Growth in Children and Adolescents with Type 1 Diabetes

Objective To investigate the effect of type 1 diabetes on growth and adult height. Study design Data from 22 651 children (10 494 females) with type 1 diabetes documented at onset of the disease from specialized centers in Germany and Austria were analyzed. Patients of non-German and non-Austrian origin and patients with celiac disease were excluded from the analysis. Near-adult height data were available in 1685 patients. Results At the time of diagnosis of type 1 diabetes, the mean age of the 22 651 children was 8.8 +/- 4.2 years, with a mean height SDS of 0.22 +/- 1.0. The 1685 patients with diabetes onset before age 11 years reached a mean adult height of -0.16 +/- 1.0 SDS. Mean adult height was was 167.1 +/- 6.2 cm (-0.16 +/- 0.97 SDS) in females (n = 846) and 179.6 +/- 7.1 cm (-0.17 +/- 1.0 SDS) in males (n = 839). Mean duration of diabetes was 9.1 +/- 2.6 years, and mean Hemoglobin A1c concentration was 7.9% +/- 1.2% (63 +/- 10 mmol/mol). In a multivariate regression model, adult height was positively correlated with height at onset of diabetes (P < .0001) and negatively with mean Hemoglobin A1c (P < .0001) and duration of diabetes (P = .0015). Conclusion Height at the time of diagnosis of type 1 diabetes is above average. Even with intensive insulin therapy, growth and adult height remain indicators of metabolic diabetes control in the 21st century. (J Pediatr 2012;160:900-3).