Growth hormone-treated children may be at higher risk for diabetes
MedWire News: Study results show that children treated with growth hormone (GH) have a significantly higher incidence of Type 2 diabetes than children in the general population.
GH is known to have an insulin antagonistic effect, and therefore may impair glucose metabolism and increase a person's risk for diabetes, say the authors.
However, they believe that pre-existing risk factors for diabetes may at least partly explain the increased numbers of Type 2 diabetes cases seen with GH treatment in this study.
Chris Child, from the Lilly Research Centre in Windlesham, Surrey, UK, and colleagues analyzed data on over 36,000 person-years of GH treatment and its association with diabetes incidence in 11,686 young people (younger than 20 years) with growth disorders. The subjects were enrolled in the Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS).
In total, 11 cases of Type 2 diabetes were recorded in GH-treated children, corresponding to an incidence of 29.3 cases per 100,000 person-years of GH treatment; a rate 6.5 times that of children in the general population. The median age at Type 2 diabetes diagnosis was 15.3 years and the median duration of GH treatment was 2.5 years.
Notably, the majority (n=10) of children who developed Type 2 diabetes had additional risk factors for the condition such as insulin resistance, impaired glucose tolerance, the genetic conditions Prader-Willi or Turner syndrome, and obesity.
Child and team note that their results are similar to those of another study by Cutfield et al published 10 years previously, which demonstrated an incidence of 34.4 cases of Type 2 diabetes per 100,000 person-years of GH treatment, a rate 6.4 fold higher than that in the general population at the time.
"Thus, despite concern that the increasing prevalence of childhood obesity will increase Type 2 diabetes in the pediatric age group, the incidence of Type 2 diabetes among GH-treated children does not appear to be increasing at a rapid rate," say Child and co-authors.
In addition, the higher dose of GH given to children in the current study compared with those in the Cutfield et al cohort did not appear to influence the incidence of Type 2 diabetes.
"Although Type 2 diabetes that presents during GH treatment may be reversible, with or without discontinuation of GH, the long-term Type 2 diabetes risk of such patients and of those with incident abnormal glucose tolerance requires further study," conclude the researchers in the Journal of Clinical Endocrinology and Metabolism.
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By Helen Albert