Growth, growth factors and diabetes

Abstract

Type 1 diabetes mellitus (T1DM) and other chronic diseases in children are well known to adversely affect linear growth and pubertal development. In the years immediately following the introduction of insulin therapy, short stature was consistently reported in children with T1DM. However, over the past 50 years significant improvement in the prognosis for growth and final height in children with diabetes has been achieved. Although pre-pubertal and post-pubertal growth are important phases in growth, puberty and its related hormonal changes represent a critical phase for growth gain and final height particularly in patients with T1DM. Growth impairment reported in diabetic patients is dependent on abnormalities in physiological bone growth and corresponds to abnormalities of the growth hormone -insulin-like growth-I (GH -IGF-I) axis. These alterations seem to be related to appropriate insulin levels and thereby to glycaemic control as judged by haemoglobin levels. Modern diabetes care, particularly intensified insulin regimens, might improve metabolic control in patients with T1DM, therefore preventing abnormalities of the GH -IGF-I axis and leading to normal growth and final height similar to that of their unaffected peers. European Journal of Endocrinology 151 U109-U117

The Effect of Type 1 Diabetes Mellitus on the Craniofacial Complex

“…It regulates osteoclastic differentiation from hematopoietic mononuclear cells, and osteoblastic functions and activity (Collins et al, 1998;Duarte et al, 2005). Moreover, Insulin may indirectly regulate the enhancement of growth hormone serum concentration by direct regulation of the hepatic growth hormone receptor, this results in abnormalities in the insulin growth factor-1 in T1DM (Chiarelli et al, 2004) which consequently may have lead to the retarded growth in uncontrolled DM in the current study.…”

Assessment of the somatic development in adolescents with type 1 diabetes based on anthropometric parameters with reference to the peer population

“…Jednak systematyczna opieka lekarska i samokontrola w połączeniu z oceną rozwoju fizycznego, prawidłową kontrolą glikemii oraz zmianą trybu życia i sposobu odżywiania pozwalają na opóźnienie wystąpienia powikłań przewlekłych cukrzycy, zmniejszenie ilości powikłań ostrych i zapewnienie prawidłowego rozwoju somatycznego, wysokości i masy ciała oraz pokwitania. Wła-ściwa edukacja i reedukacja są niezbędne w leczeniu pacjentów z cukrzycą [10][11][12].…”

“…Średni wiek kalendarzowy dziewcząt wynosił 14,6 ± 0,3 lat (95% CI: 13,9 -15,3), a chłopców 15,6 ± 0,4 lat (95% CI: 14,[8][9][10][11][12][13][14][15][16]3). Pacjenci leczeni byli intensywną funkcjonalną insulinoterapią oraz indywidualnymi pompami insulinowymi.…”

“…W badaniach Chiarelli i wsp. wykazano, że u dzieci leczonych intensywną insulinoterapią i dobrze wyrównanych metabolicznie, niezależnie od fazy pokwitania, przy czasie trwania choroby powyżej 5 lat wysokość ciała nie różniła się istotnie od grupy kontrolnej [11]. Holl i wsp.…”

The Effect of Metformin as an Adjunct Therapy in Adolescents with Type 1 Diabetes

“…Moreover, it has been observed that in adolescents with T1DM, the increase of growth hormone level during puberty is intensified compared with non-diabetic peers, leading to intensified insulin resistance in this population [8][9][10][11][12][13][14].…”