Factors affecting insulin-like growth factor-1 in type 1 diabetes mellitus in children

Type 1 Diabetes Mellitus (T1DM) is a chronic metabolic disease caused by insulin deficiency due to damage to pancreatic beta cells. The growth impairment in children with T1DM could be caused by  insulin-like growth factor-1 (IGF-1). The factors that affect IGF-1 in T1DM are complex. This study aimed to evaluate the correlation between HbA1c, DKA (Diabetic Ketoacidosis) number, and illness duration toward IGF-1 in T1DM in children. Our study used cross sectional design, and was conducted between January 2023 to January 2024 at the Polyclinic of Dr. Soetomo Hospital. Children with T1DM who were 2-18 years old were registered using consecutive sample collections. The variables assessed in this study were IGF-1 levels, HbA1c levels, number of diabetes ketoacidosis (DKA), duration, and height Z-Score. Pearson correlation was employed for statistical analyses using SPSS version 17.0, with p 0.05 indicating statistical significance. A total of 71 children were included in this study (39 boys; mean (SD) age 12.60 (4.01) y). About 98.5% of subjects had low IGF-1 (mean (SD) 9.47 (6.69) ng/mL), and 54% had poor glycemic control (mean (SD) HbA1c 9.22 (2.14)%). HbA1c, DKA number, and illness duration showed a significant negative correlation with IGF-1 [(p= 0.002; r= (-0.368)), (p= 0.011; r= (-0.302)), and (p= 0.015; r = (-0.286))], respectively. The glycemic control, the illness duration, and the number of DKA are the important factors affecting low IGF-1 levels in T1DM children. Children with poor glycemic control and longer duration of illness are associated with low IGF-1.