Reduced height as a consequence of type-I-diabetes mellitus in childhood has been reported in many studies. However, it is
still debated whether good metabolic control can normalize the growth rate. A total of 436 children (204 boys, 232 girls,
mean age at diagnosis of diabetes 8.2±0.2 years) were followed at our outpatient diabetes centre. Z-scores for height were
evaluated in relation to duration of diabetes, age at onset and long-term metabolic control. At diagnosis, height in children
with diabetes was significantly above the reference population (+0.43± 0.09). Standardized height decreased during the subsequent
course of diabetes. This likely represents a delay of growth, as the final height (chronological age >18 years, n = 144) was
+0.27 ± 0.09. Growth reduction was more pronounced in patients diagnosed before the onset of puberty and final height in patients
with a prepubertal onset of diabetes was significantly lower (+0.10 ± 0.13) compared to patients with a pubertal/postpubertal
onset (+0.52 ± 0.14). Among patients with a prepubertal onset, the subgroup with “poor” metabolic control (long-term median
HbA
1c >7%) lost significantly more height compared to patients with “good” metabolic control.
Conclusion Despite modern treatment regimens, reduced longitudinal growth can still be demonstrated in type-I diabetes. This parameter
therefore provides a valuable endpoint for quality control in paediatric diabetology.
Keywords Insulin-dependent diabetes mellitus - Height - Metabolic control - Glycosylated haemoglobin
Received: 8 December 1997/ Accepted in revised form: 11 March 1998