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January 22, 2008

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Question from South Wales:

My 15-year-old son was diagnosed with type 1 diabetes a year ago. He is 6 feet tall but has not developed sexually at all except for pubic and underarm hair. He is getting very apprehensive about this. His diabetes is well controlled. Is there any help he can get?

Answer:

It is not likely that the diabetes is an explanation because his duration is too short. Is there a family history of delayed puberty? If he already has axillary and pubic hair, then he is well on the way toward puberty. You should have your diabetologist discuss this and specifically examine for Tanner staging which will evaluate the size and shape of the penis and also the scrotum/testicles. Some other hormone testing could also be done and perhaps also a bone age X-ray. This will put into perspective if there is really delayed puberty. His growth chart should also be evaluated for the same information/patterns. If he is deficient in pituitary and/or gonadal hormones, these could be replaced. Sometimes we endocrinologists also treat for 6 to 12 months with testosterone as well, even with delayed puberty.

SB