ESPE Abstracts (2018) 89 P-P1-068

Impact on Final Height of Functional Insulin-Therapy in Type 1 Diabetes Mellitus Pediatric Patients - Experience from a Portuguese Pediatric Endocrinology Unit

Joana Serra-Caetanoa, Ana Lopes Diasb, Ana Ferraza, Adriana Lagesc, Patrícia Mirandad, Rita Cardosoa, Isabel Dinisa & Alice Mirantea

aCoimbra Pediatric Hospital – Universitary and Hospital Central of Coimbra, Coimbra, Portugal; bPediatric Service, Vila Real Hospital, Vila Real, Portugal; cEndocrinology, Coimbra Pediatric Hospital – Universitary and Hospital Central of Coimbra, Coimbra, Portugal; dPediatric Service, Leiria Hospital, Leiria, Portugal

Introduction: Type 1 diabetes mellitus (1DM) has well known long term vascular and neuropathic complications. It has also been described a positive effect of good glycemic control on physical growth and pubertal development, achieved with improvement of insulin-therapy.

Aim: To evaluate the effect of functional insulin-therapy on final height in children with type 1 diabetes mellitus.

Methods: Retrospective analysis of a cohort of portuguese 1DM children followed up to final height at a tertiary Hospital clinic from 1981 to 2017. Variables collected: age at diagnosis, sex, 1DM duration, type of treatment (conventional vs functional), height at diagnosis, final height, BMI, family target height (FTH), age at pubertal start, mean A1c, blood pressure (BP) and lipid profile.

Statistical analysis: SPSS®v22 (P<0.05). Results: 264 children were distributed according to type of therapy: group A (under conventional therapy), with 108 children, 57 (52.8%) males, with mean age at diagnosis of 8.3±3.1years, 9.6±3.5years of disease duration and 164.6±8.7 cm FTH; and group B (under functional therapy), 156 children, 82 (52.6%) males, with mean age at diagnosis of 8.4±3.9years, 9.7±4.0 years of disease duration and 166.5±8.9 cm FTH; and group B (under functional therapy). Comparing groups A and B, there were significant statistical differences regarding mean A1c 9% vs 8.1%, r<0.001), systolic BP (123.5 mmHg vs 120 mmHg, r=0.02), diastolic BP (67.5 mmHg vs 65.9 mmHg, r=0.011), HDL cholesterol (1.4 mmol/l vs 1.5 mmol/l, r=0.027) and age at puberty start (11.6 vs 11 years, r<0.001). Final height was higher than FTH in both groups and there was not different between groups (166 vs 168 cm, r=0.079). However, in group B longer duration of functional insulin-therapy was related with higher final height (Pearson 0.17, P=0.03).

Conclusions: Functional insulin-therapy had a positive effect on metabolic control and decreased microvascular complications, but this had no significant impact on final height.