Endocrine Abstracts

JOINT1744

Introduction: Adequate linear growth and final height are major aims during treatment of type 1 diabetes (T1D) in children. Such items could be influenced by suboptimal glycemic control. Modern intensified insulin therapies are fundamental tools to reach adequate metabolic control.

Aim: To evaluate growth during puberty in children and adolescents with T1D followed up at a Pediatric Endocrinology center, HIAEP Sor María Ludovica, Buenos Aires, Argentina.

Material and methods: Forty-four children with T1D were evaluated (54.5% Male), regarding mean age, height, mean target height, HbA1c at T1D onset, at the start of puberty (thelarche stage ≥ 2 or testicular volume ≥ 4 ml), at the end of puberty (menarche or testicular volume ≥ 15 ml), at pubertal growth peak, and at discharge, clinical condition at T1D debut and diabetes duration. Quantitative variables were analyzed using the Shapiro-Wilk test. Growth and HbA1c levels were compared (Student’s/Mann-Whitney tests). Correlations between anthropometrics and HbA1c were estimated (Pearson/Spearman coefficients).

Results: Median age at diagnosis was 8.49 (4,82; 9,97) and mean HbA1c at onset was 12,56±2,76. Mean height SDS was 0.52±1.34 at diagnosis and 0.47±0.97 at the end of puberty, mean height gain was 16.63±6.29 cm in males and 14.97±5.92 cm in females. At discharge, mean height SDS was 0.22±0.96 in males and -0.74± 1.05 in females. Mean SDS target height was -0.45±1.16. Median HbA1c was 8.70% at pubertal onset and 9.10% at puberty end, with no significant correlation between height gain or diabetes duration. Acute complications were experienced by 70.5% of patients and chronic complications by 34,1% at Lipodystrophy (61.4%), and hypertension (34%) were the commonest. Most presented ketoacidosis (50%) and ketosis without acidosis (42.2%) at debut. Mean diabetes duration was 7.84±2.92 years. No significant differences in HbA1c were found between patients with and without complications. Associated conditions (hypothyroidism 31.8%, celiac disease 13.6%) were found in 54.5% of patients. No significant differences in growth compared to patients without these conditions.

Conclusions: This cohort of children with T1D presented adequate growth during puberty, reaching their target height, despite suboptimal HbA1c levels. Acute complications and the presence of associated conditions did not affect the final growth outcomes.