ISSN 1662-4009 (Online)

ESPE Yearbook of Paediatric Endocrinology (2019) 16 10.12 | DOI: 10.1530/ey.16.10.12

Efficacy of growth hormone treatment in children with type 1 diabetes mellitus and growth hormone deficiency – An analysis of KIGS data

Bonfig W, Lindberg A, Carlsson M, Cutfield W, Dunger D, Camacho-Hübner C & Holl RW

Department of Pediatrics, Klinikum Wels-Grieskirchen, Wels, Austria; Department of Pediatrics, Technical University München, Munich, Germany

To read the full abstract: J Pediatr. 2018 Jul;198:260–264

This study aimed to analyze growth hormone (GH) doses and first-year growth response in prepubertal patients with the combination of type 1 diabetes (T1D) and growth hormone deficiency (GHD).

A total of 69 patients with T1D and GHD treated with GH have been enrolled in KIGS (Pfizer International Growth Database). Of these, 24 prepubertal patients had developed T1DM before GHD and were included in this analysis. For many years the presence of T1D in patients who were to be treated with GH seemed to have been regarded as a contraindication for GH use. In addition, GH therapy has falsely been associated with the development of T1D in children with GHD. This study analyzed in a large cohort from a registry of one pharmaceutical company the impact of diabetes on GH treatment. In the registry, of 30,570 patients with GHD without T1DM, 15,024 were prepubertal and served as controls.

Patients with T1DM and GHD had similar characteristics to the GHD-alone group. Neither age (10.2±3.13 vs 8.42±3.46 years, P=0.14), height SDS corrected for midparental height SDS at start of treatment (−1.62±1.38 vs −1.61±1.51, P=0.80), nor GH dose (0.24±0.08 mg/kg/wk vs 0.20±0.04 mg/kg/wk, P=0.09) were different between those with and without T1D. First-year catch-up growth was comparable between the two patient groups (first treatment year height velocity 7.54±3.11 cm/year compared with 8.35±2.54 cm/year in control patients, P=0.38). Height SDS of children with both T1DM and GHD improved from −2.62±1.04 to −1.88±1.11 over the first year of GH treatment.

In conclusion, the short-term response to GH therapy appears similar in patients with T1D who then developed GHD and in those with GHD alone. Thus, T1D does not compromise the GH response in children with GHD. The study also clearly shows that GH treatment was safe in both subgroups of patients. T1D is not a contraindication for GH treatment in those children who need it.

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