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Cited by 318Growth Hormone and Insulin-like Growth FactorsDiabetes Management and ResearchDiabetes and associated disorders

Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment

Cutfield, Wayne S, Wilton, Patrick, Bennmarker, Helge, Albertsson-Wikland, Kerstin, Chatelain, Pierre, Ranke, Michael B, Price, David A·2000·The Lancet
DOI 10.1016/s0140-6736(99)04055-6
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Abstract

Background 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.Methods 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.Findings 85 (0.36%) of 23333 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 100000 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.Interpretation 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.

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  • The incidence of developing type 2 diabetes for children under GH treatment was increased more than six times compared to the general population, especially in patients with predisposing risk factors such as obesity.

    “Large-scale cohort studies have shown that, compared to the general population, the incidence of developing type 2 diabetes for children under GH treatment was increased more than six times, especially in patients with predisposing risk factors, such as obesity (46–48).”

    From The progression of secondary diabetes: A review of modeling studies (2022) · cites this paper as [47]

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Authors
Cutfield, W. S., Wilton, P., Bennmarker, H., Albertsson-Wikland, K., Chatelain, P., Ranke, M. B., & Price, D. A.
Affiliations
  • University of Auckland (NZ)
  • Hôpital Debrousse (FR)
  • University Children's Hospital Tübingen (DE)
  • St Mary's Hospital (GB)
Corresponding author
Cutfield, Wayne S
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2000-02
Volume
355
Issue
9204
Pages
610-613
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(99)04055-6
OpenAlex
W2163954745
Cited by
318
References
27
Citations by year
2026: 3 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 12 · 2021: 10 · 2020: 8 · 2019: 22 · 2018: 10 · 2017: 17 · 2016: 13 · 2015: 18 · 2014: 11 · 2013: 10 · 2012: 9
FWCI
13.08
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Diabetes Association
  • European Society for Paediatric Endocrinology
  • European Society of Endocrinology
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords
growth hormone therapy, type 2 diabetes, type 1 diabetes, impaired glucose tolerance, insulin resistance, abnormal glucose metabolism, children and adolescents, diabetes incidence, adverse drug reactions
MeSH terms
Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Growth Disorders, Humans, Insulin Resistance, Male, Retrospective Studies, Incidence, Databases, Factual, Glucose Intolerance, Human Growth Hormone

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