T. Danne et al., FACTORS INFLUENCING HEIGHT AND WEIGHT DEVELOPMENT IN CHILDREN WITH DIABETES - RESULTS OF THE BERLIN RETINOPATHY STUDY, Diabetes care, 20(3), 1997, pp. 281-285
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.