Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06123 Perugia, Italy.
Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Int J Environ Res Public Health. 2019 Sep 30;16(19):3677. doi: 10.3390/ijerph16193677.
Ensuring normal linear growth is one of the major therapeutic aims in the management of type one diabetes mellitus (T1DM) in children and adolescents. Many studies in the literature have shown that pediatric patients with T1DM frequently present some abnormalities in their growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis compared to their healthy peers. Data on the growth of T1DM children and adolescents are still discordant: Some studies have reported that T1DM populations, especially those whose diabetes began in early childhood, are taller than healthy pediatric populations at diagnosis, while other studies have not found any difference. Moreover, many reports have highlighted a growth impairment in T1DM patients of prepubertal and pubertal age, and this impairment seems to be influenced by suboptimal glycemic control and disease duration. However, the most recent data showed that children treated with modern intensive insulin therapies reach a normal final adult height. This narrative review aims to provide current knowledge regarding linear growth in children and adolescents with T1DM. Currently, the choice of the most appropriate therapeutic regimen to achieve a good insulin level and the best metabolic control for each patient, together with the regular measurement of growth parameters, remains the most important available tool for a pediatric diabetologist. Nevertheless, since new technologies are the therapy of choice in young children, especially those of pre-school age, it would be of great interest to evaluate their effects on the growth pattern of children with T1DM.
确保线性生长正常是儿童和青少年 1 型糖尿病(T1DM)管理的主要治疗目标之一。许多文献研究表明,与健康同龄人相比,儿科 T1DM 患者的生长激素(GH)/胰岛素样生长因子-1(IGF-1)轴经常存在一些异常。关于 T1DM 儿童和青少年生长的数据仍然存在不一致:一些研究报告称,T1DM 人群,特别是那些糖尿病在幼儿期早期开始的人群,在诊断时比健康儿科人群更高,而其他研究则没有发现任何差异。此外,许多报告强调了青春期前和青春期 T1DM 患者的生长受损,这种受损似乎受到血糖控制不佳和疾病持续时间的影响。然而,最新数据显示,接受现代强化胰岛素治疗的儿童达到了正常的最终成人身高。本综述旨在提供有关 T1DM 儿童和青少年线性生长的最新知识。目前,为每个患者选择最合适的治疗方案以达到良好的胰岛素水平和最佳代谢控制,以及定期测量生长参数,仍然是儿科糖尿病专家最重要的可用工具。然而,由于新技术是幼儿(尤其是学龄前儿童)的首选治疗方法,评估它们对 T1DM 儿童生长模式的影响将非常有趣。