The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes—A SWEET collaborative study

Svensson, Jannet; Schwandt, Anke; Pacaud, Danièle; Beltrand, Jacques; Birkebæk, Niels H; Cardona-Hernández, Roque; Casteels, Kristina; Castro, Sofia; Cherubini, Valentino; Fisch, Naama; Hasnani, Dhruvi; Kordonouri, Olga; Kosteria, Ioanna; Luczay, Andrea; Pundziūtė-Lycka, Austė; Maffeis, Claudio; Piccini, Barbara; Poran, Luxmi; Šumnı́k, Zdenĕk; Beaufort, Carine de

doi:10.1111/pedi.12751

Cited by 10 publications

(12 citation statements)

References 25 publications

(74 reference statements)

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“…1,3,6,7,28 A study that collected data from 55 centers in an international network for pediatric diabetes centers (SWEET) found that the F-Ht z scores in males were significantly lower than height z score at onset in all regions, except for northern Europe. 29 The age at puberty onset (11.9 ± 1.16 years) in our cohort was similar to that recently described in boys with T1D in Italy (11.7 ± 1.1) 6 and strongly associated with age at maternal menarche. This indicates that genetic factors are major contributors to pubertal timing among boys with T1D, as in the general population.…”

Section: Discussionsupporting

confidence: 89%

Good glycemic control at puberty in boys with type 1 diabetes is important for final height

Shpitzer

Lazar

Shalitin

et al. 2021

Journal of Diabetes

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Background: Poor glycemic control in children with type 1 diabetes (T1D) may hinder sexual development and the associated growth spurt. This study aims to identify factors that may affect the timing of puberty, total pubertal growth (TPG), and final height (F-Ht) in boys with T1D.Methods: This was a retrospective longitudinal study of 68 boys diagnosed with T1D during 1996 to 2009, who were prepubertal at diagnosis and had completed puberty at the time of data collection. Data were accessed regarding anthropometric measurements, Tanner stage, and glycosylated hemoglobin (HbA1c) levels from diagnosis to F-Ht. F-Ht was compared to parental height and Israeli National Health Survey data. Results: The mean F-Ht standard deviation score (F-Ht-SDS) was lower than the mean Ht-SDS at diagnosis (P < .006) but similar to the mean target height SDS (P = .3) and to values from the national survey (P = .12). Mean HbA1c levels in the year preceding pubertal onset were associated with the age at onset of puberty (R = 0.33, P = .009) and inversely with TPG (R = À0.3, P = .03). Mean HbA1c levels during puberty were inversely associated with TPG (R = À0.26, P = .035) and F-Ht (R = À0.28, P = .02). Boys who presented with diabetic ketoacidosis at diagnosis were shorter than those who did not throughout the follow-up. Conclusions:We found associations of age of pubertal onset, pubertal growth spurt, and F-Ht with target height and glycemic control before and during puberty. Targeted interventions to achieve optimal metabolic control during these time periods are needed for normal, timely puberty and for achieving optimal adult height within the genetic target height. K E Y W O R D S diabetic ketoacidosis, glycemic control, puberty, type 1 diabetes mellitus Highlights• Boys with type 1 diabetes diagnosed before puberty achieved a final height that was similar to that of their target height and the general population.

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Section: Discussionsupporting

confidence: 89%

Good glycemic control at puberty in boys with type 1 diabetes is important for final height

Shpitzer

Lazar

Shalitin

et al. 2021

Journal of Diabetes

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“…However, a long-term increase in BMI in T1D patients can lead to insulin resistance 10 , poor glycemic control 39 , dyslipidemia, hypertension 10 , 40 , and an increased risk of cardiovascular disease 10 . The prevalence of childhood obesity has dramatically increased worldwide 41 , and similar findings have been observed in T1D 39 , 40 , 42 . A recent multinational study reported that up to 30% of children and adolescents with T1D were overweight or obese 42 .…”

Section: Discussionsupporting

confidence: 65%

“…The prevalence of childhood obesity has dramatically increased worldwide 41 , and similar findings have been observed in T1D 39 , 40 , 42 . A recent multinational study reported that up to 30% of children and adolescents with T1D were overweight or obese 42 . In this study, 21% of T1D patients were overweight and/or obese 5 years after the diagnosis, similar to the frequency in the general population of Korea 43 .…”

