Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is highly prevalent in women with type 1 diabetes mellitus (T1DM), possibly due to premenarchal exogenous hyperinsulinism (supraphysiological doses and nonphysiologic route of insulin administration). Our aim was to determine if PCOS was related to daily or basal insulin dose or T1DM duration.

Methods: We examined 47 women with T1DM (mean age 36.02 years, ±6.03) treated with continuous subcutaneous insulin infusion (78.7%) or basal/bolus insulin therapy. Rotterdam criteria were used to diagnose PCOS. Participants reported medical history, underwent clinical examination, endocrine testing and ovarian ultrasound scan.

Results: PCOS was confirmed in 20 women (42.5%). Mean HbA1c in PCOS was 7.36% (±0.81%), mean T1DM duration was 20 years (±7.16); daily insulin dose (DID) 36.11 IU (±10.02), basal insulin dose (BID) was 17.72 IU (±7.13) in PCOS and 7.22% (±0.83%), 23.17 years (±11.74), 35.25 IU (±13.34), 17.28 IU (±7.15) in non-PCOS group respectively. Neither comparison of DID and BID, premenarchal onset and T1DM duration nor multivariable logistic regression revealed statistically significant differences between the groups. No significant correlation between PCO ovarian morphology, DID and/or BID and/or T1DM duration was found. Statistically significant correlations in our sample were: correlation of DID to weight (P<0.001) and BMI (P<0.001), BID to BMI (P=0.001), DID to free testosterone concentration (P=0.001), BID to free testosterone concentration (P=0.014) and T1DM duration to BMI (P=0.022).

Conclusion: We confirmed high prevalence of PCOS in our population with long duration and good metabolic control of T1DM. However, no difference was observed in DID or BID and T1DM duration and premenarchal onset of T1DM between PCOS and non-PCOS group. Curiously, a correlation between DID and BID to free testosterone concentration was observed in the study population. Factors other than exogenous hyperinsulinemia, possibly genetics and epigenetics, might be important in pathogenesis of PCOS in women with T1DM.