Decreased growth velocity before IDDM onset.

Area of Science:

• Pediatrics
• Endocrinology
• Genetics

Background:

• Diabetes mellitus can impact physical development.
• Identical twins provide a unique model to study disease progression.
• Early detection of prediabetes is crucial for timely intervention.

Purpose of the Study:

• To investigate growth patterns in prediabetic identical twins before the clinical onset of insulin-dependent diabetes mellitus (IDDM).
• To identify potential early markers for IDDM development.

Main Methods:

• Prospective growth velocity assessment in 12 pairs of identical twins (one with and one without IDDM).
• Monitoring of prediabetic individuals for growth deceleration, islet cell antibodies, glucose tolerance, and hormone levels.
• Comparison of growth patterns between non-diabetic twins who later developed IDDM and those who did not.

Main Results:

• A significantly higher frequency of reduced growth velocity was observed in non-diabetic twins who later developed IDDM compared to their diabetic co-twins (7/12 vs 1/12; P = 0.03).
• Six of seven prediabetic twins showed growth velocity below the 3rd percentile before diabetes diagnosis, preceding impaired glucose tolerance in four cases.
• Lower testosterone or estradiol levels were noted in prediabetic twins with decreased growth compared to their diabetic co-twins.

Conclusions:

• Decreased growth velocity is an early and sensitive marker for the development of IDDM.
• Growth monitoring may aid in identifying individuals at high risk for IDDM.
• Hormonal changes may play a role in growth retardation preceding IDDM onset.