Growth and skeletal maturation in children with type 1 diabetes mellitus

Objective: To study growth and skeletal maturation in children with type 1 diabetes mellitus (T1DM). Methods: We prospectively studied the anthropometric data of 56 children with T1DM at our tertiary care teaching hospital. Height was re-measured at one year to assess height velocity. A plain radiograph of the left hand was obtained for assessment of skeletal maturation. Glycosylated haemoglobin and thyroid stimulating hormone were measured in all the patients. Results: Short stature [height standard deviation score (HtSDS) <–2] was seen in 15/56 (27%) patients. A negative correlation was observed between HtSDS at recruitment and duration of T1DM (r = –0.347, p = 0.009). Ten of the 25 patients followed up over one year had impaired (< 3rd centile) height velocity (HV). A negative correlation was observed between glycosylated haemoglobin (r = –0.664, p=<0.001) and HV. The proportion of patients with an impaired HV was more in those with an age of onset more than 7.5 yrs (42% Vs 14%, p=0.005). A delayed bone age was observed in 10/37 (27%) patients assessed for skeletal maturation. It correlated negatively with the body mass index standard deviation score (r = –0.484, p=0.002). Conclusion: Poor glycaemic control causes impaired growth in patients with T1DM. Further, T1DM may also be associated with delayed skeletal maturation.