Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct;142(Suppl 2):S43-S52.
doi: 10.1542/peds.2018-0333F.

Obesity and Endocrine Management of the Patient With Duchenne Muscular Dystrophy

David R Weber  1 , Stasia Hadjiyannakis  2 , Hugh J McMillan  2 , Garey Noritz  3 , Leanne M Ward  4
Affiliations

Obesity and Endocrine Management of the Patient With Duchenne Muscular Dystrophy

David R Weber et al. Pediatrics. 2018 Oct.

Abstract

Duchenne muscular dystrophy (DMD) is associated with an increased risk of endocrine complications due to the effects of prolonged glucocorticoid therapy as well as progressive muscle weakness. Categories of complications include obesity and its comorbidities, short stature, pubertal delay, and adrenal insufficiency. Obesity prevention is important for long-term management of patients with DMD. Preventing glucocorticoid-induced weight gain fosters patient mobility, ease of transfer, and reduces sleep-disordered breathing. Metabolic complications from obesity (glucose intolerance, dyslipidemia) also can be avoided. Short stature and pubertal delay may negatively affect self-esteem and peer relationships, and careful monitoring of growth and pubertal development can allow anticipatory counseling. Adrenal insufficiency, a potentially life-threatening complication associated with prolonged glucocorticoid use, must be recognized so as to allow prompt treatment. In this article, we provide a summary of current guidance to ensure comprehensive endocrine management is followed in patients with DMD.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Weber has previously served as a paid consultant for Marathon Pharmaceuticals; Drs Ward, Hadjiyannakis, McMillan, and Noritz have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Assessments and interventions for impaired growth and delayed puberty in patients with DMD. (Reproduced with permission from Birnkrant DJ, Bushby K, Bann CM, et al; DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, an update, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol. 2018;17[3]:258.)
See this image and copyright information in PMC

References

    1. Kinnett K, Noritz G. The PJ Nicholoff steroid protocol for Duchenne and Becker muscular dystrophy and adrenal suppression. PLoS Curr. 2017;9:ecurrents.md.d18deef 7dac96ed135e0dc8739917b6e - PMC - PubMed
    1. Must A, Curtin C, Hubbard K, Sikich L, Bedford J, Bandini L. Obesity prevention for children with developmental disabilities. Curr Obes Rep. 2014;3(2):156–170 - PMC - PubMed
    1. Schwartz AV. Diabetes mellitus: does it affect bone? Calcif Tissue Int. 2003;73(6):515–519 - PubMed
    1. Bandini L, Danielson M, Esposito LE, et al. Obesity in children with developmental and/or physical disabilities. Disabil Health J. 2015;8(3):309–316 - PubMed
    1. Vincent C, Gagnon D, Routhier F, et al.; ADMI Group. Service dogs in the province of Quebec: sociodemographic profile of users and the dogs’ impact on functional ability. Disabil Rehabil Assist Technol. 2015;10(2):132–140 - PubMed

Publication types

MeSH terms

Substances