Auxological profile and puberty attainments based on metabolic control in adolescents with type 1 diabetes

Objective

To study growth trends and pubertal alterations in type 1 diabetes (T1D) children from northwest India.

Methods

A total of 208 children aged 8 to 18 years (boys, 109; girls, 99) diagnosed with T1D were enrolled from the Department’s Pediatric Endocrinology Clinic. Anthropometric and sexual maturation assessment was made in the Growth Laboratory using standardized instruments and scale. Demographic, socioeconomic, and clinical data (disease duration, glycemic control, and insulin details) were noted for each subject.

Results

Among T1D children, mean age at diagnosis was 8.04 ± 2.84 years and mean duration of therapy was 3.72 ± 3.27 years. All patients were on basal bolus regimen, and 77% had elevated insulin requirements. A good metabolic control was found in 24% of T1D children. Height and weight attainments of T1D children being higher at onset, i.e. 8 years, than their normal peers remained lower thereafter, indicating compromised auxological status. 8.2% and 12.4% of T1D children were underweight and short statured respectively. 33.3% of our T1D girls had attained menarche (mean age: 12.71 ± 1.89 years). The average age at which T1D girls entered puberty, i.e. stage B2, was 10.56 ± 1.29 years. Mean age of initiation of puberty in T1D boys (stage-G2) was 10.49 ± 1.65 years. The pubertal onset and progression among our patients was comparable to their normal peers. Notably, T1D children with poor control showed compromised physical growth.

Conclusions

Impaired growth is a notable concern among T1D children; crucial determinant being the duration of disease and level of metabolic control. However, pubertal development in our cohort proceeded without anomalies.