The long-term effects of childhood-onset type 1 diabetes on growth and development: systematic review

Abstract

The increasing prevalence of childhood-onset type-1 diabetes (T1D) has brought to light its multifaceted implications on growth and development. This necessitates a holistic understanding of its long-term effects on physical, neurological, metabolic, and psychosocial aspects. Thus, this study systematically reviewed the long-term effects of childhood-onset T1D on growth and development in children and adolescents. Using the PRISMA guidelines, a comprehensive search was conducted mainly on PubMed for studies in English, resulting in the inclusion of nine studies with a collective participant count of 24,880. These studies spanned across various geographical locations, with a predominant focus on the younger demographic, averaging around 11 years of age. The findings indicated significant associations of T1D with altered physical growth patterns, neurological and cognitive implications, metabolic outcomes, and psychosocial challenges. Notably, growth complications and cognitive patterns seemed to intertwine with T1D onset and management. Studies showed that poor glycemic control and early T1D onset, negatively impact the projected adult height of the child. Additionally, poor glycemic control implications such as diabetic ketoacidosis have a negative impact on cognitive functions. Finally, psychosocial complications of T1D and obesity, particularly in adolescent girls, highlighted the importance of parental education and perceived stress on these vulnerable children. Childhood-onset T1D has profound implications on growth and development. While effective glycemic control is beneficial to reduce these complications, a multidisciplinary approach, encompassing endocrinology, neurology, and psychology, is essential for comprehensive care and improved life quality in these children.