P-126: Type 1 diabetes and growth delay: a dual challenge

Introduction

Type 1 diabetes mellitus (T1DM) is a chronic endocrine disorder that may negatively impact linear growth and pubertal development in children and adolescents, particularly in the context of prolonged disease duration and suboptimal glycemic control.

Objectives

To assess the prevalence of linear growth and pubertal delay in pediatric patients with T1DM and to evaluate their association with disease duration and glycemic control.

Methods

We conducted a retrospective descriptive study including 83 children and adolescents with T1DM followed at the Department of Pediatrics, University Hospital of Tlemcen.

Results

The mean age was 13.5 years, with a male-to-female ratio of 1.12. Linear growth delay was identified in 18 patients (22%). Among these, 12 patients (67%) developed growth delay after a longer mean duration of diabetes (7 years and 3 months), with poorer glycemic control (mean HbA1c: 10.7%), compared to patients without growth delay (5 years and 7 months; mean HbA1c: 8.9%).

Among 20 girls aged >13 years, only one patient (5%) presented delayed puberty (2-year delay) after 10 years of disease progression. The remaining patients had normal pubertal timing, with a shorter mean disease duration (3 years and 3 months) and better glycemic control (mean HbA1c: 8.5%).

Among 26 boys aged >14 years, 7 (27%) exhibited pubertal delay, with a mean delay of 11 months, longer disease duration (6 years), and higher mean HbA1c (10.9%), compared to boys without pubertal delay (4.5 years; HbA1c: 8.5%).

Comorbidities were present in 12 patients (14%), predominantly Hashimoto’s thyroiditis (75%).

Conclusions

Prolonged duration of T1DM and poor glycemic control are significantly associated with impaired linear growth and delayed puberty. These findings emphasize the critical importance of early and sustained optimization of glycemic control to prevent growth and developmental complications.