Endocrine Abstracts

Introduction: Type 1 diabetes (T1D) is the most frequent children’s endocrinopathy in Portugal. The duration of the disease and metabolic control may affect the final height of pediatric patients. Despite the metabolic advantages of technological advances, such as continuous subcutaneous insulin perfusion (CSII), the effect on growth is unclear.

Aim: To assess the impact of T1D treatment, with multiple daily injections (MDI) or CSII, on growth.

Materials and methods: Retrospective study with T1D patients born between 1996 and 2004. Considering 2 therapeutic groups (MDI vs CSII), patients were evaluated regarding age and pubertal Tanner stage at diagnosis, duration of T1D, metabolic control, presence of other autoimmune diseases, height and standard deviation (SD) at diagnosis and at age 18 and Mid Parental Target Height (MPTH). To compare growth between groups, the difference between the height SD at 18 years and MPTH SD was used (DifSD).

Results: From 131 patients, 52.7% were males (n=69). The mean age at T1D diagnosis was 9.4±4.3 years, mean disease duration was 8.6±4.3 years and total HbA1c was 7.5±1%. MDI group included 73 patients and the CSII group 58 patients (> 6 months, mean time of 3.8±2.6 years). At diagnosis, most were at Tanner Stage I on both groups (38 vs 46). Height SD at diagnosis was similar (0.18±1.16 vs 0.17±1, P=0.91). HbA1c was lower in the CSII group (7.7%±1.2 vs 7.3%±0.68 P=0.02) as well as MPTH SD (-0.67±0.8 vs -0.3±0.9, P=0.005). Mean height SD at age 18 was not different between groups (-0.21±0.98 vs -0.13±0.96, P=0.98). One patient had short stature without pathological cause. DifSD was lower in the CSII group (0.5±0.9 vs 0.17±0.9, P=0.02) and was associated with age at diagnosis and duration of DM1. There was no association between DifSD and pubertal Tanner stage at diagnosis, HbA1c and the presence of other autoimmune diseases.

Conclusions: The height SD at 18 years was comparable with the population without DM1. Despite the limitations of HbA1c in assessing glycemic control, it was lower in the CSII group. Even though MPTH has been reached regardless of the treatment, the difSDS in the group with CSII was lower, suggesting further fulfillment of growth potential.