MedStar Georgetown's Division of Pediatric Endocrinology, Diabetes, and Metabolism provides diagnostic and therapeutic services for children and adolescents with:
- Diabetes mellitus
- Disorders of physical growth:
- Sexual maturation
- Thyroid, adrenal and pituitary function
- Calcium and phosphorous metabolism
Our pediatric endocrinologists function as private physicians within a large academic health center and keep abreast of the latest science and technologies in pediatric care. We coordinate our care with primary care providers, sub-specialists within and outside of MedStar Georgetown, and families to provide compassionate, specialized medical care for your child.
Our team of experts includes board certified pediatric endocrinologists, a certified pediatric nurse practitioner, a psychiatrist, and skilled nursing staff. Together, we evaluate, manage, and treat a broad range of endocrine and metabolic disorders, and provide diagnostic endocrine tests for patients (children and adolescents) in the areas of endocrinology and carbohydrate, amino acid, mineral, and lipid metabolism disorders.
Diabetes Outpatient Clinic
Our team of experts is dedicated to the evaluation, diagnosis and treatment of children from birth to age 21 with Type 1, Type 2, and other forms of diabetes mellitus. We believe that diabetes is managed best when there is a partnership between the family and our team of experts. This partnership encourages independence, self-reliance and collaboration, which increase the likelihood that a child with diabetes will experience a normal and healthy life.
We have a comprehensive and extensive clinical research agenda designed to improve treatment options, as well as to advance the current knowledge of this disease. Our active research with the Diabetes National Institute puts us at leading edge of applying innovative techniques and practices towards diabetes treatment and management.
Learn more about diabetes treatment at MedStar Georgetown.
Short Stature Diagnosis and Management/Growth Hormone Clinic
Short stature is defined as height below the 3rd percentile for the child's age (according to standard charts for age and height). Most adolescents have short stature because their families are short, or because their growth spurt comes at the late end of the normal range of time for such development. However, some adolescents are short because of certain chronic illnesses or genetic and endocrine disorders. Our team of experts is dedicated to the evaluating, diagnosing, and treating children from birth to 21 years of age with growth and pubertal disorders.
In order for a child to grow, a gland deep inside the brain, called the pituitary, must release enough growth hormone (GH). Many factors influence the release of GH, including nutrition, sleep, exercise, stress, medications, blood sugar levels, and other hormones present in the body.
When a child's body does not produce or release enough GH, he or she may have several symptoms, the most noticeable being slow or no growth or facial features that make the child look a lot younger than his or her peers. Although being small has no effect on a child's intelligence, it may cause self-esteem issues and interfere with the development of mature social skills. For that reason, GH treatment may be prescribed to help a child reach his or her fullest growth potential-both in height and in personal development.
Growth hormone injections are a safe, effective treatment prescribed for children who have been diagnosed with growth hormone (GH) deficiency and other conditions causing short stature.
A number of other tests must be conducted first to confirm GH deficiency, Turner Syndrome, or other conditions for which GH therapy is indicated. These tests may include stimulation tests, MRIs, and x-rays.
Although it takes about 3 to 6 months to realize any height differences, the important thing is that your child will grow—probably 1 to 2 inches within the first 6 months of starting treatment. There may be a few other things you notice:
- Your child may outgrow his or her shoes quickly. Foot growth may occur within 6 to 8 weeks, so you may have to buy new shoes more often.
- Your child may want to eat more. An increase in appetite is common, especially if he or she had a poor appetite before treatment.
- Your child may look skinnier for a while once height growth starts. An increase in lean body mass and decrease of fat mass are common with GH treatment.
It may take a number of years for your child to reach his or her adult height, so you should be aware that GH treatment is often a long-term commitment. Routine visits with the pediatric endocrinologist will be needed, as will periodic blood tests and x-rays to monitor your child's progress on the treatment. Although the length of treatment varies, your child probably will have to stay on GH treatment until he or she has:
- Reached his or her full adult height
- Reached full bone maturity
- Grown less than 2 cm in the last year
GH is sold under a number of different prescription brand names, but all of them contain the same medication. Which brand name your child will use, and the shape and color of the pen that delivers the medication, will depend upon your medical insurance.
Because GH is very expensive, our team works with insurance reimbursement specialists to determine which brand will be covered under your medical insurance. Once we have made this determination and prescribed GH based on your coverage benefits, you should receive your child's GH with 2 to 4 weeks after approval.
Stimulation testing may be ordered to measure the way your child's endocrine system responds to different types of hormones. Different types of stimulation tests can be ordered to diagnose or rule out different medical conditions. Some of the stimulation tests that might be ordered include:
- Growth Hormone Stimulation is used to find out if your child's pituitary gland is producing enough growth hormone
- Lupron Stimulation is used to diagnose precocious (too early) or delayed (too late) puberty in boys and girls
- Glucose Tolerance is used to rule out diabetes, hypoglycemia, and insulin resistance
- ACTH Stimulation is used to find out if your child's adrenal glands are producing enough cortisol and to rule out congenital adrenal hyperplasia