June 15, 2005
Question from Lubbock, Texas, USA:
I would like to know more about the effects of normal growth and development on children with type 1 diabetes. I know that growth hormone and sex hormones have an antagonistic effect to insulin and that insulin requirements are usually greater during puberty due to hormonal changes and increased food intake. Can you recommend some good resources to learn more, such as books, articles, etc.?
I would suggest two teaching manuals, Understanding Insulin-Dependent Diabetes by Peter Chase and Insulin-Dependent Diabetes in Children, Adolescents and Adults by Ragnar Hanas, M.D. in Sweden. If you search on Medline or similar web sites and use growth and diabetes and children and adolescents as the search parameters, you will also find some scientific research articles. With only reasonable and not even excellent glucose control, we rarely see growth or puberty delay problems as were reported 15 to 20 years ago; in other parts of the world where specialty care and supplies are still not available, this problem persists, however, but it is directly related to average blood glucose control, A1c etc.