Growth and igf-i in type 1 diabetic children and adolesents

الملخص EN

The aim of the work is to study growth and Insulin-like growth factor I (IGF-I) levels in a group of type I diabetic children and adolescents, and find if any relation is existing to different demographic,glycemic, and hormonal variables.

One hundred and one diabetic children and adolescent (54 males, 47 females), and 79 age and sex matched healthy controls are recruited in the study.

Their chronological ages ranged from 1.92-19.83 years, with variable duration of diabetes and variable glycemic control.

Different anthropmetrfic measurements and pubertal assessment were obtained regularly over two years period.

Glycemic control was estimated from self monitoring of blood glucose, GHbAl, number of DKAs and insulin dose in the three years preceding the study.

Hormonal analysis included IGF-I, thyroid profile and sex hormones.

Patients were also classified into two groups, patients with fair growth (78%) and patients with compromised growth (22%).

Patients with compromised growth were significantly older with older age at onset, longer duration with higher glycemic indices and lower IGF-1 values compared to patients with fair growth. Mean IGF-I level was significantly higher in prepubertal male diabetics compared to controls.

IGF-I correlated positively to insulin dose.

Also patients with sensory neuropathy had lower IGF-I levels compared to patients without.

Co-existing diseases such as chronic systemic infections and chromosomal diseases operated additionally in the process of growth retardation. Poor glycemic control may delay or arrest growth.

Puberty is also considered a stress period which adds further impact an glycemic control.

Detailed medical history, clinical examination and guided diagnostic procedures are important tools to exclude chronic systemic infections and associatedantoimmune diseases.