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د. بشار نعمات فاضل سهر

Hi. From the description, ur daughter is having a condition called ''Premature adrenarche''. This is considered to be a variant of normal puberty but not a true precocious puberty, high DHEA-S is part of premature activity of the adrenal gland. I suggest to do bone age x-ray of the left wrist and to do baseline blood tests for the master gland of the brain (pituitary gland) for the following hormones:LH. FSH and estradiol. Please do also baseline test for the thyroid gland as well (TSH and T4).Watchful waiting and periodic monitoring is the main stay of treatment.Agents that suppress puberty such as monthly decapeptyl injections are of doubtful benefit in her case but may be needed after sometime.Hope u find it useful.

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د. بشار نعمات فاضل سهر

Hi. Ya our pancreas secretes both insulin and glucagon. In people with (longstanding) type 1 diabetes in particular the pancreas cells will fail to secrete glucagon and this can put the patient at increased risk of low blood sugar.Unfortunately we can not mimic our natural pancreas. our natural pancreas secretes the exact amount of insulin following a meal and therefore low blood glucose does not happen in normal people. However if u r having diabetes and taking exogenous insulin, we may underestimate or overestimate the dose and therefore sugar swings can happen. Hope u find it useful.

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د. بشار نعمات فاضل سهر

Hi. Ya the test result is fine.

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د. بشار نعمات فاضل سهر

Hi. Any weight reduction that reaches 2 digits (in ur case 15 kg) will have significant impact on the health and well being of the patient.Ur risk to develop diabetes will reduce drastically by at least 60-80 percent, sleep quality will improve and if u have fatty liver that also will be better. If u can continue on intermittent fasting do continue. Hope u find it useful.