Case series / case reportindependent cross-checkabstract checked★ key study I-INS-107 in-depth review
Growth failure from poorly controlled type 1 diabetes in Sudan
Mauriac Syndrome in Sudanese Children: An Old Syndrome Still Existing in Resource-Limited Countries.
Overview
Ismail MM et al.. Pediatr Diabetes 2025 · PMID 40904852 · DOI 10.1155/pedi/7047312
Children with long-standing poor control were short and had enlarged livers; most improved when their insulin treatment was intensified.
Does the study support the specific claim? No · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Describe Mauriac syndrome in Sudanese children.
- How was the study done?
Record review with follow-up.
- How many people, animals or samples were studied?
37 children.
- What was actually found?
57% improved with better control; nephropathy in one third.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Too little insulin effect, not insulin itself, stunts growth.
- What are the study's limitations?
Small, no control group.
- What does it say about Elawady's specific claim?
Contradicts 'insulin causes short stature'.
- Do the results apply to Germany and Europe?
Rare in Europe today.
- What can explicitly not be concluded from this study?
Cannot give exact effect sizes.
Scientific in-depth review
1. Full reference
- Authors
- Ismail MM et al.
- Journal
- Pediatr Diabetes
- Year
- 2025
- Identifier
- PMID 40904852 DOI 10.1155/pedi/7047312
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
No conflicts declared (record).
2. Research question
What are the features and outcomes of Mauriac syndrome (growth failure with poor control) in Sudanese children?
3. Study design and population
- Study design
- Case series / case report – Hospital-based cross-sectional record review with follow-up after re-education and intensified management
- Population
Children and adolescents with T1D (and 2 with neonatal diabetes) and Mauriac syndrome
- Country
Sudan
- Period
As in paper
- Sample size
37
- Inclusion and exclusion criteria
Clinical diagnosis of Mauriac syndrome
4. Methods and endpoints
- Exposure / intervention
Prolonged inadequate glycaemic control
- Comparator
None (before/after intensification)
- Endpoints
Growth, liver size, complications, outcome
- Statistical methods
Descriptive
5. Actual results
- Results
37 patients, median age 12; short stature and hepatomegaly with prolonged poor control; nephropathy in 33.3%; after re-education and intensified management 56.8% improved (smaller liver with or without faster growth), 18.9% static, 21.6% lost to follow-up, 1 died (2.7%).
- Absolute risks
not reported
- Authors' conclusion
Mauriac syndrome still exists in resource-limited settings and can be reversed with good metabolic control.
6. Strengths
- Arab-region/African data
- Outcome after intensification reported
7. Weaknesses
- Small, uncontrolled
- Clinical diagnosis only
- Loss to follow-up 21.6%
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- high
- Rationale
Case series; no control group.
9. Assessment of the statistical interpretation
Descriptive only.
10. Relevance to the specific claim
Growth failure in T1D arises from under-treatment (inadequate insulin effect) and improves when insulin management is intensified; relevant to Arab-region settings.
11. Independent contrary findings
12. Transferability to Germany and Europe
Mauriac syndrome is now rare in Europe; mechanism universal.
13. Overall methodological judgement
Low-quality but regionally relevant and mechanistically consistent.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | high |
| Precision of results | low |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |