with endocrine disorders from birth into adulthood.
The hormones produced by your child’s endocrine system control metabolism, growth, nutrition, and energy. When the hormone production in the glands of the endocrine system is deficient, excessive, or abnormal in some way, your child’s endocrinologist can help in identifying and treating the problem.Because conditions that affect the endocrine system often involve multiple structures and/or systems within the child’s body, the endocrinologists at EAD work closely with your pediatrician and any other necessary specialists to provide your child with the best possible care for his/her condition.
Type 1 Diabetes (T1D) in Pediatric Endocrinology
Type 1 diabetes (T1D) or juvenile diabetes, is the result of the immune system’s destruction of the cells in the pancreas which produce the hormone insulin. Insulin helps the glucose (sugar) in your child’s body move through the bloodstream and into the cells of the body for energy. When the body cannot produce enough insulin, blood glucose levels become high. Acutely high blood sugars can result in increased thirst, frequent urination and weight loss. These symptoms warrant immediate evaluation.
At this time, there is no cure for type 1 diabetes, therefore treatment for diabetes focuses on managing the condition. Your endocrinologist can help you successfully manage your child’s diabetes through:
- Up-to-date diabetes education
- Individualized insulin therapy
- Nutrition counseling
- Technologies to facilitate monitoring and care of diabetes, such as continuous glucose monitoring (CGM) and insulin pump technologies
Pediatric endocrinologists share a goal to control the blood sugars so that long term complications do not occur. With time, poorly controlled blood sugars will result in vascular disease (affecting eyes, heart and kidneys). In addition to insulin therapy, leading an active life, eating a healthy diet and monitoring blood sugar levels are essential for long term success. You and your endocrinologist will formulate a plan that allows you to fully engage in what is important to you.
The Endocrine physicians at Endocrine Associates of Dallas (EAD) have a common objective to assist their patients to live their life without limits. Our diabetic patients have healthy pregnancies, participate in competitive sports and attain graduate degrees in their desired fields of study.
Growth Disorders in Pediatric Endocrinology
Growth disorders can affect height, weight, sexual maturity, as well as other bodily functions. Problems with other glands, such as the adrenal gland, the hypothalamus, and the thyroid gland can also contribute to pediatric growth disorders.
Growth disorders are often the result of the pituitary gland failing to produce a sufficient amount of the growth hormone. Growth hormone deficiency can cause a child to grow slower than is normally expected (usually less than 2 inches per year vs. normal growth in childhood of >2 inches per year with an increased growth rate in puberty). Growth hormone deficiency can be congenital or develop during childhood. Other patients at risk for growth hormone disorders include children:
- Small for age at birth with poor growth
- Children growing < 3% on the growth chart
- Illness or brain trauma that results in slowing of growth
- Chromosomal disorders (i.e. Turner, Noonan, Prader Willi syndromes)
Testing for Growth Disorders
In addition to blood and urine tests, a growth hormone stimulation study is needed to confirm the presence of growth hormone deficiency.
Treatment for Growth Disorders
Treatment for growth hormone deficiency is recombinant growth hormone therapy. This is administered by a subcutaneous injection (like an insulin injection). Treatment is continued until the growth plates have closed.
Puberty Disorders in Pediatric Endocrinology
Puberty disorders typically involve either significantly early or late onset of puberty. Precocious puberty occurs when a child enters puberty prior to the age of 8 for girls or 9 for boys. While this early puberty may not be the result of a medical problem, often an abnormality involving the pituitary gland is the cause.
Delayed puberty is typified by the lack of breast development in girls or testicular enlargement in boys at the age of 13 and 14 respectively, or not having started menstruation by age 16. In many cases, genetics is a major factor in delayed puberty, however, it can be a sign of damaged or underdeveloped ovaries or testicles or a hormone deficiency.
- Some genetic disorders, such as Turner syndrome and Klinefelter syndrome can also disrupt puberty.
- Other diseases of the endocrine system which can affect children and that we treat at Endocrine Associates of Dallas include:
- Thyroid diseases, such as hypothyroidism (Hashimoto’s disease) and hyperthyroidism (Grave’s disease)
- Adrenal disorders, such as congenital adrenal hyperplasia, Addison’s disease, and Cushing syndrome.
- Menstrual disorders, such as polycystic ovary syndrome
- Bone diseases/calcium and vitamin D disorders, such as rickets
- Obesity (weight which is significantly over the norm for a child’s height and age)
- Genetic disorders, such as Turner syndrome, Noonan syndrome, Klinefelter syndrome, Russell Silver syndrome, and Prader–Willi syndrome
Testing for Puberty Disorders
Blood testing is typically needed to evaluate and diagnose pubertal disorders. Often stimulation testing is needed to determine the diagnosis.
If your child has been diagnosed with an endocrine system disorder or disease, please ask your pediatrician for a referral to Endocrinology Associates of Dallas (EAD) and Plano. Our board certified pediatric endocrinologist and advanced degree specialty staff are here to provide your child with the specialized care he/she deserves. Our goal is to assist children in reaching their full potential in growth and development.