Growth Studies of Children With Diabetes Mellitus

Abstract

Since the beginning of the use of insulin, it has been possible for children with diabetes to approach the status of normal children, in contrast to the marked retardation of development shown previous to its use.A study of the physiologic progress of children suffering with diabetes under the modern regimen should furnish valuable information, and determine whether it is possible for these children to attain maturity with a normal physique.The information obtained from such a study of the diabetic child should be applicable also to problems concerning the nutrition and development of the nondiabetic child. When the normal person is studied, his many compensatory mechanisms will often mask a response which would be obvious if his margin of metabolic balance were reduced to the minimum, as is the case in children with diabetes. It is well known that children suffering with diabetes, if untreated, react rapidly to adverse conditions by diminution of growth. A regimen which will result in normal development in these children should be even more effective if applied to the nondiabetic child.During the past five years approximately sixty diabetic children have been observed in this clinic, and thirty-two of these have been studied during repeated periods of hospitalization. The total number of hospital admissions of the various patients is 242. Metabolic studies of various types have been made. The data pertaining to the physical development of these children will be outlined in this article. Other studies will be reported later.For the past two years, a standardized type * of diabetic management has been employed. This should make developmental observations more significant, since the diet for each child has been qualitatively similar, and quantitatively proportional to the degree of physiologic development as determined by the height.

Height of diabetic children at onset of symptoms

“…In this study, by using SD scores, diabetic boys were found to be significantly taller Boyd and Nelson (1928) Baldwin 20 'Slightly overheight'* Jackson and Kelly (1946) Jackson 86 Shorter Beal (1948) Stuart than diabetic girls. A sex difference was not found for the subgroups 4-9 years and 9-14 years, but a sex difference could conceivably have been shown to occur if both subgroups had been larger.…”

Change in glycemic control predicts change in weight in adolescent boys with type 1 diabetes

“…Within 3 yr of treating diabetic children with insulin, Joslin et al (1) reported that the weight velocity of these children exceeded that of normal children. Thereafter, others reported that inadequate insulin delivery in children with type 1 diabetes (T1D) resulted in lesser weight gain or even weight loss (2–4).…”