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Question:

From Brazil:

My daughter, age 10, has been diabetic over the past 8 years (she's been diabetic since she was 22 months old). Her control has been a good one with an average of 4 blood glucose tests and as many insulin shots a day. And of course with all the challenges that such a control imposes. But over the last 3 (three) weeks she's been complaining about pain in her mammary glands. And at the same time it has been almost impossible to keep her results down below some acceptable figures.

My question is: Is there any relation between the growth of the mammary glands (or the production of Growth Hormones, in general) to blood glucose readings? And if so, what to do?

We've been sort of anxious because we are not managing to control her effectively.

Answer:

There is no specific link between breast budding and blood sugar levels; but the onset of puberty is associated with a physiologically driven increased need for insulin which affects control. In addition there is all the emotional turbulence of this stage of growing up and in your daughter's case this may be triggered by an unusually demanding regimen of diabetes control, by the early physical changes of puberty or by some other factor, perhaps to do with school.

There are several steps that can be taken to remedy matters. Perhaps the first is to arrange for a thorough physical exam including Tanner staging of breast bud and pubic hair development. This should not only exclude any other obvious organic cause of chest pain, but reassure your daughter that her complaint is being taken seriously and that it does not have an organic basis. An explanation that breast discomfort and even tenderness is common at this stage of development should be a component of this.

It would help too if you could talk to her teacher to find out if there are any special academic or social problems recently at school or whether she has become uncomfortable about doing blood sugars or giving injections.

It would be understandable too if a ten year old was beginning to rebel against a pattern of four shots and four blood sugars a day and if the stress from this was being converted into an exaggeration of breast pain. So I would suggest that you talk with her diabetes doctor about changing to three or even two shots and blood sugars a day at least for a time. This might actually improve the overall level of control. You can always go back to more intensive therapy at a later date.

If these simple measures do not help you may need additional counselling help from an experienced medical social worker or clinical psychologist.

DO'B

Original posting 6 Jan 97

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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