The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study

Jannet Svensson; Anke Schwandt; Daniele Pacaud; Jacques Beltrand; Niels H Birkebaek; Roque Cardona-Hernandez; Kristina Casteels; Sofia Castro; Valentino Cherubini; Declan Cody; Naama Fisch; Dhruvi Hasnani; Olga Kordonouri; Ioanna Kosteria; Andrea Luczay; Auste Pundziute-Lyckå; Claudio Maffeis; Barbara Piccini; Poran Luxmi; Zdenek Sumnik; Carine de Beaufort

doi:10.1111/pedi.12751

The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study

Jannet Svensson, Anke Schwandt, Daniele Pacaud, Jacques Beltrand, Niels H Birkebaek, Roque Cardona-Hernandez, Kristina Casteels, Sofia Castro, Valentino Cherubini, Declan Cody, Naama Fisch, Dhruvi Hasnani, Olga Kordonouri, Ioanna Kosteria, Andrea Luczay, Auste Pundziute-Lyckå, Claudio Maffeis, Barbara Piccini, Poran Luxmi, Zdenek SumnikCarine de Beaufort

Department of Clinical Medicine

3 Citations (Scopus)

Abstract

OBJECTIVE: To describe the association between height, demographics, and treatment in youths with type 1 diabetes participating in an international network for pediatric diabetes centers (SWEET).

METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. World Health Organization growth charts were used to calculate height and body mass index z-scores. Multiple hierarchic regression models adjusting for known confounders were applied.

RESULTS: Data on 22 941 subjects (51.8% male) were analyzed with a median and interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (3.1, 8.9), and height z-score 0.34 (-0.37, 1.03). Children were taller in the youngest age groups: adjusted height z-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (<2 years: 0.36 [±0.06]; 2-<5 years: 0.34 [±0.06]; ≥5 years: 0.21 [±0.06]) and if they were pump users: 0.35 ± 0.05 vs 0.25 ± 0.05 (>three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males.

CONCLUSION: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth.

Original language	English
Journal	Pediatric Diabetes
Volume	19
Issue number	8
Pages (from-to)	1441-1450
ISSN	1399-543X
DOIs	https://doi.org/10.1111/pedi.12751
Publication status	Published - Dec 2018

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Svensson, J., Schwandt, A., Pacaud, D., Beltrand, J., Birkebaek, N. H., Cardona-Hernandez, R., Casteels, K., Castro, S., Cherubini, V., Cody, D., Fisch, N., Hasnani, D., Kordonouri, O., Kosteria, I., Luczay, A., Pundziute-Lyckå, A., Maffeis, C., Piccini, B., Luxmi, P., ... de Beaufort, C. (2018). The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study. Pediatric Diabetes, 19(8), 1441-1450. https://doi.org/10.1111/pedi.12751

Svensson, J, Schwandt, A, Pacaud, D, Beltrand, J, Birkebaek, NH, Cardona-Hernandez, R, Casteels, K, Castro, S, Cherubini, V, Cody, D, Fisch, N, Hasnani, D, Kordonouri, O, Kosteria, I, Luczay, A, Pundziute-Lyckå, A, Maffeis, C, Piccini, B, Luxmi, P, Sumnik, Z & de Beaufort, C 2018, 'The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study', Pediatric Diabetes, vol. 19, no. 8, pp. 1441-1450. https://doi.org/10.1111/pedi.12751

