title: Menstrual irregularities are more common in adolescents with type 1 diabetes: association with poor glycaemic control and weight gain.
abstract: Ovarian function in post-menarchal girls with Type 1 diabetes was evaluated. Menstrual histories from 24 adolescents with Type 1 diabetes were compared with those from 24 age and sex matched controls. A fasting blood sample was obtained from subjects with Type 1 diabetes for the measurement of ovarian and adrenal sex hormones, LH and FSH, glucose and insulin, insulin-like growth factor-I (IGF-I), and insulin-like growth factor binding protein-1 (IGFBP-1); and an ovarian ultrasound scan was performed. Menstrual irregularity was more prevalent in patients with Type 1 diabetes than controls (54% vs 21%, p < 0.01) and their mean body mass index (BMI) was greater (22.3 +/- 0.5 (+/- SEM) vs 20.7 +/- 0.6 kg m-2, p < 0.05). Subjects with Type 1 diabetes with irregular menses (when compared with diabetic subjects with a regular cycle) had a significantly higher HbA1 (12.8 +/- 0.4 vs 10.5 +/- 0.5%, p < 0.01) and BMI (23.2 +/- 0.6 vs 21.4 +/- 0.6 kg m-2, p < 0.05) associated with a lower sex hormone binding globulin (SHBG) (37.2 +/- 4.0 vs 52.6 +/- 4.0 nmol l-1, p < 0.025) and IGF-I (1.4 +/- 0.2 vs 2.2 +/- 0.2 mUI-1, p < 0.025) and a higher LH:FSH ratio (2.6 +/- 0.5 vs 1.4 +/- 0.2, p < 0.05). Polycystic ovarian changes were identified in 10/13 (77%) of these patients with an irregular cycle. Menstrual irregularity is common in post-menarchal girls with Type 1 diabetes and is associated with poor glycaemic control and weight gain. The apparent high incidence of polycystic ovarian change requires further investigation.
authors.affiliation: Department of Paediatrics, John Radcliffe Hospital, Oxford, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Adcock
authors.forename: L A
authors.initials: LA
authors.lastname: Perry
authors.forename: D R
authors.initials: DR
authors.lastname: Lindsell
authors.forename: A M
authors.initials: AM
authors.lastname: Taylor
authors.forename: J M
authors.initials: JM
authors.lastname: Holly
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: D B
authors.initials: DB
authors.lastname: Dunger
mesh_terms: D000293:Adolescent; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000503:physiopathology*; D008599:Menstruation Disturbances / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D015430:Weight Gain / Q000502:physiology*