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Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment
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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“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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Metadata
- 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
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2000-02
- Volume
- 355
- Issue
- 9204
- Pages
- 610-613
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- 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
- 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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