Endocrine Abstracts

Introduction: Puberty is associated with various hormonal changes which can influence glycemic control in youth with type 1 diabetes mellitus, especially with the increase in growth hormone. Conversely, a poor control of diabetes can lead to delayed puberty.

Objective: To assess pubertal status in young patients with diabetes Type 1 and determine factors that influence pubertal development.

Patients and methods: Analytical retrospective study of 7 years in the period ranging between January 2010 and November 2017, in young with type 1 diabetes aged between 14 and 20 years, collected in Endocrinology-Diabetology departement of the University Hospital of Casablanca. Puberty was compared at the stage expected for chronological age. Weight and size were measured and compared with targets (WHO curves). The listed according puberty Tanner was compared stadium expected for chronological age of puberty according to Tanner listed was compared stadium expected for chronological age of puberty according to Tanner listed was compared to the expected stage for chronological age Statistical analysis performed by the software SPSS.16

Results: During the studied period, 200 patients were studied (57% girls, 43% boys), average age of diabetes discovery was 10±2 years. The mean HbA1c level was 11%. A low socioeconomic level was found in 62% of patients. A pediatric transition was noted in 15% of patients. An intensive insulin regimen was adopted in 115 patients (57%). Delayed puberty was found in 11 boys (13%) and in 4 girls (5.3%). Menarche average age was 12 (9–16) years. Irregular menstruations were found in 21% of girls with secondary amenorrhea reported in a girl. Short stature was found in 9 boys and 16 girls. Underweight was seen in 20% of patients, normal weight in 75% and overweight in 5% of cases. Delayed puberty was correlated to glycemic control (P<0.05), with diabetes duration (P<0.02), rural origin (P<0.05) and to repeated hypoglycemic episodes (P<0.02). No significant association regarding the insulin regimen and micro-angiopathy presence (P<0.2) was found.

Discussion: Metabolic control of diabetes and age at diagnosis are major factors influencing growth and pubertal development in young diabetics. It is therefore essential to ensure close monitoring of young diabetics growth and pubertal development and good glycemic control must be maintained.