Related Experiment Videos
Does glycemic control affect growth velocity in children with insulin-dependent diabetes mellitus
P Pitukcheewanont1, R Alemzadeh, W R Jacobs
1Department of Pediatrics, University of Tennessee, Graduate School of Medicine, Knoxville 37920, USA.
Insights
Glycemic control does not significantly impact linear growth in children with insulin-dependent diabetes mellitus type 1. Weight gain and growth hormones like insulin-like growth factor-1 are more critical for growth than blood sugar levels.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Children with insulin-dependent diabetes mellitus type 1 (IDDM) require careful management to prevent complications.
- Linear growth is a key indicator of health and development in pediatric populations.
- The relationship between glycemic control and growth in type 1 diabetes remains an area of investigation.
Purpose of the Study:
- To investigate the effect of glycemic control on linear growth in children with type 1 diabetes.
- To determine if glycosylated hemoglobin (GHb) levels correlate with growth parameters (weight and height Z scores).
Main Methods:
- A 6-year longitudinal study of 82 children with type 1 diabetes.
- Glycemic control assessed via glycosylated hemoglobin (GHb) measurements at clinic visits.
- Growth assessed using age and sex-normalized Z scores for weight and height.
Main Results:
- No significant correlation found between GHb levels and changes in weight or height Z scores.
- A significant correlation existed between weight and height changes, independent of glycemic control.
- Good glycemic control was associated with more frequent clinic visits.
Conclusions:
- Glycemic control does not appear to be a significant regulator of linear growth in children with type 1 diabetes.
- Weight gain and growth-promoting hormones, such as insulin-like growth factor-1 (IGF-1), are likely more influential on linear growth.
- Linear growth velocity is dependent on weight gain in this population.
Abstract:
To determine the effect of glycemic control on linear growth in children with insulin-dependent diabetes mellitus type 1, we studied 82 patients (40 male, 42 female) over a 6-year period. The mean +/-SD for age of onset and duration of IDDM were 7.3 +/- 3.9 years and 4.8 +/- 3.5 years, respectively. At each clinic visit, glycemic control was assessed by measuring glycosylated hemoglobin (GHb). For a total of 751 clinic visits, the mean +/- SD for chronologic age and GHb were 11.5 +/- 3.8 years and 10.2% +/- 2.3%, respectively. Good glycemic control was correlated with more frequent clinic visits (r= 0.219, P < 0.05). Growth was assessed by determining both weight and height, which were normalized for age and sex by calculating Z scores for weight and height and GHb. Moreover, regression analysis revealed no significant correlation between GHb levels and delta Z for either weight or height. While a significant correlation was observed between delta Z for weight and height (r = 0.30, P < 0.01), the relationship was not affected by glycemic control. Therefore, these data demonstrate that weight gain and growth rate do not seem to be significantly affected by glycemic control. This study also confirms that linear growth velocity is dependent on weight gain and suggests that in type 1 children, weight gain and level of growth-producing hormones such as insulin-like growth factor-1 (IGF-1) are more important regulators of linear growth than glycemic control.