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


RESULTS
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.


CONCLUSIONS
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.
Cutfield
W S
WS
Department of Paediatrics, University of Auckland, New Zealand. waynec@ahsl.co.nz
Wilton
P
P
Bennmarker
H
H
Albertsson-Wikland
K
K
Chatelain
P
P
Ranke
M B
MB
Price
D A
DA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000139:chemically induced* / Q000453:epidemiology; D006130:Growth Disorders / Q000188:drug therapy; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D012189:Retrospective Studies
D019382:Human Growth Hormone