Assessment of Anthropometric and Pubertal Growth of Children and Adolescents with Type 1 Diabetes Mellitus

Abstract

Abstract Background Type 1 diabetes mellitus (T1DM) is a wasting disease which is characterized by a severe deficiency or absence of insulin. It can interfere with growth and pubertal development, especially in uncontrolled patients with diabetes. Aim of the Work Our primary aim was to assess the anthropometric measures and pubertal growth of children and adolescents with T1DM regularly attending Pediatric and Adolescents Diabetes Unit (PADU), Ain Shams University. Our secondary aim was to detect risk determinants affecting these measures and their link to glycemic control. Patients and Methods This cross-sectional observational study was carried out on 200 children and adolescents with T1DM attending the PADU clinic. Patients were assessed using anthropometric measurements, lipid profile (Fasting serum triglycerides, total cholesterol, HDL and LDL) and HbA1c%. Those with short stature were further evaluated using insulin like growth factor1 (IGF1), bone age, lipid profile and thyroid profile. while those with delayed puberty were evaluated using sex hormones. Results we found that 12.5% of our patients were short (SD<-2), Cut off point of IGF-1 SDS (≤ -1.2) and GF1( 2ng/ml) was low in72% of them. Diabetic patients with short stature have significantly earlier age of onset of diabetes, earlier age at diagnosis and longer duration of diabetes compared to those with normal stature (P < 0.05). Additionally, patients with short stature and those with delayed puberty have higher HbA1c. Patients with short stature also have higher lipid profile and lower IGF1 compared to those with normal stature (p < 0.05). Conclusion Children with uncontrolled T1DM are at risk of being short and had delayed puberty. IGF-1 level can be used as a screening test for short stature in diabetic children.