title: 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.
  
  
  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.
authors.affiliation: Department of Paediatrics, University of Auckland, New Zealand. waynec@ahsl.co.nz
authors.forename: W S
authors.initials: WS
authors.lastname: Cutfield
authors.forename: P
authors.initials: P
authors.lastname: Wilton
authors.forename: H
authors.initials: H
authors.lastname: Bennmarker
authors.forename: K
authors.initials: K
authors.lastname: Albertsson-Wikland
authors.forename: P
authors.initials: P
authors.lastname: Chatelain
authors.forename: M B
authors.initials: MB
authors.lastname: Ranke
authors.forename: D A
authors.initials: DA
authors.lastname: Price
mesh_terms: 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
chemical_list: D019382:Human Growth Hormone