Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus.
OBJECTIVE
To evaluate the prevalence and risk factors of menstrual cycle irregularities in adolescents with type 1 diabetes mellitus.


METHODS
Prospective diary of menstrual cycle.


METHODS
Pediatric diabetes clinics and nearby schools.


METHODS
Adolescents with type 1 diabetes mellitus treated with multiple daily insulin doses (n = 56) and 56 healthy adolescents.


METHODS
Duration and variability of menstrual cycle.


RESULTS
Duration of the menstrual cycle was 48 ± 39 and 32 ± 7 days in girls with type 1 diabetes mellitus and controls, respectively. Oligomenorrhea (58.9% vs. 19.6%) and amenorrhea (10.7% vs. 1.8%) were more prevalent in girls with type 1 diabetes mellitus than in controls. Oligomenorrhea was observed in 53.3% of the girls with type 1 diabetes mellitus with optimal metabolic control. Girls with an HbA1c level of 7.6% to 8.9% exhibited increased cycle duration, menstrual cycle variability, and prevalence of oligomenorrhea compared with controls. Regression analysis showed that, for each point of increase in HbA1c, the menstrual cycle duration increased by 5.1 days. Cycle variability was associated with a higher daily insulin dose.


CONCLUSIONS
Despite optimal metabolic control, a higher prevalence of oligomenorrhea was observed in girls with type 1 diabetes mellitus compared with controls. This is the first report to describe the high variability of the menstrual cycle in type 1 diabetes mellitus. HbA1c and insulin dose are important factors related to menstrual irregularities in type 1 diabetes mellitus.
Hospital Roberto Del Río, Santiago, Chile.
Ximena
X
Gaete
Maritza
M
Vivanco
Francisca C
FC
Eyzaguirre
Patricia
P
López
Hana K
HK
Rhumie
Nancy
N
Unanue
Ethel
E
Codner
D000293:Adolescent; D000568:Amenorrhea / Q000453:epidemiology; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008597:Menstrual Cycle / Q000502:physiology; D008599:Menstruation Disturbances / Q000453:epidemiology*; D009839:Oligomenorrhea / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin