Insulin in children with Type 1 Diabetes mellitus the effect of treatment modalities on somatic growth: A controlled archive study

Objective: Type 1 Diabetes Mellitus (Type 1 DM) is characterized by insulin deficiency due to destruction of pancreatic beta cells and is treated with exogenous insulin replacement. In recent years, technological advances such as intensive insulin therapies, insulin pumps and continuous blood glucose monitoring systems (CGM) have led to significant improvements in the management of Type 1 DM. In this study, it was aimed to investigate the effect of insulin treatment types on somatic growth in children with Type 1 DM admitted to Düzce University Faculty of Medicine Pediatrics Outpatient Clinics. Materials and Methods: The study included 85 patients with type 1 DM using pump insulin and 85 patients with type 1 DM using pen insulin who applied to the Pediatric Endocrinology outpatient clinic of Düzce University Research and Practice Hospital between 2013 and 2024 and 85 healthy children who applied to the pediatrics outpatient clinic. The height, weight and percentile values used in somatic growth during the follow-up of the patients were obtained retrospectively from the patient files and the data were analyzed and evaluated. Results: While no significant change was observed in the height percentiles of patients using pen insulin therapy (p=0.615), a significant decrease was observed in the height percentiles of patients using pump insulin therapy (p=0.013). There was no significant change in the weight percentiles of patients using both pump insulin and pen insulin (p=0.182, p=0.813, respectively). There was a significant decrease in HbA1c values (p<0.001) as a result of the insulin treatments used by the patients Conclusion: Considering the decrease in the height percentile in patients using pump insulin, the growth development of patients should be monitored more closely and the effects of pump insulin on growth should be examined in more detail with long-term studies. Treatment protocols should be reviewed in patients with a high risk of severe hypoglycemia and educational programs should be organized to raise awareness of patients and families. Large-sample studies comparing the long-term effects of pump insulin and pen insulin treatments should be conducted. Keywords: Type 1 Diabetes Mellitus, SCII, MDI, somatic growth