I think my nine year old daughter, diagnosed with type 1 diabetes four years ago, started a menstrual period the other day but does not show any other signs of puberty other than moodiness. Since most of the women in my family started their periods much later (I was thirteen and a half), I am concerned with such an early start. Can having type 1 diabetes cause puberty happen sooner?

No, diabetes does not usually trigger puberty earlier than would have normally occurred. Sometimes a hypothyroidism or hyperthyroidism can trigger puberty early, and thyroid problems are more common in children with type 1 diabetes. If there is no family history of early puberty on either side, I would make sure someone has reviewed her growth and development and feels that this is normal for her.

You say there are “no other signs of puberty other than moodiness,” but it is unusual to have a menstrual period before breast development and pubic hair development, and a growth spurt. If she has no physical signs of breast development or pubic hair and is not tall for her age, perhaps the blood is not true menstrual bleeding and could be from a urine infection or perhaps from a vaginal candidal infection if she has scratched a lot and caused local irritation.

I suggest you bring her to your pediatrician or to your pediatric endocrinologist to be evaluated.

TGL