Background: The combination of type 1 diabetes mellitus (T1DM) and GH deficiency is uncommon. In a previous study (1) we found that in children with T1DM and GHD with adequate adaptation of insulin dosage, the metabolic control of T1DM did not worsen during GH treatment. However, decreased catch-up growth was observed and no data on GH dose was available.
Objective: To analyse first year treatment growth response and GH dosage in prepubertal patients with T1DM and GHD.
Patients and method: A total of 69 patients with T1DM and GHD treated with GH have been documented in KIGS (Pfizer International Growth Database). Of these, 24 patients were prepubertal and were included in this analysis. Of 30 570 GHD patients without T1DM, 15 024 were prepubertal and served as controls.
Results: Patients with combined T1DM and GHD were older at start of GH treatment (median age at start of therapy 10.2 years (S.D. 3.13) compared to 8.42 years (S.D. 3.46) in controls, although statistically not significant, P=0.14). Height SDS corrected for mid-parental height SDS at start of treatment was not different between the two groups (−1.62 vs −1.61, P=0.80). There was also no significant difference in mean GH dosage (0.24 mg/kg per week vs 0.20 mg/kg per week, P=0.09). First year catch-up growth in prepubertal children was comparable within the two patient groups, median first treatment year height velocity 7.54 cm/year (S.D. 3.11) in children with T1DM and GHD compared to 8.35 cm/year (S.D. 2.54) in controls, P=0.38. Median height SDS of children with T1DM and GH deficiency improved from −2.62 (mean −2.58, S.D. 1.04) to −1.88 (mean −1.90, S.D. 1.11).
Conclusion: In KIGS database prepubertal children with T1DM and GH deficiency were treated with adequate GH dosage and demonstrated regular catch-up growth. Therefore taken together with previous data, GH treatment is safe and effective.
10 Sep 2016 - 12 Sep 2016