August 31, 2006
Other
Question from Kent, United Kingdom:
My daughter is 15 years, eight months old. She was diagnosed with type 1 diabetes at the age of 14 years, six months.
Looking back with hindsight, we feel she may have been becoming ill for over nine months before this. At about 13, she had the beginnings of breast buds, but with the onset of the illness, weight loss and hair loss, her development stopped. She has now had four menstrual periods which started just after she was 15.
Her diabetes is maintained with two insulin injections a day. Her consultant feels she would benefit from the four injection regime. Unfortunately, she refuses to change to this because she does not want to have to give herself an injection at school mid-day.
My question is about her height. At birth, she was 8 pounds, 2 ounces and or above the 90th percentile. During toddlerhood, she continued to follow this line. Unfortunately, in the United Kingdom, children are not checked regularly as in the U.S. so her weight loss and growth went undetected. At the time of her diagnosis with diabetes, we found that she had dropped to the third percentile. As you can imagine, this came as quite a shock. She is currently 5 feet, 2 inches. Will she continue to grow considering she has already begun the menarche? I am 5 feet, 5 inches and her father is 6 feet, 1 inch. Should I ask her doctor for a bone age x-ray? As she has started her menarche, is it too late to do anything to encourage her height growth?
Answer:
Peak growth for girls is about the time of menarche. There is growth afterwards, but less until growth plates close. There will be less growth potential if the blood glucose levels are out of control. Bone age would answer your questions about future height potential, but usually is not needed as the growth chart can provide a good assessment.
It sounds like your daughter is being stubborn about her long term future health needs if the diabetology team recommends more than two shots and she refuses. Day-to-day flexibility will also be increased and there will be fewer episodes of hypoglycemia as well. You may want her to chat with other teens on the childrenwithdiabetes.com web site or subscribe to Diabetes Health magazine to read about complications issues.
SB
