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Growth and diabetes GROWTH AND DIABETES
Children with diabetes usually grow normally and reach the adult height that would have been expected from the family pattern of growth. On the other hand, insulin is needed for normal growth, and if a child with diabetes is not having enough insulin, he or she may not grow normally. Poor diabetic control and poor nutrition may also lead to impaired growth. Persisting and very poor control of diabetes can lead to such severe impairment of growth that the child may actually appear dwarfed and if this is not corrected, the ultimate adult height may be short. Fortunately, this is now rare and can be readily prevented by good diabetes control.
If a child develops diabetes in early life, the onset of puberty may be delayed for a year or more. If this happens, the growth spurt that occurs during puberty will also be delayed and the child will be growing slowly in his or her early teenage years when most other teenagers are growing rapidly. For a few years, he may be relatively short compared to his friends, but with good control, catch-up growth will occur later.
Occasionally, we see children who have delays in growth or develop puberty later than expected even though diabetic control seems quite satisfactory. We cannot always find an explanation for this, but if it is a concern, other investigations may be needed.
Of course children with diabetes are in all other respects normal children and there will be the same variations in growth and in the timing of the onset and progress of puberty that all children experience. We just have to be sure the child is having adequate nutrition and insulin and that diabetic control is satisfactory. That is one of the reasons why regular medical check ups are helpful in childhood diabetes.
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DIABETES
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