Association Between Time-Weighted Haemoglobin A1c and Longitudinal Changes in Growth Parameters Among Children With Type 1 Diabetes: A Retrospective Cohort Study.
6 affiliations
- 1Paediatric Endocrinology, Jordanian Royal Medical Services, Amman, JOR.
- 2Paediatrics, Jordanian Royal Medical Services, Amman, JOR.
- 3Endocrinology, Queen Rania Children's Hospital, Amman, JOR.
- 4Paediatric Surgery, Jordanian Royal Medical Services, Amman, JOR.
- 5Endocrinology and Diabetes, King Hussein Medical City, Amman, JOR.
- 6Paediatric Endocrinology, King Hussein Medical City, Amman, JOR.
Abstract
Managing early-onset type 1 diabetes requires balancing glycaemic control with developmental milestones. The relationship between cumulative glycaemic exposure and auxological outcomes in children has not been well characterised using time-weighted haemoglobin A1c (HbA1c). Objective: This study explored the longitudinal association between time-weighted average HbA1c and changes in height-for-age, weight-for-age, and body mass index z-scores among children diagnosed with type 1 diabetes. Methods: A retrospective cohort study included children aged 2-14 years with type 1 diabetes and ≥18 months of follow-up (n=200). The primary exposure was time-weighted average HbA1c. Outcomes were changes in height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and BMI z-score (BMI-z). Linear mixed-effects models adjusted for age, sex, diabetes duration, insulin regimen, and pubertal status. Results: Mean age was 9.5 ± 2.8 years, with 105 (52.5%) female subjects. Mean diabetes duration was 4.8 ± 3.2 years. A significant negative association was found between time-weighted average HbA1c and ΔHAZ (β = -0.15, 95% CI: -0.26 to -0.04, p < 0.01). Positive associations were identified with ΔWAZ (β = 0.08, 95% CI: 0.01-0.15, p<0.05) and ΔBMI-z (β = 0.10, 95% CI: 0.03-0.17, p<0.01). At baseline, suboptimal glycaemic control (HbA1c > 7.5%) was present in 116 (58.0%) of participants. The negative effect on HAZ was most pronounced in children with a diabetes duration >5 years (β = -0.22, p = 0.003) and in those with a baseline HbA1c >9% (β = -0.28, p < 0.001). Conclusions: Lower time-weighted HbA1c, reflecting early and sustained glycaemic control, is associated with enhanced linear growth and a more favourable weight profile in children with type 1 diabetes.
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BibTeX
@article{ayyash2026association,
title = {{Association Between Time-Weighted Haemoglobin A1c and Longitudinal Changes in Growth Parameters Among Children With Type 1 Diabetes: A Retrospective Cohort Study.}},
author = {Fadi Ayyash and Sondos Harahshih and Hadeel Alqurieny and Asmaa M Al Quraan and Waed Itewi and Aseel Nimri and Osama Al Fanek and Saif Batarseh and Abdelrazaq A Al-Yasin},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117044},
url = {https://europepmc.org/article/MED/42953436},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Time-Weighted Haemoglobin A1c and Longitudinal Changes in Growth Parameters Among Children With Type 1 Diabetes: A Retrospective Cohort Study.
AU - Fadi Ayyash
AU - Sondos Harahshih
AU - Hadeel Alqurieny
AU - Asmaa M Al Quraan
AU - Waed Itewi
AU - Aseel Nimri
AU - Osama Al Fanek
AU - Saif Batarseh
AU - Abdelrazaq A Al-Yasin
PY - 2026
DA - 2026/09/28
JO - Cureus
DO - 10.7759/cureus.117044
UR - https://europepmc.org/article/MED/42953436
AB - Managing early-onset type 1 diabetes requires balancing glycaemic control with developmental milestones. The relationship between cumulative glycaemic exposure and auxological outcomes in children has not been well characterised using time-weighted haemoglobin A1c (HbA1c). Objective: This study explored the longitudinal association between time-weighted average HbA1c and changes in height-for-age, weight-for-age, and body mass index z-scores among children diagnosed with type 1 diabetes. Methods: A retrospective cohort study included children aged 2-14 years with type 1 diabetes and ≥18 months of follow-up (n=200). The primary exposure was time-weighted average HbA1c. Outcomes were changes in height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and BMI z-score (BMI-z). Linear mixed-effects models adjusted for age, sex, diabetes duration, insulin regimen, and pubertal status. Results: Mean age was 9.5 ± 2.8 years, with 105 (52.5%) female subjects. Mean diabetes duration was 4.8 ± 3.2 years. A significant negative association was found between time-weighted average HbA1c and ΔHAZ (β = -0.15, 95% CI: -0.26 to -0.04, p < 0.01). Positive associations were identified with ΔWAZ (β = 0.08, 95% CI: 0.01-0.15, p<0.05) and ΔBMI-z (β = 0.10, 95% CI: 0.03-0.17, p<0.01). At baseline, suboptimal glycaemic control (HbA1c > 7.5%) was present in 116 (58.0%) of participants. The negative effect on HAZ was most pronounced in children with a diabetes duration >5 years (β = -0.22, p = 0.003) and in those with a baseline HbA1c >9% (β = -0.28, p < 0.001). Conclusions: Lower time-weighted HbA1c, reflecting early and sustained glycaemic control, is associated with enhanced linear growth and a more favourable weight profile in children with type 1 diabetes.
SN - 2168-8184
ER -