Growth, puberty, and final height in children with Type 1 diabetes

ObjectiveThe aims of this study were to assess the physical growth and pubertal development in a group of diabetic children and to evaluate the effect of height at diagnosis, duration of illness, and degree of glycemic control on final height and sexual maturation.Research designA cohort of 72 Sudanese diabetic children, 7–13 years of age at diagnosis, was followed longitudinally from the onset of diabetes until the attainment of final height.ResultsThe mean height standard deviation scores (SDS) at diagnosis were 0.04 in boys and −0.15 in girls, which was greater than their genetic target height (GTH). The growth velocity between diagnosis and final height was slow, with significant reduction in pubertal growth spurt. The mean final height attained by these children was lower than their GTH, a finding that contradicts most of the recently published reports. The average age at menarche in girls (15.1 years) and the mean age of full sexual maturation in boys (17.2 years) were significantly delayed in this group of diabetic patients. This retardation in physical growth and pubertal development was positively correlated with the duration of diabetes before the onset of puberty and glycated haemoglobin (HbA1c) concentration. The majority of these patients were thin at diagnosis of diabetes, with median body mass index (BMI) <22, but showed a remarkable, progressive weight gain during puberty, which was more evident in girls. The weight gain was independent of weight at diagnosis and duration of diabetes, but was positively correlated with the daily dose of insulin and HbA1c concentration.ConclusionConventional therapy of diabetic children is associated with impairment of physical growth and delayed sexual maturation.