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Hormones are made by endocrine glands to influence the growth or activity of other parts of the body. We diagnose and treat children whose endocrine glands are not working properly. Some endocrine disorders are present at birth; others occur later in childhood. Your pediatrician or family doctor can often screen your child for an endocrine problem. If one is found, you may be referred to our clinic. Examples of endocrine problems include:

• An overactive or under active thyroid gland. An overactive thyroid causes a fast heart rate, weight loss, and hyperactivity. An underactive thyroid causes modest weight gain but poor height gain. All newborns are screened for an underactive thyroid.
• The adrenal glands produce several important hormones. If the adrenal glands are overactive, your child may have early puberty or severe acne. If they are underactive, your child may have repeated flu-like illnesses and very tan skin. All newborns are screened for underactive adrenal glands.
• The gonads (testes in boys, ovaries in girls) are responsible for puberty and fertility. If puberty occurs too early (before 7 years in girls or before 9 years in boys), a child may not have enough time to grow to full potential. More commonly, puberty is delayed. Rarely, puberty never starts. All of these conditions are evaluated in our clinic.

Many endocrine problems affect growth since many hormones stimulate growth. If your child is missing one of these hormones, he may seem healthy but just have slow growth. We monitor a child's growth. If that growth is too slow, we test the child for missing hormones (thyroid hormone, growth hormone) or other causes of slow growth (such as poor nutrition). We have been a part of the clinical testing of several biosynthetic growth hormones now used to treat children with growth hormone deficiency.

Juvenile diabetes is a disorder resulting from destruction of pancreatic beta cells that produce insulin, a hormone that controls blood sugar. Children and adolescents with type 1 diabetes require daily insulin injections and insulin pump for the control of blood sugars and preventing long-term complications of diabetes such as eye disease, kidney disease and nerve disease. The incidence of Juvenile or type 1 diabetes is 14.9/100,000 population in the United States and has been increasing dramatically in children under the age of 5 years. Our Diabetes Center provides diabetes care and education to over 1200 children and adolescents with type 1 diabetes. We are part of the Max McGee Diabetes Research Center which conducts Children and adolescents with type 1 diabetes require insulin injections family genetic linkage studies for the evaluation of immunological and metabolic cause(s) of Juvenile diabetes.

There has been a significant increase in the incidence of type 2 diabetes, known as adult diabetes, in children and adolescents parallel to the rise in incidence of obesity in the United States. The incidence of type 2 diabetes is 7.2/100,000 population. Children with type 2 are currently treated with insulin for the control of blood sugars. We are participating in a multi-center trial for the study of oral medication for the treatment of type 2 diabetes in children.

The Lipid Clinic evaluates children and adolescents with abnormal blood lipids, such as high levels of cholesterol and triglyceride, in order to prevent future coronary artery disease. Treatment usually involves dietary counseling. If blood lipid levels are extremely high, medication may be needed. The Lipid Clinic also evaluates children in whom there is a strong family history of early heart disease.