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

. 2018 Dec ; 19 (8) : 1441-1450. [epub] 20181010

Language English Country United States Media print-electronic

Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't

Grant support
Johnson & Johnson - International

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.

1st Department of Paediatrics Semmelweis University Budapest Hungary

Child and Young Department APDP Diabetes Lisbon Portugal

Childrens's Hospital Auf Der Bult Hannover Germany

DECCP Pediatric Clinic CHL Luxembourg Luxembourg Centre Hospitalier de Luxembourg Luxembourg Luxembourg

Department of Development and Regeneration KULeuven Leuven Belgium

Department of Endocrinology and Diabetes Our Lady's Children's Hospital Dublin Ireland

Department of Pediatric Aarhus University Hospital Aarhus Denmark

Department of Pediatric and adolescents Copenhagen University Hospital Herlev Denmark

Department of Pediatrics Motol University Hospital Prague Czech Republic

Department of Pediatrics University Hospitals Leuven KULeuven Leuven Belgium

Diabetology Unit Meyer Children's Hospital Florence Italy

Diacare Diabetes Care and Hormone Clinic Ahmedabad India

Division of Diabetes and Endocrinology Alberta Children's Hospital Department of Paediatrics University of Calgary Calgary Canada

Division of Endocrinology and Diabetes Hospital Sant Joan de Déu Barcelona Spain

Division of Endocrinology Metabolism and Diabetes 1st Department of Pediatrics National and Kapodistrian University of Athens Medical School Aghia Sophia Children's Hospital Athens Greece

Division of Pediatric Diabetes Department of Women's and Children's Health Salesi Hospital Ancona Italy

German Center for Diabetes Research Munich Neuherberg Germany

Institute of Epidemiology and Medical Biometry ZIBMT University of Ulm Ulm Germany

Non Profit Organisation T1Diams Quatre Bornes Mauritius

Pediatric Diabetes and Metabolic Disorders Unit and Regional Center for Pediatric Diabetes University Hospital University of Verona Verona Italy

Service d'endocrinologie gynécologie et diabètologie pédiatrique Hôpital universiataire Necker Enfants Malades Assistance publique Hôpitaux de Paris Faculté de médecine Paris Descartes Paris France

The Jesse and Sara Lea Shafer Institute of Endocrinology and Diabetes Schneider Children's Medical Center Petach Tikva Israel

The Queen Silvia Childrens Hospital Sahlgrenska University Hospital Gothenburg Sweden

References provided by Crossref.org

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