Growth, growth factors and diabetes

Eur J Endocrinol. 2004 Nov:151 Suppl 3:U109-17. doi: 10.1530/eje.0.151u109.

Abstract

Type 1 diabetes mellitus (T1DM) and other chronic diseases in children are well known to adversely affect linear growth and pubertal development. In the years immediately following the introduction of insulin therapy, short stature was consistently reported in children with T1DM. However, over the past 50 years significant improvement in the prognosis for growth and final height in children with diabetes has been achieved. Although pre-pubertal and post-pubertal growth are important phases in growth, puberty and its related hormonal changes represent a critical phase for growth gain and final height particularly in patients with T1DM. Growth impairment reported in diabetic patients is dependent on abnormalities in physiological bone growth and corresponds to abnormalities of the growth hormone-insulin-like growth-I (GH-IGF-I) axis. These alterations seem to be related to appropriate insulin levels and thereby to glycaemic control as judged by haemoglobin levels. Modern diabetes care, particularly intensified insulin regimens, might improve metabolic control in patients with T1DM, therefore preventing abnormalities of the GH-IGF-I axis and leading to normal growth and final height similar to that of their unaffected peers.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Blood Glucose
  • Body Height* / drug effects
  • Child
  • Diabetes Complications*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Growth Disorders / etiology
  • Growth Hormone / metabolism
  • Growth Hormone / physiology
  • Humans
  • Insulin / administration & dosage
  • Insulin / deficiency
  • Insulin-Like Growth Factor I / metabolism
  • Puberty

Substances

  • Blood Glucose
  • Insulin
  • Insulin-Like Growth Factor I
  • Growth Hormone