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Horm Res Paediatr. 2018;89(3):172-177. doi: 10.1159/000486698. Epub 2018 Feb 16.

Growth Trajectory in Children with Type 1 Diabetes Mellitus: The Impact of Insulin Treatment and Metabolic Control.

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Endocrinology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Dipartimento di Endocrinologia e Diabetologia Pediatrica, Azienda Ospedaliera Policlinico Universitario, Catania, Italy.
Diabetes Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Dipartimento Universitario Ospedaliero, University of Rome Tor Vergata, Rome, Italy.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.



Linear growth was reported to be negatively affected by type 1 diabetes mellitus (T1DM), in relation to disease duration and poor metabolic control. It is unclear whether a subtle growth failure still persists despite the optimization of therapy. Our aim was to analyse pubertal growth, adult height, and metabolic profile in a cohort of children with T1DM undergoing intensive insulin treatment by multiple daily injections or continuous subcutaneous insulin infusion (CSII).


One-hundred and four children (51 males) with prepubertal onset of T1DM were prospectively followed up to final height attainment.


Age at puberty onset was 11.7 ± 1.1 years in males and 10.9 ± 1.3 in females. Age at adult height attainment was 16.4 ± 1.6 years in males and 14.1 ± 1.8 years in females. Pubertal height gain was 24.4 ± 4.9 cm in males and 19.0 ± 3.8 cm in females. HbA1c, HDL cholesterol, and triglyceride levels increased during puberty. HDL cholesterol levels were higher in patients treated with CSII. Height standard deviation score (SDS) at diagnosis (0.52 ± 1.04) was higher than target height SDS (0.01 ± 1.07), but declined afterwards, and both height SDS at puberty onset (0.22 ± 1.1) and adult height SDS (-0.1 ± 1.02) were not significantly different from target height SDS. BMI SDS showed a positive trend from diagnosis to puberty onset and stabilized later (-0.04 ± 1.4 at T1DM onset, 0.55 ± 2.1 at puberty onset, and 0.53 ± 2.1 at adult height attainment).


Although subtle abnormalities of growth still persist, the modern advancements of insulin therapy are able to normalize puberty and final height of children with T1DM.


Final height; Growth; Insulin; Puberty; Type 1 diabetes mellitus

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