Objective: Linear growth is impaired in children with type 1 diabetes (T1D) and poor metabolic control. A good metabolic control is a key therapeutic goal to prevent vascular complications but also for ensuring an appropriate anthropometric development during childhood. In this study, we aimed to identify and characterize the effects of glycemic variability on linear growth in children with T1D.
Methods: Data from 144 prepubertal children with T1D were evaluated. Anthropometric measurements (weight, weight-SDS, height, height-SDS, BMI, BMI-SDS) were collected and glycosylated hemoglobin (HbA1c) was measured at admission and every four months over a 2-year period. Glycemic variability indexes (glycemic coefficient of variation [CV], glycemic CV percentage [CV%] and the product between HbA1c-mean and HbA1c-SDS/100 [M*SDS-HbA1c/100]) were calculated. According to height-SDS changes after 2-years of follow up, the study population was divided into three tertiles groups and differences across groups were investigated for variables of interest.
Results: The three groups were similar in terms of age, gender and follow up period. After 2 years, all prepubertal children showed a significant positive trend of anthropometric data. Across the three tertiles groups, HbA1c-SDS, CV, CV% and M*SDS-HbA1c significantly decreased from the first to the third tertiles of height-SDS. During follow-up children with lower Δheight-SDS values, reported higher values of HbA1c-SDS, CV, CV% and M*SDS-HbA1c than subjects with higher linear growth.
Conclusions: Glycemic variability correlates with the linear growth in children with T1D. Low glycemic variability indexes were reported in higher height-SDS tertile. Δheight-SDS is inversely correlated with glycemic CV, CV% and M*SDS-HbA1c.
15 Sep 2022 - 17 Sep 2022