GROWTH DURING CHILDHOOD AND FINAL HEIGHT IN TYPE-1 DIABETES

The growth of 184 children with Type 1 diabetes was analysed using data collected prospectively in the Oxford district between 1969 and 1992. The overall mean height standard deviation score (Ht SDS +/- SD) at diagnosis was 0.35 +/- 1.05 which was significantly greater than the national standard of Tanner (1966). However, there is evidence of a secular trend in the heights of Oxford children over the last 20 years when compared with Tanner. When data from children with diabetes were compared with local controls, it was only the children aged 5-10 years at diagnosis who were taller (Ht SDS +/- SD, 0.58 +/- 1.14, versus 0.31 +/- 0.90 n = 73, p < 0.05). Those diagnosed under the age of 5 years (n = 37) were shorter (Ht SDS 0.1 2 +/- 0.93) and those diagnosed aged more than 10 years (n = 74) were similar in size (Ht SDS 0.22 +/- 0.98) to controls. These differences could not be explained by social class. Loss of height occurred between diagnosis and puberty, particularly in those diagnosed between the ages of 5 and 10 years. The pubertal growth spurt was blunted in all groups but this abnormality was more profound in the girls (mean peak height velocity SDS -1.09 +/- 1.02, p < 0.0005) than in the boys (mean peak height velocity SDS -0.5 =/- 1.14, p < 0.025). The mean final height SDS was -0.74 +/- 0.96 in those diagnosed < 5 years, 0.00 +/- 1.26 in those diagnosed between the ages of 5 and 10 years and 0.09 +/- 1.10 in those aged more than 10 years at diagnosis. Overall final heights were not significantly different from the mid-parental height SDS. It is of interest that those children who were diagnosed under 5 years had short parents (mid-parental height SDS, -0.39 +/- 1.09). Height at diagnosis may reflect the heterogeneity of genetic and environment factors in the aetiology of diabetes. Growth following diagnosis is abnormal although there is no major impact on final height.