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Does glycemic control affect growth velocity in children with insulin-dependent diabetes mellitus

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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 using Hanes I reference data. Differences in Z score between clinic visits (ΔZ) were calculated for both weight and height to determine changes in — growth velocity. The mean Z scores for weight and height were not attenuated in type 1 children compared with healthy children (0.56±1.00 and 0.25±0.99, respectively). There was no correlation between either mean Z scores for weight or height and GHb. Moreover, regression analysis revealed no significant correlation between GHb levels and ΔZ for either weight or height. While a significant correlation was observed between ΔZ 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-promoting hormones such as insulin-like growth factor-1 (IGF-1) are more important regulators of linear growth than glycemic control.

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Pitukcheewanont, P., Alemzadeh, R., Jacobs, W.R. et al. Does glycemic control affect growth velocity in children with insulin-dependent diabetes mellitus. Acta Diabetol 32, 148–152 (1995). https://doi.org/10.1007/BF00838483

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