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Longitudinal data on growth and final height in diabetic children
M V Du Caju1, R P Rooman, L op de Beeck
1Department of Pediatrics, University Hospital Antwerp, Belgium.
Insights
Children with insulin-dependent diabetes mellitus (IDDM) show normal prepubertal growth. However, diabetic girls experience reduced final height and obesity, indicating conventional therapy may not ensure optimal growth for all children.
Area of Science:
- Pediatrics
- Endocrinology
- Growth and Development
Background:
- Conflicting data exist on growth in children with insulin-dependent diabetes mellitus (IDDM).
- Previous studies primarily used cross-sectional designs, limiting insights into growth trajectories.
Purpose of the Study:
- To longitudinally assess growth patterns in children with IDDM.
- To evaluate the impact of diabetes onset before age 10 on final height and pubertal development.
Main Methods:
- Longitudinal study of 46 children (22 girls, 24 boys) with IDDM.
- Recorded height, weight, skeletal age, and pubertal development until final height attainment.
Main Results:
- Prepubertal growth was unaffected in both sexes.
- Diabetic boys experienced delayed puberty but achieved normal final height.
- Diabetic girls had a suboptimal pubertal growth spurt, leading to slightly reduced final height and a tendency towards obesity.
Conclusions:
- Conventional IDDM therapy may not guarantee optimal growth, particularly in girls.
- Longitudinal data reveal sex-specific differences in growth outcomes for children with IDDM.
Abstract:
The available data on growth in children with insulin-dependent diabetes mellitus are conflicting and are mainly derived from cross-sectional studies. In this longitudinal study, height, weight, skeletal age, and pubertal development were recorded until final height was attained in 46 children (22 girls and 24 boys) with onset of diabetes before the age of 10 y. At the onset of diabetes, height SD score (SDS) averaged 0.41 in girls and 0.56 in boys, which was normal when corrected for the secular trend. Prepubertal growth was unaffected in both sexes. Diabetic boys had a marked delay in onset of puberty (mean age at genitalia stage 2: 13.7 y) but attained a normal final height (final height SDS: 0.48 +/- 0.89). In girls final height was slightly reduced (height SDS 0.27 +/- 0.97) due to a suboptimal pubertal growth spurt. Mean pubertal height gain in girls was 16.6 cm and mean age at breast stage 2 was 11.6 y. Diabetic girls also tended to become obese during puberty. Skeletal maturation was normal at all ages. These data suggest that conventional therapy does not guarantee optimal growth, especially in girls.