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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Anke Schwandt
  • Daniele Pacaud
  • Jacques Beltrand
  • Niels H Birkebaek
  • Roque Cardona-Hernandez
  • Kristina Casteels
  • 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

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. World Health Organization growth charts were used to calculate height and body mass index 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 interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (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-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (<2 years: 0.36 [±0.06]; 2-<5 years: 0.34 [±0.06]; ≥5 years: 0.21 [±0.06]) and if they were pump users: 0.35 ± 0.05 vs 0.25 ± 0.05 (>three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a 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.

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

Bibliografisk note

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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