Growth and puberty in type 1 diabetes mellitus - experience from a pediatric endocrinology unit

Abstract

Background: Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease in children. It is associated with vascular and neuropathic complications, and may also affect growth and development.

Objective: To correlate the metabolic control and disease duration with growth and puberty in patients with T1DM followed in a Pediatric Endocrinology Outpatient Clinic.

Subjects and methods: Retrospective analysis. Sample obtained from patients with T1DM followed in Hospital Santa Maria Pediatric Endocrinology Outpatient Clinic (Lisbon – Portugal) since 1994 until March 2011. Inclusion criteria: patients diagnosed before the onset of puberty and who had attained their final height during the follow-up. Variables: sex, age, weight and height at diagnosis and final, parents’ height, growth velocity, pubertal height gain, age at menarche and metabolic control during puberty.

Results: 39 patients, 51% female, 82% diagnosed less than five years before puberty. Fifty-four percent presented an average HbA1c between 8-10%, what we considered reasonable. There seems to be a trend towards an inverse association between HbA1c and the maximum speed of growth and pubertal height gain, although not statistically significant. These patients were taller than average at diagnosis (z-score: male 0.9; female: 0.5) and lost height during puberty, yet attained final heights within normal range and matching their target heights.

Conclusions: Although HbA1c seems to negatively influence maximum growth rate and pubertal height gain, there was no compromise in final height in this group of patients.