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The Capital Region of Denmark - a part of Copenhagen University Hospital

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

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  • 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 Sumnik
  • Carine de Beaufort
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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.

Original languageEnglish
JournalPediatric Diabetes
Issue number8
Pages (from-to)1441-1450
Number of pages10
Publication statusPublished - Dec 2018

ID: 55230377