**1. Introduction**

Growth hormone (GH) has effect in carbohydrate metabolism including the stimulation of glucose production from the liver, in particular when it is abundant. The hormone also increases the extent to which beta cells in the Langerhans pancreatic cells can secrete insulin in response to glucose alert [1]. It was found that the daily injection of dogs with this hormone leads to diabetes with total atrophy in the islands of Langerhans as a result of the demoralization of the continued alertness of the islands of Langerhans, which leads to exhaustion due to excessive secretion of the hormone insulin caused by injection pituitary extracts [2]. Because the growth of growth hormone in dogs and cats accompanies the incidence of diabetes, it is not surprising to note the emergence of diabetes in all patients with Acromegaly. In general [3], insulin and growth hormone can be considered as complementary agents, each regulating the supply of energy to the tissues of the body where Insulin becomes active immediately after eating (a time when glucose as the most important source of energy in the body is forming) while growth hormone becomes active in hunger or fasting [4]. Insulin and Insulin-like growth factor-I (IGF-I) are the two hormones that control glucose metabolism; hence, IGF-I is the second factor after insulin that has an antihypertensive effect [5]. The growth element IGF-I, a polypeptide hormone with 70 amino acids and a molecular weight of 7649 Da, is a member of a big family that is highly similar to one another and is very close to the proportion of insulin [6]. It indirectly affects the growth of many cells and tissues in the body. IGF-amino I's acid sequence was discovered to be 48% similar to that of human proinsulin hormone, often known as "insulin-like," which is mostly released from the liver, according to Humble and Rinderknecht's research from 1978. Laron [7], where the body's nutritional situation is the main secretion. Additional hormones include the most potent one, growth hormone (GH), as well as insulin, thyroxin, and anabolic steroids [8]. Growth hormone is secreted under joint and coordinated control of three hypothalamus hormones: growth hormone-releasing hormone (GHRH). Somatostatin and Ghrelin (GHRH), GHRH and gerlin are positive regulators that stimulate growth hormone release [9]. Somatostatin (SST) is a negative regulator that inhibits the secretion of the hormone. Another factor is insulin-like growth factor (IGF-I), which affects the thalamus and pituitary, reducing growth hormone secretion [10]. Hypoglycemia is a potent stimulant for GH secretion. At the same time, hyperglycemia prevents the secretion of hormone in most cases [11]. Some report that a hypoglycemia level of 50% of normal level promotes hormone secretion. In secretion [12]. Causing Fasting for a long time increase the secretion of the hormone and after eating begins three stages of secretion of the hormone as the secretion of the hormone insulin is predominantly in the first stage while in the second phase less secretion of insulin and increases the secretion of growth hormone and in the third stage is the secretion of growth hormone is predominantly, also Physical exertion causes increased secretion of the hormone and there is a direct relationship between the effort exerted and the amount of the hormone secreted [13]. Some neurotransmitters such as fear, anxiety and noise may activate hormone secretion. It is also observed that hormonal factors influence GH secretion Thyroxin extracted from the thyroid gland, increases the amount of growth hormone releasing factor (GHRF) extracted from the hypothalamus, which increases the secretion of GH from the anterior lobe of the pituitary anterior pituitary gland [14]. The incidence of growth hormone deficiency in European societies is about 1/4000 births, which is similar to the rate in Iraq [15]. However, the increase in diabetes and other endocrine diseases in the context of wars and economic siege, and the increase in children with growth hormone deficiency of the reviewers of the unit of hormone The growth in the women's and children's education hospital in Ramadi as a result of war, displacement, lack of health care, interruption of treatment and diagnosis exacerbated this problem. Due to the lack of studies at the level of Al-Anbar province on the condition of lack of growth hormone in children with short stature therefore, this study was conducted in order to investigate the effect of therapeutic hormone growth hormone on the metabolism of carbohydrates, fats and bones in a group of children with hormone deficiency hormone (growth hormone deficiency only) and for 6 months of treatment, where growth hormone affects the form and function of the developing body and regardless of These functions as a stimulus to growth have specific effects on metabolism and energy, affect the fat cells to reduce the amount of stored fat, promote protein synthesis in cells and play a role in regulating blood sugar levels [16]. GH is necessary for natural growth and cell proliferation and regeneration in humans and some other organisms.

### *Carbohydrate Metabolism in Growth Hormone Therapy for Children DOI: http://dx.doi.org/10.5772/intechopen.110778*

Apart from these functions as growth stimuli, it has distinct effects on metabolism and energy affects fat cells to reduce the amount of stored fat, promotes protein synthesis in cells and plays a role in regulating Blood sugar levels [17]. The insufficient secretion of growth hormone in the early periods of the life of the individual causes the weakness of the skeleton and the incidence of dwarfism, while excessive secretion of GH before the completion of growth or before the closure of rectangular bones causes the increase of the growth of these bones to a large extent, which is expressed by the disease Gigantism [18]. If the excessive increase in excretion happens in adulthood, the so- called Acromegaly will develop, which is characterized by the swelling of the bones of the head and jaw, hands and feet [3]. In fact, the increase in the secretion of GH after the epiphyseal cartilage is locked (calcified) causes the previous condition, which also the continued growth of bones without Epiphyses (under the influence of the increase in the hormone) contributes to, making the body organs ultimately inconsistent. In general, there are several centers for the formation of the human and animal skeleton, including the aforementioned Epiphyseal cartilage centers. These centers become active under the influence of GH where their cells divide and increase in fish while some of these cells are constantly transformed into bones [19].

Growth hormone is not directly affected by the insulin-like growth factor or somatomedin, as the growth hormone stimulates its secretion in peripheral tissues, especially the liver [2]. GH is believed to perform its functions on the cartilage (multiplying cartilage cells) indirectly by regulating the level of Somatomedins in blood plasma, some of which are known as insulin- like growth factors. These somatomedins therefore have anabolic effects in the cartilage in terms of activating the transfer of amino acids and stimulating the process of protein synthesis, DNA and RNA and increasing absorption of sulfate [7].
