Endocrine Abstracts

The aim of the study was to evaluate hormonal profile in diabetic adolescent girls with menstrual disorders and compare them to regularly menstruating diabetic and healthy girls.

We studied 54 adolescent girls with T1DM treated with intensive and continuous insulin therapy in the chronological age of 15.9±1.3 years and gynecological age of 33.7±16.7 months with the mean HbA1c for the last year 7.4±1.5%. In 18 (33%) girls menstrual disturbances (MD) were present (amenorrhea in three, oligomenorrhea in seven, and irregular menses in eight), while 36 (67%) of girls experienced regular menses (RM). 24 healthy girls with regular menses served as a control group (CG). In each subject hirsutism was evaluated, transabdominal ultrasound of the ovaries was performed and concentrations of gonadotropins and androgens were measured.

Difference between mean HbA1c from the beginning of T1DM and for the last year as well as daily insulin requirement in both diabetic groups were statistically insignificant (P>0.05). The occurrence of hirsutism (1 (6%) MD vs 2 (6%) RM vs 2 (8%) CG, P>0.05), polycystic ovary morphology (9 (50%) MD vs 12 (33%) RM vs 11 (42%) CG, P>0.05) and hyperandrogenaemia (4 (22%) MD vs 12 (33%) RM vs 11 (42%) CG, P>0.05) were similar in all three groups studied. Only 3 (17%) girls from MD group fulfilled the criteria of PCOS by Androgen Excess Society for adolescents. There were no significant differences between the two diabetic groups with respect to the concentration of gonadotropins, estradiol, and androgens except for higher androstenedion in RM vs. MD (2.2±1.0 vs 2.5±1.4 ng/ml respectively, P=0.03). The occurrence of the menstrual disorders correlated only with the age of the first menarche (r=0.3, P=0.02).

It is concluded that in diabetic girls menstrual disturbances do not seem to be associated with increased hyperandrogenemia and PCOS incidence is similar to that in general population (6%).