Role of glucose variability on linear growth in children with type 1 diabetes
Annalisa Blasetti1, Valeria Castorani1, Nella Polidori1
1Department of Paediatrics, University of Chieti, Chieti, Italy.
Insights
Glycemic variability negatively impacts linear growth in children with type 1 diabetes (T1D). Lower variability is linked to better height gains, emphasizing its importance for growth in T1D management.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Linear growth is often impaired in children with type 1 diabetes (T1D), particularly with poor metabolic control.
- Optimal metabolic control is crucial for preventing vascular complications and ensuring appropriate childhood anthropometric development.
Purpose of the Study:
- To investigate the relationship between glycemic variability and linear growth in prepubertal children with T1D.
- To identify specific glycemic variability metrics that correlate with growth outcomes.
Main Methods:
- Evaluated anthropometric data and glycosylated hemoglobin (HbA1c) in 144 prepubertal children with T1D over two years.
- Calculated glycemic variability indexes including coefficient of variation (CV) and a composite metric (M*SDS-HbA1c).
- Stratified children into tertiles based on height-SDS changes to compare glycemic control and variability.
Main Results:
- All children demonstrated positive anthropometric trends over two years.
- Higher tertiles of height-SDS changes showed significant decreases in HbA1c-SDS, CV, CV%, and M*SDS-HbA1c.
- Children with lower linear growth (Δheight-SDS) exhibited higher glycemic variability metrics.
Conclusions:
- Glycemic variability is a significant correlate of linear growth in children with T1D.
- Lower glycemic variability is associated with better height-SDS outcomes.
- Height gain is inversely correlated with glycemic variability indexes like CV, CV%, and M*SDS-HbA1c.
Objective:
Linear growth is impaired in children with type 1 diabetes (T1D) and poor metabolic control. A good metabolic control is a key therapeutic goal to prevent vascular complications and also to ensure appropriate anthropometric development during childhood. In this study, we aimed to identify and characterize the effects of glycemic variability on linear growth in children with T1D.
Methods:
Data from 144 prepubertal children with T1D were evaluated. Anthropometric measurements (weight, weight-SDS, height, height-SDS, BMI, BMI-SDS) were collected and glycosylated hemoglobin (HbA1c) was measured at admission and every 4 months over a 2-year period. Glycemic variability indexes (glycemic coefficient of variation (CV), glycemic CV percentage (CV%), and the product between HbA1c-mean and HbA1c-SDS/100 (M*SDS-HbA1c/100)) were calculated. According to height-SDS changes after 2 years of follow-up, the study population was divided into three tertile groups and differences across groups were investigated for variables of interest.
Results:
The three groups were similar in terms of age, gender, and follow-up period. After 2 years, all prepubertal children showed a significant positive trend of anthropometric data. Across the three tertile groups, HbA1c-SDS, CV, CV%, and M*SDS-HbA1c significantly decreased from the first to the third tertile of height-SDS. During follow-up, children with lower Δheight-SDS values reported higher values of HbA1c-SDS, CV, CV%, and M*SDS-HbA1c than subjects with higher linear growth.
Conclusions:
Glycemic variability correlates with linear growth in children with T1D. Low glycemic variability indexes were reported in higher height-SDS tertiles. Δheight-SDS is inversely correlated with glycemic CV, CV%, and M*SDS-HbA1c.
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