ESPE Abstracts (2019) 92 P1-187

Course of Puberty and Growth Spurt in Boys with Type 1 Diabetes

Hana Shpitzer1,2, Liora Lazar1,2, Shlomit Shalitin1,2, Moshe Phillip1,2, Liat de Vries1,2

1Sackler Faculty of Medicine, Tel Aviv, Israel. 2The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel

Background: Data on the course of puberty and pubertal growth in boys with Type 1 diabetes (T1D) are sparse.

Objectives: To study the course of puberty, pubertal growth and final height in boys with T1D as well as possible factors affecting these.

Methods: In this retrospective longitudinal study, 68 boys diagnosed with T1D between 1996-2009 who were pre-pubertal at diagnosis and had completed puberty served as the cohort. Collected were data on anthropometric measurements, Tanner stage, and HbA1c levels from diagnosis to final height (F-Ht). F-Ht was compared to parental height and to the data of the national health survey

Results: In the study cohort final height-SDS was lower than that at diagnosis. It was similar to parental Ht-SDS as well as to that of the national health survey (P=0.126). F-Ht was inversely related to average HbA1c during puberty (R=-0.27, P=0.045). Boys who presented with diabetic ketoacidosis at diagnosis were shorter than those who did not throughout the entire follow-up. Age at onset of puberty was significantly related to the age of maternal menarche (R=0.44, P=0.01) and to HbA1c levels in the year preceding puberty onset (R=0.36, P=0.01). Total pubertal growth was inversely related to HbA1c levels in the year preceding onset of puberty (average R=-0.3, P=0.03)

Conclusions: Boys with T1D diagnosed before puberty achieve final height similar to that of their parents and that of the general population. Diabetic ketoacidosis at the diagnosis is associated with diminished F-Ht. Age of pubertal onset and F-Ht are affected by genetic factors as well as by glycemic control before and during puberty. These results emphasize the importance of tight metabolic control in adolescents, to enable growth within the genetic target.

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