Crescimento e puberdade na diabetes mellitus tipo 1 – experiência de uma unidade de endocrinologia pediátrica

Abstract

Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease in children. It is associated with vascular and neuropathic complications, and may also affect growth and development. To correlate the metabolic control and disease duration with growth and puberty in patients with T1DM followed in a Pediatric Endocrinology Outpatient Clinic. Retrospective analysis. Sample obtained from patients with T1DM followed in Hospital Santa Maria Pediatric Endocrinology Outpatient Clinic (Lisbon - Portugal) since 1994 until March 2011. patients diagnosed before the onset of puberty and who had attained their final height during the follow-up. sex, age, weight and height at diagnosis and final, parents' height, growth velocity, pubertal height gain, age at menarche and metabolic control during puberty. 39 patients, 51% female, 82% diagnosed less than five years before puberty. Fifty-four percent presented an average HbA1c between 8-10%, what we considered reasonable. There seems to be a trend towards an inverse association between HbA1c and the maximum speed of growth and pubertal height gain, although not statistically significant. These patients were taller than average at diagnosis (z-score: male 0.9; female: 0.5) and lost height during puberty, yet attained final heights within normal range and matching their target heights. Although HbA1c seems to negatively influence maximum growth rate and pubertal height gain, there was no compromise in final height in this group of patients.