ESPE Abstracts (2018) 89 P-P1-155

Prevalence of Diabetes among Children Treated with Growth Hormone in Israel

Miri Lutskia, Inbar Zukera,b, Carmit Librudera, Orit Blumenfelda, Zvi Zadikc, Tamy Shohata,d & Zvi Larone


aIsrael Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel; bDepartment of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; cPediatric Endocrinology Unit, Kaplan Medical Center, Rehovot, Israel; dDepartment of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; dEndocrinology and Diabetes Research Unit, Schneider Children’s Medical Center, Petah Tikva, Israel


Background: Growth hormone (GH) is a diabetogenic hormone.

Objective: To determine the long term risk for diabetes in a cohort of children treated with recombinant human (rhGH) in Israel, using data from the Israeli National Diabetes Register (INDR) for 2014 as a reference.

Methods and patients: Between the years 1988 and 2009, 2,513 children under the age of 19 were approved for GH treatment. The patients were categorized to a low-risk category that included patients treated for isolated GH deficiency and small for gestational age and a high-risk category that included patients treated for multiple pituitary hormone deficiency, chronic renal failure, Turner syndrome and Prader-Willi syndrome. This cohort was cross linked with the Israeli National Diabetes Register for 2014 and prevalent cases with diabetes were identified. The expected number of patients with diabetes was calculated for each risk category using the diabetes prevalence rates in 2014 as a reference. Standardized prevalence ratios (SPRs) of diabetes were calculated for the age group 10–29 years. The calculations were repeated after excluding patients who had diabetes before the commencement of GH treatment.

Results: Diabetes was identified in 23 patients. In the low risk category there was no difference in the prevalence of diabetes compared to the general population (SPR 2.05, 95% CI 0.94–3.89). In the high risk category there was a significantly higher prevalence of diabetes (SPR 11.94, 95% CI 6.53–20.0) compared to the general population. After exclusion of people with pre-existing diabetes, the SPR in the all-risk category was slightly attenuated.

Conclusion: GH treatment in individuals with pre-existing risk factors for diabetes is associated with increased prevalence of diabetes; therefore their glucose should be closely monitored during and after the treatment.

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