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Growth and maturation of children with insulin-dependent diabetes mellitus
Insights
Children with diabetes on structured diets and insulin therapy show normal growth and maturation when metabolic control is good to fair. Improved control in previously poorly managed cases leads to accelerated growth.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Diabetic control is crucial for managing insulin-dependent diabetes in children.
- Assessing the impact of metabolic control on growth and maturation is essential for pediatric endocrinology.
- Previous studies have indicated potential links between poor diabetic control and growth delays.
Purpose of the Study:
- To establish criteria for classifying pediatric diabetic control.
- To determine if good metabolic control in children with diabetes prevents delayed growth and maturation.
- To analyze growth patterns in relation to diabetic control levels.
Main Methods:
- Review and analysis of growth records for 252 children with insulin-dependent diabetes over 3-16 years.
- Classification of diabetic control based on glycosuria frequency and degree.
- Standardized treatment including twice-daily insulin injections and structured meals.
Main Results:
- 84% of children achieved "good" or "fair to good" diabetic control.
- Children in these control groups exhibited normal growth and maturation rates.
- Accelerated growth was observed in children with previously lower control levels after achieving better metabolic management.
Conclusions:
- Good to fair metabolic control in children with insulin-dependent diabetes is compatible with normal growth and maturation.
- Effective management strategies can mitigate growth issues associated with diabetes.
- Early and sustained metabolic control is vital for optimal pediatric development in diabetic patients.
Abstract:
The purpose of this paper is to define criteria used for classifying patients into varying degrees of diabetic control and to verify that children with diabetes maintained in higher degrees of metabolic control do not have delayed growth and maturation. Growth records of 252 children with insulin-dependent diabetes who have been under continuous observation in our clinic at three- to five-month intervals for at least three years and up to 16 years have been individually reviewed and analyzed. All children received two daily injections of a mixture of two parts of an intermediate to one part of regular insulin and were instructed to eat structured meals of high-quality selected foods. An over-all rating for diabetic control based primarily on the frequency and degree of glycosuria was made for the time period between clinic visits. The over-all diabetic control rating and the size of the subgroups were "good"--20 per cent, "fair to good"--64 per cent, and "fair"--16 per cent. All children maintained in "good" and "fair to good" control (84 per cent), grew and matured at a normal rate regardless of the age at onset or duration of diabetes. All children in lower degrees of control coming under care for greater than 24 months after diagnosis had accelerated growth during the early months after attaining a higher degree of control.