Limited joint mobility in diabetes mellitus of childhood: Natural history and relationship to growth impairment

We report a prospective study of the recently recognized complication of limited joint mobility in childhood diabetes, summarizing data collected over the seven years after the initial description of this sign. Of 309 patients, ranging in age from 1 to 28 years, 30% had limited joint mobility. No race or sex influence on expresiion of limited joint mobility was found; its appearance was temporally more influenced by age than by duration of diabetes. Of 142 patients with diabetes onset before puberty and of longer than three years' duration, 74 had limited joint mobility. Disproportionate distribution of height percentiles for age characterized this entire group, but those with limited joint mobility had four times the skewing of those without (74 vs 37% below the twenty-fifth percentile). The presence or absence of thyroid microsome or islet cell antibodies did not relate significantly to limited joint mobility. Diabetes control, assessed subjectively by clinical estimation and objectively by hemoglobin A 1 levels, was generally unrelated to the joint findings. For patients with diabetes duration less than five years, there was a significant association between hemoglobin A 1 and limited joint mobility, but the variability in values explained by this association was small (11%).