Study of growth parameters in children and adolescents with type 1 diabetes mellitus

Abstract

Objectives: Data on anthropometry in children with type 1 diabetes mellitus (T1D) are sparse in India. The study aimed to assess the growth parameters and the effect of age at diagnosis, duration of diabetes, hemoglobin A1C (HbA1c), and insulin regimens on the growth of children with T1D. Material and Methods: The study included subjects with T1D between the ages of 1 and 18 years, with a duration of diabetes for at least one year. Height for age Z-scores (HAZ), weight for age Z-scores (WAZ), and body mass index for age Z-scores (BAZ) were calculated using standard Indian Academy of Pediatrics 2015 growth charts for Indian children.The study design was an observational cross-sectional study. Results: The number of subjects was 57 (F: M 30:27). The median age (interquartile range) was 13.8 (9–17.1) years, the age at diagnosis was 8 (4–11.5) years, and the mean duration of T1D was 5 (3–7) years. The mean HbA1c was 10.33 ± 1.88%. The growth parameters as assessed by HAZ −0.83 (−1.98–−0.16), WAZ −0.98 (−1.72–−0.11), and BAZ −0.55 (−1.41–0.1) were low in comparison to the population medians. The age at diagnosis, duration of diabetes, and the type of insulin regimen did not significantly impact HAZ and WAZ. Children with HbA1c <8.5% had better HAZ −0.21 (−0.94–0.35) versus −1.07 (−2.07–−0.25), (P = 0.069), and WAZ −0.33 (−0.73–0.23) versus –1.07 (−1.77–−0.29), (P = 0.041) compared to those with HbA1c >8.5%. Conclusion: Children with T1D were shorter and leaner than age- and sex-matched controls. Age at diagnosis, duration of diabetes, and insulin regimens did not significantly impact growth, whereas children with lower HbA1c had better HAZ and WAZ.