Longitudinal data on growth and final height in diabetic children

The available data on growth in children with insulin-dependent diabetes mellitus are conflicting and are mainly derived from cross-sectional studies. In this longitudinal study, height, weight, skeletal age, and pubertal development were recorded until final height was attained in 46 children (22 girls and 24 boys) with onset of diabetes before the age of 10 y. At the onset of diabetes, height SD score (SDS) averaged 0.41 in girls and 0.56 in boys, which was normal when corrected for the secular trend. Prepubertal growth was unaffected in both sexes. Diabetic boys had a marked delay in onset of puberty (mean age at genitalia stage 2: 13.7 y) but attained a normal final height (final height SDS: 0.48 +/- 0.89). In girls final height was slightly reduced (height SDS 0.27 +/- 0.97) due to a suboptimal pubertal growth spurt. Mean pubertal height gain in girls was 16.6 cm and mean age at breast stage 2 was 11.6 y. Diabetic girls also tended to become obese during puberty. Skeletal maturation was normal at all ages. These data suggest that conventional therapy does not guarantee optimal growth, especially in girls.