title: The association of increased total glycosylated hemoglobin levels with delayed age at menarche in young women with type 1 diabetes.
abstract: BACKGROUND
  Delayed menarche is associated with subsequent reproductive and skeletal complications. Previous research has found delayed growth and pubertal maturation with type 1 diabetes and poor glycemic control. The effect of diabetes management on menarche is important to clarify, because tighter control might prevent these complications.
  
  
  OBJECTIVE
  The objective of this study was to investigate age at menarche in young women with type 1 diabetes and examine the effect of diabetes management [e.g. total glycosylated hemoglobin (GHb) level, number of blood glucose checks, insulin therapy intensity, and insulin dose] on age at menarche in those diagnosed before menarche.
  
  
  METHODS
  The Wisconsin Diabetes Registry Project is a follow-up study of a type 1 diabetes population-based incident cohort initially enrolled between 1987 and 1992.
  
  
  METHODS
  This study was performed in 28 counties in south-central Wisconsin.
  
  
  METHODS
  The study participants were recruited through referrals, self-report, and hospital/clinic ascertainment. Individuals with newly diagnosed type 1 diabetes, less than 30 yr old, were invited to participate. Of 288 young women enrolled, 188 reported menarche by 2002; 105 were diagnosed before menarche.
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  The main outcome measure was age at menarche.
  
  
  RESULTS
  Mean age at menarche was 12.78 yr, compared with 12.54 yr in the United States (P = 0.01). Ages at menarche and diagnosis were not associated. For those diagnosed before menarche, age at menarche was delayed 1.3 months with each 1% increase in mean total GHb level in the 3 yr before menarche.
  
  
  CONCLUSIONS
  Age at menarche was moderately delayed in young women with type 1 diabetes. Delayed menarche could potentially be minimized with improved GHb levels.
authors.affiliation: Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin 53726-2397, USA. kdaniel2@wisc.edu
authors.forename: Kirstie K
authors.initials: KK
authors.lastname: Danielson
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
authors.forename: Catherine
authors.initials: C
authors.lastname: Allen
authors.forename: Donn J
authors.initials: DJ
authors.lastname: D'Alessio
mesh_terms: D000293:Adolescent; D000375:Aging; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008572:Menarche
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin