GROWTH VELOCITY IN CHILDREN WITH TYPE 1 DIABETES MELLITUS AGED 2-18 YEARS ATTENDING MITTAYI CLINIC IN GOVT. TDMC ALAPPUZHA KERALA

Dr. Aiswarya Danesh and Dr. Sunil Daniel*

ABSTRACT

Background: Type 1 diabetes mellitus is the commonest metabolic-endocrine disease in children. The absence of physiologic insulin response leads to dysfunctional quantities of growth hormone, insulin-like growth factorI resulting in growth impairment. Growth parameters are important indicators of a child's health and they are influenced by factors like blood glucose control in diabetic children. Objectives: 1. To assess growth velocity of children aged 2-18 years with T1DM attending MITTAYI clinic 2.To identify the factors affecting the growth velocity of Type 1 Diabetic children. Methods: Longitudinal follow up study done in MITTAYI clinic under Department of pediatrics, Govt. TDMCH Alappuzha. All children in the age group 2-18 years were selected for the study by universal sampling. Anthropometric measurements were taken using standard scales and BMI was measured 3 monthly. Growth velocity of the child was calculated at the end of the year. An average of readings of HbA1C taken 3 monthly was used to describe the metabolic control over a year. Data obtained was analysed using SPSS 26.0v software. Result: Study was conducted among 92 children aged 2-18 years registered under MITTAYI clinic in Govt. TDMC Alappuzha. In our study 29(31.5%) children had decreased height velocity. The height velocity was more affected in females(p=0.021). Children diagnosed at an early age and having the disease for a longer duration was more affected(p value – 0.036). Height velocity was also affected by HbA1C value (p value -0.002).Children who were not compliant with the dietary advices and who had increased frequency of missed doses also had decreased height velocity (p <0.001). Conclusion: Height velocity was reduced in 31.5 % of our children with T1DM.Weight gain of these children was not much affected. Important factors affecting height velocity in children were early age of diagnosis, longer duration of disease, poor metabolic control, inadequate dietary compliance and irregular insulin administration.

Keywords: T1DM, HbA1C, growth velocity.