Jarmila Vojtková, Miriam Čiljaková, Milan Kuchta, Peter Bánovčin
Summary Child’s growth may be negatively influenced by many factors such as chronic inflammation, acidosis, hypoxia
and dysbalance of the metabolism of water and electrolytes. Therefore, it is understandable that type 1 diabetes (T1D)
may lead to growth disorders. Height increment may slow down during T1D, especially with chronic insufficient compensation.
In our cross-sectinal study, selected parameters were observed in 46 adolescents at the age 15 – 19 years with
T1D (average diabetes duration 6.42 years) and 25 healthy controls. Boys and girls with T1D were shorter compared to
age- and sex-matched controls with the same puberty stage (171.96 cm vs. 177.01 cm, p > 0.05; 163.02 cm vs. 166.83 cm,
p > 0.05, respectively), however this difference was not significant. In patients with decompensated diabetes, Mauriac
syndrome has been described, which is manifested by hepatomegalia, elevated liver enzymes, short stature, delayed
puberty and cushingoid appearance. Despite current possibilities of intensified insulin therapy, this syndrome exists also
now. Patients with long-lasting insufficiently compensated T1D usually have increased secretion of growth hormone
as a consequence of reduced concentration of insulin-like growth factor 1 (IGF-1), which may be partially modified by
improvement of diabetes compensation. Growth disorders may be associated also with some autoimmune diseases
(autoimmune thyreoiditis with hypothyreosis, celiac disease). Rare associated condition may be growth hormone deficiency
whose diagnosis is complicated by diabetes. Interesting finding is, that accelerated growth in early childhood
represents the risk factor for development of T1D and an average height of patients at the time of T1D diagnosis is increased
compared to healthy subjects. Possible explanation is accelerator hypothesis which assumes that insulin resistance
(following weight gain and physical inactivity) contributes to autoimmune damage of pancreatic beta cells.