Melhora da estatura final de pacientes com diabetes mellitus tipo 1 após implementação da insulinoterapia intensiva

Abstract

Objective: to compare the growth of individuals with type 1 Diabetes Mellitus (DM1) before and after institution of intensive insulin therapy and the related. Methods: 50 patients diagnosed with DM1 (56% male and female) were evaluated. female), followed up at the Pediatric Endocrinology Service of the Hospital of the Clinics of the Federal University of Minas Gerais, since 2000, in intensive insulin therapy. The data was retrieved from medical records of patients who grew less than 1 cm in the last year and with complete puberty. Glycemic control was assessed by the mean of HbA1c (RV<7.5%) throughout the follow-up. Results: The mean age at the time of the study was 18.5 ± 1.80 years and the mean disease duration 12.4 ± 4.64 years. The final height z-score for age was -0.44 ± 0.45. The mean final height was 159.87 ± 5.62 cm (-0.51 ± 0.87 SD) in girls and 173.85 ± 7.70 cm (-0.35 ± 1.05 SD) in boys. At comparison by NCHS reference curve for age 18 years with data from the same service before intensive insulin therapy (n=72 height/age = -1.5 DP) there was a gain of 1 SD in final height. HbA1c was 9.9 ± 1.8% in 4 girls and 9.8 ± 1.7% in boys. In the multiple regression model significant associations were observed between target height and final height (p=<0.001). No association was observed with disease duration, control glycemic and sex. Conclusion: the patients presented final height within the limits of the normality. There was improvement in final height after institution of intensive insulin therapy, suggesting that maintaining a regimen of treatment closer to the physiological one may contribute to this finding, even without obtaining optimal control.