title: Delayed menarche in young German women with type 1 diabetes mellitus: recent results from the DPV diabetes documentation and quality management system.
abstract: BACKGROUND
  Findings have been inconsistent regarding the effect of T1DM (type 1 diabetes) on age at menarche.
  
  
  OBJECTIVE
  The purpose was to investigate in young German women with T1DM menarcheal age and factors potentially affecting menarche, including glycemic control, BMI (body mass index), relative T1DM duration (proportion of life with diabetes), insulin dose, and insulin therapy intensity. Initiated in 1990, the DPV program is an ongoing, prospective long-term longitudinal follow-up study to benchmark the quality of care provided to pediatric and, more recently, adult diabetes patients. Two hundered two German diabetes centers participated in nationwide data collection. Based on ethnicity and the availability of menarche and T1DM onset data as the main inclusion criteria, 643 young German women were selected from 11,629 female T1DM patients aged <20 years, recruited by referral, clinic or hospital ascertainment, or self report. Mean age at menarche (+/-SD) was 13.22 +/- 1.31 years, representing a delay of 0.52 years (p < 0.001) relative to the general population. Significant delay (p < 0.05) was also found for relative T1DM duration, BMI SD score, insulin dose, and HbA1c level, with a 1% increase in HbA1c resulting in a delay in menarche by 0.07 years.
  
  
  CONCLUSIONS
  Age at menarche is delayed in type 1 diabetes mellitus. The delay increases with relative T1DM duration and poor quality of glycemic control.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Pediatric Diabetes Unit, Saarland University Hospital, Homburg, Saar, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Rohrer
authors.forename: Eva
authors.initials: E
authors.lastname: Stierkorb
authors.forename: Matthias
authors.initials: M
authors.lastname: Grabert
authors.forename: Paul-Martin
authors.initials: PM
authors.lastname: Holterhus
authors.forename: Thomas
authors.initials: T
authors.lastname: Kapellen
authors.forename: Ina
authors.initials: I
authors.lastname: Knerr
authors.forename: Monika
authors.initials: M
authors.lastname: Mix
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003625:Data Collection; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D016014:Linear Models; D008572:Menarche; D011628:Puberty, Delayed / Q000150:complications*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin