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[Pediatric patients with type 1-diabetes: growth and growth failure associated factors]
Jessie Nallely Zurita Cruz1, Gabriela Esthephania Dosta Martínez1, Miguel Ángel Villasís Keever1
1Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Insights
High blood sugar (HbA1c) in the first year after type 1 diabetes diagnosis is linked to growth failure in children. Monitoring HbA1c is crucial for assessing growth in pediatric patients with type 1 diabetes.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Growth and Development
Context:
- Type 1 diabetes (T1D) commonly affects children and can impact their growth.
- Understanding factors contributing to growth failure in pediatric T1D is essential.
Purpose:
- To identify factors associated with growth failure in children diagnosed with T1D.
- To analyze growth patterns and associated clinical data over a four-year follow-up period.
Summary:
- A case-control study followed 95 pediatric T1D patients for up to four years.
- Fifty percent of patients experienced growth failure.
- Elevated glycosylated hemoglobin (HbA1c) in the first year post-diagnosis was significantly associated with growth failure (OR 4.08).
Impact:
- This study highlights the critical role of glycemic control in the initial year post-T1D diagnosis for preventing growth failure.
- Findings emphasize the need for close monitoring of HbA1c to support optimal growth in children with T1D.
Background:
Type 1 diabetes (T1D) usually occurs in the pediatric age and affects the growth of children. The aim of this work was to describe growth and growth failure associated factors in a population of children with T1D in a tertiary level pediatric hospital.
Methods:
A case-control nested in a cohort study was conducted. We included patients with TD1 under 16 years of age with a minimum follow-up of 12 months. Data as age at T1D diagnosis, anthropometry, glycosylated hemoglobin (HbA1c), as well as the pubertal development (Tanner stage) were collected at the time of diagnosis and during 4 years of follow-up. At the end of the follow-up, patients with growth failure and without it were compared, matched by sex, age at TD1 diagnosis. Univariate and multivariate analyses were performed.
Results:
On the first year of follow-up, 95 patients were gathered, 88 patients were still followed by the second year, 56 patients were kept for the third year, and 46 patients were still followed-up by the fourth year. Median age was 9.5 years and 50% were preadolescents. During their evolution, 50% had growth failure. According to the multivariate analysis, the factor associated with growth failure was the HbA1c in the first year post-diagnosis (OR 4.08; 95% CI 1.34-12.42).
Conclusions:
In the first year post-diagnosis of children with T1D, HbA1c was associated with growth failure.
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