FACTORS INFLUENCING HEIGHT AND WEIGHT DEVELOPMENT IN CHILDREN WITH DIABETES - RESULTS OF THE BERLIN RETINOPATHY STUDY

OBJECTIVE - To investigate the influence of glycemic control and insul in therapy on the longitudinal growth and weight development of childr en with diabetes. RESEARCH DESIGN AND METHODS - Prospective measuremen ts of standing height and weight were recorded longitudinally in 634 c hildren after IDDM onset (median age at onset, 9 years [range 1-15 yea rs]; median diabetes duration at final examination, II years [range 1- 19]; 3,236 patient-years on two or three injections daily; 399 patient -years on multiple injection therapy [MIT]). RESULTS - Normal developm ent was found until puberty, with a tendency toward stunted growth and overweight (weight > 97th centile) thereafter. Female sex (P < 0.01) and MIT (P < 0.01) were associated with overweight. Final height was e valuated in a subgroup of 197 young adults followed until age 18 years . Relative growth was calculated as the difference between the standar d deviation scores (SDSs) at manifestation (median 0.2 [range -3.5 to 2.9]) and at 18 years of age (reduction of -0.5 [-2.5 to 1.8]), equiva lent to a median loss of 2.9 cm in boys and 2.3 cm in girls. Significa nt linear correlations with the change in height SDS after diabetes ma nifestation were found for age at manifestation (r = 0.21, P < 0.001) and prepubertal (r = -0.40, P < 0.001) and postpubertal HbA(1c) (r = - 0.15, P < 0.001). While children with poorer relative growth also had a higher BMI (P < 0.05), no influences of sex, prevalence of limited j oint mobility, or presence of retinopathy were found. CONCLUSIONS - Fe male sex and MIT are associated with diabetes-related obesity. Prepube rtal and postpubertal glycemic control appear to be of importance for the diabetes-associated relative growth deficit.