Effect of intensive insulin treatment on linear growth in the young diabetic patient

Mary C.J. Rudolf, Robert S. Sherwin, Richard Markowitz, Susan E. Bates, Myron Genel, Judith Hochstadt, William V. Tamborlane

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Although impaired growth is a well-recognized complication of uncontrolled diabetes, it has not been established whether less servere metabolic derangements commonly seen with conventional treatment adversely affect growth potential. To examine this question, growth velocity was measured in nine type 1 diabetic patients (age 14±3 years) before and after six months of intensive insulin treatment either with the insulin pump or with multiple injections, which lowered mean plasma glucose concentration from 270±96 to 105±55 mg/dl and total glycosylated hemoglobin from 12.4±3.0 to 8.4±1.5% (mean ±SD). During conventional treatment, growth velocity (5.3±2.2 cm/year) was within the range of normal despite elevations in plasma glucose concentrations. However, growth velocity increased sharply during intensive treatment (to 9.4±3.9 cm/year, P<0.005), reaching values in excess of normal in seven patients. The increase in growth velocity observed during intensive treatment was associated with a twofold rise in plasma somatomedin-C values. Skeletal maturation, previously normal or slightly delayed, did not advance excessively. These data indicate that the metabolic changes accompanying intensive treatment may enhance growth in diabetic children, even in those with apparently normal growth velocity during conventional therapy.

Original languageEnglish
Pages (from-to)333-339
Number of pages7
JournalJournal of Pediatrics
Issue number3
StatePublished - Sep 1982
Externally publishedYes

Bibliographical note

Funding Information:
From the Departments of Pediatrics, Medicine and Radiology, Yale University School of Medicine. Supported by grants from the National Institutes of Health (RR 125), the Juvenile Diabetes Foundation and the American Diabetes Association. Dr. Sherwin is a recipient of a Research Career Development Award (AM 00334). Dr. Tamborlane is a recipient of a Clinical Investigator Award (AM 00621)from the National Institutes of Health. Dr. Hochstadt is the recipient of a Post-Doctoral Fellowship Award from the Juvenile Diabetes Foundation. *Reprint address: Department of Pediatrics, Yale University School of Medicine, P. O. Box 3333, New Haven, CT 06510.


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