Growth and development in type 1 diabetes

• Published in: Current opinion in endocrinology, diabetes, and obesity Vol. 29; no. 1; p. 57
• Main Author: Koren, Dorit
• Format: Journal Article
• Language: English
• Published: England 01.02.2022
• Subjects: Adolescent; Child; Diabetes Mellitus, Type 1; Diet, Carbohydrate-Restricted; Growth and Development; Human Growth Hormone; Humans; Hyperglycemia
• ISSN: 1752-2978
• DOI: 10.1097/MED.0000000000000694

The purpose of this review is to summarize the current literature on the subject of linear growth in children and adolescents with or at risk for type 1 diabetes mellitus (T1DM). Poor glycemic control in T1DM is associated with growth hormone resistance, and improving glycemic control can improve linear growth. Newer reports suggest that the increasingly popular very low carbohydrate diets, may reduce linear growth velocity. Linear growth during childhood is a complex process regulated influenced by genetic, hormonal, nutritional and environmental factors. Linear growth may be impaired in children with T1DM, correlating with poor metabolic control; an extreme example is Mauriac syndrome. This decrement in linear growth appears to be driven in part by a reduction in growth hormone responsiveness, leading to low insulin-like growth factor-1 (IGF-1) levels. Improving glycemic control can lead to improved IGF-1 levels and linear growth. Other factors associated with poor linear growth in T1DM include celiac disease and dietary alterations, with early reports suggesting that very low carbohydrate diets, if not carefully managed, may increase risk of attenuated linear growth. This review examines the latest data regarding the associations between T1DM and linear growth in children.