E-Mail karger@karger.com Original Paper Horm Res Paediatr DOI: 10.1159/000360856 Combined Therapy with Insulin and Growth Hormone in 17 Patients with Type-1 Diabetes and Growth Disorders Stefano Zucchini   a Dario Iafusco   b Silvia Vannelli   c Ivana Rabbone   c Giuseppina Salzano   d Gabriella Pozzobon   e Mohamad Maghnie   f Valentino Cherubini   g Carla Bizzarri   h Riccardo Bonfanti   e Giuseppe D’Annunzio   f Lorenzo Lenzi   i Maria Cristina Maggio   j Marco Marigliano   k Andrea Scaramuzza   l Stefano Tumini   m Lorenzo Iughetti   n a  Department of Pediatrics, S. Orsola-Malpighi Hospital, Bologna, b  Department of Pediatrics, Second University of Naples, Naples, c  Department of Pediatrics, University of Turin, Turin, d  Department of Pediatrics, University of Messina, Messina, e  Department of Pediatrics, Endocrine Unit, Scientific Institute Hospital San Raffaele, Vita-Salute University, Milan, f  Pediatric Clinic, IRCCS Giannina Gaslini Institute, Genoa, g  Division of Pediatric Diabetes, Maternal- Infant Department, G. Salesi Hospital, Ancona, h  Bambino Gesù Children’s Hospital, Rome, i  Meyer Children’s Hospital, Florence, j  Maternal Infantile Department, University of Palermo, Palermo, k  Department of Life and Reproduction Sciences, University of Verona, l  Luigi Sacco Hospital, Milan, m  Department of Pediatrics, University of Chieti, Chieti, n  Department of Pediatrics, University of Modena and Reggio Emilia, Modena, Italy T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients af- fected by GH deficiency ranged from –0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA 1c was unchanged during the first 6 months of combined therapy. Conclusions: Most Italian physicians do not consider pre- scribing the combined GH-insulin therapy in diabetic chil- dren with growth problems. However, the results of the 17 patients identified would confirm that the combined thera- py was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control. © 2014 S. Karger AG, Basel Key Words Growth hormone · Insulin therapy · GH deficiency · Type-1 diabetes · Turner syndrome Abstract Background/Aim: Combined growth hormone (GH) and in- sulin therapy is rarely prescribed by pediatric endocrinolo- gists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM). Methods: A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected. Results: Data from 42 centers (84%) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before Received: August 14, 2013 Accepted: February 25, 2014 Published online: June 11, 2014 HORMONE RESEARCH IN PÆDIATRICS Stefano Zucchini Department of Pediatrics S. Orsola-Malpighi Hospital Via Massarenti 11, IT–40138 Bologna (Italy) E-Mail stefano.zucchini  @  aosp.bo.it © 2014 S. Karger AG, Basel 1663–2818/14/0000–0000$39.50/0 www.karger.com/hrp Downloaded by: Azienda Ospedaliera Malpighi 137.204.230.5 - 6/11/2014 4:57:02 PM