Section: Discussionsupporting

confidence: 65%

“…Excessive energy intake along with inadequate insulin treatment causes an increase in the HbA1c level and BMI, while suboptimal glycemic control with chronic hyperglycemia may lead to weight loss, resulting in an increase in the HbA1c level and a decrease in BMI. A recent study reported a U-shaped association between the HbA1c level and BMIz in children and adolescents with T1D 42 , indicating the importance of appropriate weight control.…”

Section: Discussionmentioning

confidence: 96%

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Trajectories in glycated hemoglobin and body mass index in children and adolescents with diabetes using the common data model

Lee

Yoo

et al. 2021

Sci Rep

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We evaluated trajectories of glycated hemoglobin (HbA1c) levels and body mass index z-scores (BMIz) for 5 years after diagnosis among Korean children and adolescents with type 1 diabetes (T1D) or type 2 diabetes (T2D) using the common data model. From the de-identified database of three hospitals, 889 patients < 15 years of age diagnosed with T1D or T2D (393 boys, 664 T1D patients) were enrolled. Diagnosis was defined as first exposure to antidiabetic drug at each center. Compared with T2D patients, T1D patients had lower BMIz at diagnosis (− 0.4 ± 1.2 vs. 1.5 ± 1.4, p < 0.001) and 3 months (− 0.1 ± 1.0 vs. 1.5 ± 1.5, p < 0.001), and higher HbA1c levels at diagnosis (10.0 ± 2.6% vs. 9.5 ± 2.7%, p < 0.01). After 3 months, HbA1c levels reached a nadir of 7.6% and 6.5% in T1D and T2D patients, respectively, followed by progressive increases; only 10.4% of T1D and 29.7% of T2D patients achieved the recommended HbA1c target (< 7.0%) at 60 months. T1D patients showed consistent increases in BMIz; T2D patients showed no significant change in BMIz during follow-up. Peri-pubertal girls with T1D had higher HbA1c and BMIz values. Achieving optimal glycemic control and preventing obesity should be emphasized in pediatric diabetes care.

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“…European centres, which constitute the largest part of the database, were additionally subdivided according to geographical latitude into Southern and Northern European (above or beyond 48°). Data from Asia and Australia were merged because of the relatively low number of participants from those regions .…”

Section: Participants and Methodsmentioning

confidence: 99%

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database

et al. 2019

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Aims To examine the effect of pump vs injection therapy on the lipid profile of children with Type 1 diabetes mellitus.Methods A cross-sectional analysis of the lipid profile of children aged ≤ 18 years with Type 1 diabetes mellitus from SWEET, an international diabetes registry, was conducted with a focus on the effect of treatment regimen. Dyslipidaemia was defined as LDL cholesterol ≥2.6 mmol/l or non-HDL cholesterol ≥3.1 mmol/l. LDL and non-HDL cholesterol values among 14 290 children (52% boys, 51% receiving pump therapy) from 60 SWEET centres were analysed by linear and logistic regression analysis adjusted for sex, age, diabetes duration, HbA 1c and BMI-standard deviation score group, region, and common interactions between age, sex, HbA 1c and BMI.Results This study confirmed the established associations of increased lipids with female sex, age, diabetes duration, HbA 1c and BMI. LDL and non-HDL cholesterol levels were lower in the pump therapy group compared to the injection therapy group [LDL cholesterol: injection therapy 2.44 mmol/l (95% CI 2.42 to 2.46) vs pump therapy 2.39 mmol/l (95% CI 2.37-2.41), P<0.001; non-HDL cholesterol: injection therapy 2.88 mmol/l (95% CI 2.86 to 2.90) vs pump therapy 2.80 mmol/l (95% CI 2.78-2.82), both P<0.0001]. Similarly, the odds ratios for LDL cholesterol ≥2.6 mmol/l [0.89 (95% CI 0.82-0.97)] and non-HDL cholesterol ≥3.1 mmol/l [0.85 (0.78 to 0.93)] were significantly lower in the pump therapy group, even after all adjustments. ConclusionsOur results indicate that pump therapy is associated with a better lipid profile.

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The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes—A SWEET collaborative study

Abstract: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth.

Cited by 10 publications

References 25 publications

Good glycemic control at puberty in boys with type 1 diabetes is important for final height

Good glycemic control at puberty in boys with type 1 diabetes is important for final height

Trajectories in glycated hemoglobin and body mass index in children and adolescents with diabetes using the common data model

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database

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