Age at onset and long term metabolic control affect height in type-1 diabetes mellitus

Reduced height as a consequence of type-I-diabetes mellitus in childhood ha s been reported in many studies. However, it is still debated whether good metabolic control can normalize the growth rate. A total of 436 children (2 04 boys, 232 girls, mean age at diagnosis of diabetes 8.2 +/- 0.2 years) we re followed at our outpatient diabetes centre. Z-scores for height were eva luated in relation to duration of diabetes, age at onset and long-term meta bolic control. At diagnosis, height in children with diabetes was significa ntly above the reference population (+0.43 +/- 0.09). Standardized height d ecreased during the subsequent course of diabetes. This likely represents a delay of growth, as the final height (chronological age > 18 years, n = 14 4) was +0.27 +/- 0.09. Growth reduction was more pronounced in patients dia gnosed before the onset of puberty and final height in patients with a prep ubertal onset of diabetes was significantly lower (+0.10 +/- 0.13) compared to patients with a pubertal/postpubertal onset (+0.52 +/- 0.14). Among pat ients with a prepubertal onset, the subgroup with "poor" metabolic control (long-term median HbA(1c) > 7%) lost significantly more height compared to patients with "good" metabolic control. Conclusion Despite modern treatment regimens, reduced longitudinal growth c an still be demonstrated in type-I diabetes. This parameter therefore provi des a valuable endpoint for quality control in paediatric diabetology.