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Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment
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Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment
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Journal Article
Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment
2000
Overview
Growth hormone (GH) contributes to insulin resistance, but whether children treated with GH are at increased risk of diabetes has not been established. We undertook a retrospective analysis of data from an international pharmacoepidemiological survey of children treated with GH to find out the incidence of impaired glucose tolerance and types 1 and 2 diabetes mellitus.
Reports to the survey of abnormal glucose metabolism were investigated and classified. The incidence and age-distribution of type 1 diabetes were compared with values from a model of reference data. The incidence of type 2 diabetes was compared with data from two reports of children not treated with GH.
85 (0·36%) of 23 333 children were reported with abnormal glucose metabolism. After investigation, 43 had confirmed glucose disorders (11 with type 1 diabetes, 18 with type 2 diabetes, and 14 with impaired glucose tolerance). The incidence and age at diagnosis of type 1 diabetes in children treated with GH did not differ from expected values. The incidence of type 2 diabetes was 34·4 cases per 100 000 years of GH treatment which was six-fold higher than reported in children not treated with GH. Type 2 diabetes did not resolve after GH therapy was stopped.
GH treatment did not affect the incidence of type 1 diabetes mellitus in any age group. We postulate that the higher than expected incidence of type 2 diabetes mellitus with GH treatment may be an acceleration of the disorder in predisposed individuals.
Publisher
Elsevier Ltd,Lancet,Elsevier Limited
Subject
/ Biological and medical sciences
/ Child
/ Diabetes
/ Diabetes Mellitus, Type 1 - chemically induced
/ Diabetes Mellitus, Type 1 - epidemiology
/ Diabetes Mellitus, Type 2 - chemically induced
/ Diabetes Mellitus, Type 2 - epidemiology
/ Female
/ Glucose Intolerance - chemically induced
/ Glucose Intolerance - epidemiology
/ Growth Disorders - drug therapy
/ Hormones
/ Human Growth Hormone - adverse effects
/ Human Growth Hormone - therapeutic use
/ Humans
/ Insulin
/ Male
