Growth and Pubertal Status in Children with Type 1 Diabetes: A Cross-Sectional Comparison with Non-Diabetic Controls.

Abstract

Background/Objectives: Type 1 diabetes mellitus (T1DM) has historically been associated with impaired linear growth and delayed pubertal development due to chronic insulin deficiency. Advances in intensive insulin therapy and glucose monitoring may have substantially reduced these effects. This study evaluated growth and pubertal development in children with T1DM treated with multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) compared with non-diabetic controls and investigated whether metabolic control was associated with anthropometric outcomes. Methods: This retrospective observational study included 177 children aged 3-18 years: 102 with T1DM (60 treated with MDI and 42 with CSII) and 75 non-diabetic hospital-based controls. Height SDS, BMI SDS, Tanner stage, biochemical parameters, and diabetes-related variables were analyzed. Comparisons, correlations and multiple linear regression analyses were performed to evaluate associations between metabolic control and anthropometric parameters. Results: No significant differences were observed between children with T1DM and healthy controls regarding height SDS, BMI SDS, or pubertal development. Likewise, no anthropometric differences were identified between the MDI and CSII groups. Fasting plasma glucose was significantly lower in the CSII group (p < 0.001), whereas HbA1c was comparable between treatment modalities. Neither HbA1c nor other routinely assessed metabolic parameters showed significant associations with height SDS or BMI SDS in correlation or multivariable regression analyses. Conclusions: Children and adolescents with T1DM showed no significant differences in height SDS, BMI SDS, or Tanner stage compared with controls, and similar anthropometric findings were observed in patients receiving MDI and CSII. These results suggest that major disturbances in attained height and pubertal status were not evident in this contemporary cohort of children with T1DM. However, given the retrospective cross-sectional design, longitudinal studies are needed to determine how contemporary diabetes management and long-term metabolic control influence growth trajectories and pubertal progression.