Endocrine Abstracts

Background: The onset of type 1 diabetes before menarche was a risk factor for the subsequent development of hyperandrogenic disorders. It has been also suggested that the use of exogenous insulin to treat type 1 diabetes mellitus in those patients may contribute to the development of PCOS. Abnormal lipid levels were also reported in children with type 1 diabetes mellitus during pubertal years.

Aim of work: This study was designed to investigate metabolic and some hormonal changes in relation to puberty among type 1 diabetic girls.

Subjects and methods: The study was carried out on 60 girls, 40 of them were type 1 diabetic patients (the diabetic group), subdivided into two groups (according to age and Tanner breast staging), and 20 of them were normal healthy girls (the control group), also subdivided into two groups (according to age and Tanner breast staging). All girls were subjected to full history taking, thorough clinical examination, estimation of fasting blood glucose and HbA1c (as an estimation for glycemic control), lipid profile, hormonal profile (FSH, LH and free testosterone) in addition to pelvic ultrasound.

Results: There is an increased frequency of dyslipidemia in the form of hypercholesterolemia and increased levels of LDL among type 1 diabetic girls, and pubertal type 1 diabetic girls show higher BMI and cholesterol levels compared to controls, and also show higher levels of LDL compared to prepubertal type 1 diabetic children. Age at menarche is delayed in pubertal type 1 diabetic girls having PCOS, while not delayed in those without PCOS but positively correlated to the longer duration of diabetes and with the level of HbA1c. Both the frequency of PCOS and the level of free testosterone are higher in pubertal type 1 diabetic girls compared to their normal controls.