Good glycemic control at puberty in boys with type 1 diabetes is important for final height.

Abstract

Poor glycemic control in children with type 1 diabetes (T1D) may hinder sexual development and the associated growth spurt. This study aims to identify factors that may affect the timing of puberty, total pubertal growth (TPG), and final height (F-Ht) in boys with T1D. This was a retrospective longitudinal study of 68 boys diagnosed with T1D during 1996 to 2009, who were prepubertal at diagnosis and had completed puberty at the time of data collection. Data were accessed regarding anthropometric measurements, Tanner stage, and glycosylated hemoglobin (HbA1c) levels from diagnosis to F-Ht. F-Ht was compared to parental height and Israeli National Health Survey data. The mean F-Ht standard deviation score (F-Ht-SDS) was lower than the mean Ht-SDS at diagnosis (P< .006) but similar to the mean target height SDS (P= .3) and to values from the national survey (P= .12). Mean HbA1c levels in the year preceding pubertal onset were associated with the age at onset of puberty (R= 0.33, P= .009) and inversely with TPG (R= -0.3, P= .03). Mean HbA1c levels during puberty were inversely associated with TPG (R= -0.26, P= .035) and F-Ht (R= -0.28, P= .02). Boys who presented with diabetic ketoacidosis at diagnosis were shorter than those who did not throughout the follow-up. We found associations of age of pubertal onset, pubertal growth spurt, and F-Ht with target height and glycemic control before and during puberty. Targeted interventions to achieve optimal metabolic control during these time periods are needed for normal, timely puberty and for achieving optimal adult height within the genetic target height.