Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment

Lancet. 2000 Feb 19;355(9204):610-3. doi: 10.1016/S0140-6736(99)04055-6.


Background: Growth hormone (GH) contributes to insulin resistance, but whether children treated with GH are at increased risk of diabetes has not been established. We undertook a retrospective analysis of data from an international pharmacoepidemiological survey of children treated with GH to find out the incidence of impaired glucose tolerance and types 1 and 2 diabetes mellitus.

Methods: Reports to the survey of abnormal glucose metabolism were investigated and classified. The incidence and age-distribution of type 1 diabetes were compared with values from a model of reference data. The incidence of type 2 diabetes was compared with data from two reports of children not treated with GH.

Findings: 85 (0.36%) of 23333 children were reported with abnormal glucose metabolism. After investigation, 43 had confirmed glucose disorders (11 with type 1 diabetes, 18 with type 2 diabetes, and 14 with impaired glucose tolerance). The incidence and age at diagnosis of type 1 diabetes in children treated with GH did not differ from expected values. The incidence of type 2 diabetes was 34.4 cases per 100000 years of GH treatment which was six-fold higher than reported in children not treated with GH. Type 2 diabetes did not resolve after GH therapy was stopped.

Interpretation: GH treatment did not affect the incidence of type 1 diabetes mellitus in any age group. We postulate that the higher than expected incidence of type 2 diabetes mellitus with GH treatment may be an acceleration of the disorder in predisposed individuals.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Databases, Factual
  • Diabetes Mellitus, Type 1 / chemically induced*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Glucose Intolerance / chemically induced*
  • Glucose Intolerance / epidemiology
  • Growth Disorders / drug therapy
  • Human Growth Hormone / adverse effects*
  • Human Growth Hormone / therapeutic use
  • Humans
  • Incidence
  • Insulin Resistance
  • Male
  • Retrospective Studies


  • Human Growth Hormone