Abstract
Introduction: Mauriac is a severe form of growth failure in children with type 1 diabetes mellitus (DM1) and it was frequently observed prior to insulin treatment. In recent decades, new and improved medical treatments and follow-ups of these patients have helped them to grow and develop within the normal range.
Objective: To review the current situation of growth in children with DM1 and to report the local experience.
Discussion: More than 3,300 investigations on growth in children with DM-1 have been published with varied results. Most authors describe a bigger size in the beginning but within the normal range; the adolescent growth spurt is of lesser magnitude and inversely correlated with HbA1c levels. Different growth patterns in males and females are observed; the final height is within the normal range, but shorter than the parental mean size. Regarding the pathophysiology of the GH-IGF-1 axis, a growth hormone resistance is observed, with IGF-1 deficiency and increase of the proteolytic activity against IGFBP-3. Qther possible factors such as zinc, ghrelin and leptin are discussed, as well as their role in children with DM-1. The size of our patients is normal and did not change with the addition of the DM-1 to the Chilean AUGE/GES Plan; however, an improved metabolic control was observed.
Conclusions: Normal growth is one of the main goals treating children with DM1. with current treatments and good metabolic control these patients can grow and develop normally, but showing some differences in growth patterns compared to the normal population. Deficiencies regarding the GH-IGF1 axis have been described and more studies are needed to clarify the importance of other factors such as zinc, ghrelin and leptin in the growth of these patients. Growth expectations in children with type 1 diabetes mellitus are currently normal and growth failure requires further studies.
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