title: Metabolic safety of growth hormone in type 1 diabetes and idiopathic growth hormone deficiency.
abstract: OBJECTIVE
  To evaluate metabolic consequences of growth hormone (GH) treatment in children with type 1 diabetes.
  
  
  METHODS
  This study is an analysis of metabolic changes in 37 patients with childhood-onset GH deficiency and type 1 diabetes, documented in the Diabetes Patienten Verlaufsdocumentationsystem database. Main outcome measures were changes in hemoglobin A1c and daily insulin requirements during GH therapy in children with GH deficiency and type 1 diabetes compared with a large cohort of adolescents with type 1 diabetes.
  
  
  RESULTS
  Thirty-seven patients with type 1 diabetes and a diagnosis of idiopathic GH deficiency after onset of diabetes were compared with 48856 patients with type 1 diabetes. After adjustment for age, sex, duration of diabetes, and migration background, a significant difference in mean daily insulin requirement was seen between the 2 groups (1.0 IU/kg/day in subjects with GH deficiency and type 1 diabetes vs 0.85 IU/kg/day in controls; P < .01) and height-SDS (-2.0 in subjects with GH deficiency and diabetes vs +0.03 in controls; P < .0001). There was no significant between-group difference in hemoglobin A1 concentration, however (8.1% ± 1.4% in patients with GH deficiency and type 1 diabetes vs 8.2% ± 1.7% in those with type 1 diabetes only; P > .05).
  
  
  CONCLUSIONS
  An increased daily insulin requirement should be considered in patients with type 1 diabetes treated with GH. With adequate adaptation of insulin dosage, metabolic control is not impaired during GH treatment.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Technical University München, Munich, Germany. Electronic address: Walter.Bonfig@lrz.tum.de.
authors.forename: Walter
authors.initials: W
authors.lastname: Bonfig
authors.forename: Katharina
authors.initials: K
authors.lastname: Molz
authors.forename: Joachim
authors.initials: J
authors.lastname: Woelfle
authors.forename: Sabine E
authors.initials: SE
authors.lastname: Hofer
authors.forename: Berthold P
authors.initials: BP
authors.lastname: Hauffa
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schoenau
authors.forename: Sven
authors.initials: S
authors.lastname: Golembowski
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Wudy
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D048909:Diabetes Complications / Q000097:blood* / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000378:metabolism / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D008297:Male; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: DPV; Diabetes Patienten Verlaufsdocumentationsystem; GH; Growth hormone; H-SDS; HbA1c; Height-SDS; Hemoglobin A1c; IGF; Insulin-like growth factor