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Overview

The Section of Pediatric Diabetes and Endocrinology at Boston Medical Center is committed to comprehensive, compassionate, supportive medical care to children and adolescents with a wide range of metabolic and endocrine disorders. We are part of BMC’s innovative Department of Pediatrics, which is nationally renowned for its excellence in pediatric care.

We work closely with pediatric primary care physicians at BMC and throughout New England, and with specialists in adolescent medicine and adult endocrinology at BMC. We have special expertise in:

  • Diabetes (Type 1 and Type 2)
  • Adrenal insufficiency
  • Statural disorders
  • Short stature
  • Hypothyroidism and hyperthyroidism
  • Pubertal disorders
  • Hypopituitarism
  • Metabolic disorders, such as:
  • Pre-diabetes
  • Insulin resistance
  • Hyperlipidemia
  • Obesity
  • Thyroid disorders
  • Premature adrenarche (early maturation of the cortex of the human adrenal glands)
  • Polycystic ovarian syndrome (PCOS)

The Section of Pediatric Diabetes and Endocrinology has experience with the full range of pediatric endocrine disorders, and we provide a full complement of evaluation, diagnostic and treatment services.

We offer testing in Boston Medical Center’s Pediatric STAR Unit. Our testing capabilities include–but are not limited to–growth hormone stimulation tests, oral glucose tolerance tests, gonadotropin releasing hormone (GnRH) tests and ACTH tests for adrenal gland function evaluation.

Diagnosis, evaluation, and recommendations for appropriate educational and medical therapies are provided by board-certified pediatric endocrinologists. Initial evaluations consist of a detailed medical history, a physical exam and, typically, laboratory tests. Results and conclusions are discussed thoroughly with parents and/or guardians and, depending on age and maturity, the patient. The patient’s primary provider is provided with a comprehensive report documenting the visit.

After the initial evaluation, ongoing follow-up is scheduled as needed, based on the child’s age as well as medical and educational needs of the child and family. Dietary counseling is available as part of the clinic visit when deemed useful or necessary.

For diabetic cases, continued diabetes education is maintained by the Diabetes Educator at each visit. Patients and families remain in contact with the diabetes team via pagers.

When a patient is first seen in the clinic, he or she will meet with a board-certified pediatric endocrinologist who will take a detailed medical history and perform a physical exam. Typically, the doctor will also order laboratory tests. Sometimes, patients need additional testing that include, but are not limited to:

  • Growth Hormone Stimulation Test

    The growth hormone stimulation test measures the ability of the body to produce GH. Blood is drawn several times through an IV. The first sample is typically drawn in the morning, followed by an administered dose of growth hormone stimulant, known to encourage an increase in GH production. Several more blood samples will be taken at regular intervals. The entire procedure usually takes between 2-5 hours.

  • Oral Glucose Tolerance Test

    The oral glucose tolerance test (OGTT) measures how well your body is able to break down glucose, or sugar. First, a blood sample will be collected, providing a baseline for comparing other glucose values. You will then be asked to quickly drink between 75 and 100 grams of a sweet liquid containing a measured amount of glucose. Blood samples will be collected at timed intervals of 1, 2, and sometimes 3 hours after you drink the glucose.

  • Gonadotropin releasing hormone test

    A blood sample is taken, followed by a shot of GnRH (gonadotropin-releasing hormone). Over a period of time, typically between 20 minutes and 60 minutes after the injection, additional blood samples will be drawn so the luteinizing hormone (LH) can be measured.

  • ACTH Tests

    A sample of blood is drawn and analyzed to measure the levels of both ACTH (adrenocorticotropic hormone) and cortisol in the blood. This helps to detect diseases that are associated with too much or too little cortisol in the body.

The results and conclusions of these tests are discussed thoroughly with parents and/or guardians and, depending on age and maturity, the patient. The patient’s primary provider is provided with a comprehensive report documenting the visit.

After the initial visit, future appointments are scheduled as needed for each patient. These are based on the child’s diagnosis, age, and medical and educational needs. Dietary counseling is available as part of the clinic visit when necessary.

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