@article{d2b8b19a2a824fffae192e2cd28bbc9b,

title = "The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study",

abstract = "OBJECTIVE: To describe the association between height, demographics, and treatment in youths with type 1 diabetes participating in an international network for pediatric diabetes centers (SWEET).METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. World Health Organization growth charts were used to calculate height and body mass index z-scores. Multiple hierarchic regression models adjusting for known confounders were applied.RESULTS: Data on 22 941 subjects (51.8% male) were analyzed with a median and interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (3.1, 8.9), and height z-score 0.34 (-0.37, 1.03). Children were taller in the youngest age groups: adjusted height z-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (<2 years: 0.36 [±0.06]; 2-<5 years: 0.34 [±0.06]; ≥5 years: 0.21 [±0.06]) and if they were pump users: 0.35 ± 0.05 vs 0.25 ± 0.05 (>three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males.CONCLUSION: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth.",

author = "Jannet Svensson and Anke Schwandt and Daniele Pacaud and Jacques Beltrand and Birkebaek, {Niels H} and Roque Cardona-Hernandez and Kristina Casteels and Sofia Castro and Valentino Cherubini and Declan Cody and Naama Fisch and Dhruvi Hasnani and Olga Kordonouri and Ioanna Kosteria and Andrea Luczay and Auste Pundziute-Lyck{\aa} and Claudio Maffeis and Barbara Piccini and Poran Luxmi and Zdenek Sumnik and {de Beaufort}, Carine",

note = "{\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2018",

month = dec,

doi = "10.1111/pedi.12751",

language = "English",

volume = "19",

pages = "1441--1450",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Wiley-Blackwell",

number = "8",

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TY - JOUR

T1 - The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes

T2 - A SWEET collaborative study

AU - Svensson, Jannet

AU - Schwandt, Anke

AU - Pacaud, Daniele

AU - Beltrand, Jacques

AU - Birkebaek, Niels H

AU - Cardona-Hernandez, Roque

AU - Casteels, Kristina

AU - Castro, Sofia

AU - Cherubini, Valentino

AU - Cody, Declan

AU - Fisch, Naama

AU - Hasnani, Dhruvi

AU - Kordonouri, Olga

AU - Kosteria, Ioanna

AU - Luczay, Andrea

AU - Pundziute-Lyckå, Auste

AU - Maffeis, Claudio

AU - Piccini, Barbara

AU - Luxmi, Poran

AU - Sumnik, Zdenek

AU - de Beaufort, Carine

PY - 2018/12

Y1 - 2018/12

N2 - OBJECTIVE: To describe the association between height, demographics, and treatment in youths with type 1 diabetes participating in an international network for pediatric diabetes centers (SWEET).METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. World Health Organization growth charts were used to calculate height and body mass index z-scores. Multiple hierarchic regression models adjusting for known confounders were applied.RESULTS: Data on 22 941 subjects (51.8% male) were analyzed with a median and interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (3.1, 8.9), and height z-score 0.34 (-0.37, 1.03). Children were taller in the youngest age groups: adjusted height z-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (<2 years: 0.36 [±0.06]; 2-<5 years: 0.34 [±0.06]; ≥5 years: 0.21 [±0.06]) and if they were pump users: 0.35 ± 0.05 vs 0.25 ± 0.05 (>three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males.CONCLUSION: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth.

AB - OBJECTIVE: To describe the association between height, demographics, and treatment in youths with type 1 diabetes participating in an international network for pediatric diabetes centers (SWEET).METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. World Health Organization growth charts were used to calculate height and body mass index z-scores. Multiple hierarchic regression models adjusting for known confounders were applied.RESULTS: Data on 22 941 subjects (51.8% male) were analyzed with a median and interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (3.1, 8.9), and height z-score 0.34 (-0.37, 1.03). Children were taller in the youngest age groups: adjusted height z-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (<2 years: 0.36 [±0.06]; 2-<5 years: 0.34 [±0.06]; ≥5 years: 0.21 [±0.06]) and if they were pump users: 0.35 ± 0.05 vs 0.25 ± 0.05 (>three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males.CONCLUSION: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth.

U2 - 10.1111/pedi.12751

DO - 10.1111/pedi.12751

M3 - Journal article

C2 - 30105887

SN - 1399-543X

VL - 19

SP - 1441

EP - 1450

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 8

ER -

The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes: A SWEET collaborative study

Abstract

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