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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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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