Menstrual Disorders in Patients with Type I Diabetes Mellitus

Kwon, Ah Reum; Chae, Hyun Wook; Kim, Ho Seong; Kim, Duk Hee

Abstract

PURPOSE: This study compares the prevalence of pubertal menstrual disorders in type 1 diabetes mellitus (DM) patients with that in normal subjects.
METHODS
A questionnaire was used to obtain data on pubertal development and menstrual history from 43 type 1 DM patients, who were diagnosed at the pediatrics department of Severance Children's Hospital, Yonsei University, and 56 normal control subjects. We evaluated the estrogen levels in all type 1 DM patients.
RESULTS
The age at onset of puberty did not significantly differ between the 2 groups. However, the prevalence of oligomenorrhea in type 1 DM patients (21.21%) was significantly higher than that in the control group (2.08%; P<0.05). In addition, the incidence of amenorrhea in type 1 DM patients (20.59%) was significantly higher than that in the control group (2.08%; P<0.05). Pubertal development in type 1 DM patients was delayed due to elevated levels of glycosylated hemoglobin (HbA1c). The delay (9 months) in pubertal development in the patients diagnosed with type 1 DM at prepubertal ages was shorter than that (14.8 months) in the patients diagnosed with type 1 DM at postpubertal age (P<0.05). The level of LH, FSH were higher and E2 level was lower in DM patients compared to control group, especially in diabetics with amenorrhea (P<0.05).
CONCLUSION
We observed a high frequency of delayed pubertal development and menstruation irregularities in patients who were diagnosed with type 1 DM at the prepubertal age or in type 1 DM patients with high levels of HbA1c. This finding can be attributed to the decreased plasma levels of E2 or due to the decreased E2 activity in patients with type 1 DM. Further evaluation of hormonal changes in type 1 DM patients is essential.