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Question:

From Isfahan, Iran:

My 12-year-old son was diagnosed with type 1 at the age of three. Today, I met with his endocrinologist who said that he would be as tall as almost 160 to 165 cm (5 feet, 3 inches to 5 feet, 4 inches), probably closer to 160 cm (5 feet, 3 inches), but she said she does not recommend usage of growth hormones because these medicines can make blood glocose control hard. I'm not sure how hard it can be. Is it impossible or just hard? Do these medicines have any other harmful side effects or not? Would you recommend that we pursue the hormones or just accept that he will probably be around 160 cm (5 feet, 3 inches)?

Answer:

Height is controlled with very complicated mechanisms. So, it is difficult to answer your question since height also has a genetic component. How different is your son's height from his mom and dad, as well as other adults in the family (aunts, uncles, grandparents)? If his diabetes glucose control has been difficult with high A1c levels, then this would be another factor and one that can be corrected with lowered glucose levels and lowered A1c levels. It is actually quite rare with better glucose control to have such short stature be caused by the diabetes or to have a serious growth hormone deficiency as a second major illness explaining the short stature. We would go look for other explanations, such as low thyroid, celiac disease since these are both easier to treat and much less expensive to treat in someone who also has diabetes. If you don't know if this has already been checked, please ask your diabetes/endocrine team. Growth hormone itself is very expensive and also has some possibility of interference with diabetes control - but more importantly, growth hormone deficiency would be very, very rare in someone with type 1 diabetes so that makes it less likely an explanation. There are specific tests that would need to be done, for instance, IGF-1 levels, brain/pituitary gland special imaging studies like CT and MRI tests and special growth hormone stimulation testing that would answer the question of whether or not your son is growth hormone deficient.

SB

DTQ-20151013170226
Original posting 19 Oct 2015
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Last Updated: Monday October 19, 2015 19:16:58
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