Pediatric Diabetes 2002: 3: 189–193 Copyright C Blackwell Munksgaard 2002 Printed in Denmark. All rights reserved Pediatric Diabetes ISSN 1399-543X Original Article Linear growth and height outcomes in children with early onset type 1 diabetes mellitus – a 10-yr longitudinal study Kanumakala S, Dabadghao P, Carlin JB, Vidmar S, Cameron FJ. Linear Shankar Kanumakala a , growth and height outcomes in children with early-onset type 1 diabetes Preeti Dabadghao a , mellitus – a 10-yr longitudinal study. John B. Carlin b,c , Pediatric Diabetes 2002: 3: 189–193. C Blackwell Munksgaard, 2002 Suzanna Vidmar b,c and Fergus J. Cameron a Abstract: Objective: To assess the linear growth and height outcomes and a Department of Endocrinology & the influence of metabolic control on the near-final height in children Diabetes, Royal Children’s Hospital, with early onset type 1 diabetes mellitus (DM). Parkville; b Clinical Epidemiology & Study Design and Methods: Retrospective longitudinal evaluation of 99 Biostatistics Unit, Murdoch Children’s children with prepubertal onset of type 1DM before 8yr of age, who Research Institute, Parkville; and were regularly assessed, clinically and metabolically, from 8yr of age to c Department of Paediatrics, University of 17.99yr of age. Melbourne, Australia Results: The mean prepubertal height Z scores at 8yr of age were ª0.17 (standard deviation, SD Ω 0.99) for boys and ª0.29 (1.19) for girls, Key words: body height – growth – respectively. There was normal linear growth in girls with their mean near- HbA1c – longitudinal study – type 1 final height Z score being ª0.13 (1.07). This was not statistically different diabetes mellitus from the mean at 8yr (p Ω0.13). The mean near-final height Z score in Corresponding author: Dr Fergus J boys was ª0.39 (0.98), which was 0.22 SD lower than their mean prepubertal Cameron, Department of Endocrinology & height Z score (p Ω0.03). There was no significant correlation between Diabetes, Royal Children’s Hospital, metabolic control and linear growth in either males or females. Parkville 3052, Australia. Tel: π61 39345 Conclusions: Linear growth and near-final height in children with type 1 5951; fax: π61 39347 7763; e-mail: DM compares favorably with the general population. Although there was fergus.cameron/cryptic.rch.unimelb.edu.au some evidence of suboptimal peripubertal growth in boys, the actual extent of this height reduction was minimal and was not correlated with their Submitted 9 May 2002. Accepted for metabolic control. publication 17 September 2002 Normal growth is a steady and continuous process, with some age, sex and pubertal variations occurring. In type 1 diabetes mellitus (DM), additional factors such as age of diabetic onset, duration of diabetes, coexisting diseases and degree of metabolic control of diabetes can potentially influence growth (1). Growth failure has historically been associated with children with type 1 DM with or without insulin therapy (2). Mauriac syndrome illustrates the extreme example of growth failure in type 1 DM, with dwarfism, hepatomegaly, sexual immaturity and obesity (3–5). With major advances in insulin prep- arations, capillary blood glucose monitoring devices and appropriate nutrition, such severe growth retar- dation is now a very rare occurrence in many coun- tries worldwide (6). However, several investigators 189 have suggested that children with type 1DM suffer growth retardation during the course of their diabetes (7–18). Other investigators have not demonstrated any negative effect on growth (19). Some authors have used normal growth velocity as a surrogate marker of good control of diabetes (15, 20) but the link between linear growth and metabolic control is not well established (15, 21–23). Early onset and long duration of diabetes in children have also been associated with poor growth. Several studies show that patients with prepubertal onset of diabetes lose more height than those with pubertal or postpubertal onset (8–10,13, 15–18). However, many of these studies suffer from small numbers of patients or limited follow-up. In this study we analyzed auxologic data from