GROWTH IN DIABETIC CHILDREN: Studies in Identical Twins

Abstract

An inquiry to determine whether early-onset diabetes leads to retardation of growth and development is described. Healthy monozygotic twins are normally very similar in height and therefore provide ideal comparisons for the effect of disease on height. The adult height and age of menarche in 35 young-onset identicaltwin pairs, one or both of whom has diabetes, have been studied. In all but one of 12 pairs in which one twin developed diabetes before puberty and the other did not, the affected twin was shorter; the mean difference was 21/4 in., which is much more than would be expected by chance. In the pairs in which diabetes appeared after puberty in one or both twins there was no significant difference in height. When both twins developed diabetes before puberty, again there was no significant difference in height. In 2 pairs of girl twins in whom diabetes appeared before puberty in one but not in the other, menarche was 4 and 5 years later in the affected than in the unaffected twin, whereas in the other pairs the difference was only about 1 month. These differences were seen despite apparently satisfactory diabetic control. It is concluded that diabetes of early onset leads to retardation of growth and development, even when its treatment is adequate as judged by conventional criteria, that these criteria are inadequate, and that the control of insulin-dependent diabetes is almost always poor.