The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes - A SWEET collaborative study

Jannet Svensson, Anke Schwandt, Daniele Pacaud, Jacques Beltrand, Niels Birkebaek, Roque Cardona-Hernandez, Kristina Castell, Sofia Castro, Valentino Cherubini, Declan Cody, Naama Fisch, Dhruvi Hasnani, Olga Kordonouri, Ioanna Kosteria, Andrea Luczay, Auste Pundziute-Lyckå, Claudio Maffeis, Barbara Piccini, Poran Luxmi, Zdenek SumnikCarine de Beaufort

9 Citationer (Scopus)

Abstract

OBJECTIVE: To describe the association between height, demographics and treatment in youths with Type 1 Diabetes participating in an international network for pediatric diabetes centers (SWEET).

METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. WHO growth charts were used to calculate height and BMI z-scores. Multiple hierarchic regression models adjusting for known confounders were applied.

RESULTS: Data on 22,941 subjects (51.8% male) were analyzed with a median and IQ range for age 14.8y (11.2; 17.6), diabetes duration 5.6y (3.1; 8.9), and height z-score 0.34 (-0.37; 1.03). Children were taller in the youngest age groups: adjusted height z-score of 0.31 (± 0.06) and 0.39 (±0.06) respectively; with shorter diabetes duration (< 2y: 0.36 (± 0.06); 2-<5y: 0.34 (± 0.06); ≥ 5y: 0.21 (± 0.06) and if they were pump users: 0.35 ± 0.05 versus 0.25 ± 0.05 (> 3 injections /day and 0.19 ± 0.06 (0-3 injections daily) respectively. High HbA1c and low to normal weight was associated with lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males.

CONCLUSION: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftPediatric Diabetes
Vol/bind19
Udgave nummer8
Sider (fra-til)1441-1450
Antal sider10
ISSN1399-543X
DOI
StatusUdgivet - dec. 2018

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