Endocrine Abstracts

Introduction: In some cases pubertal growth and sexual maturation and relating normal physiology can be disturbed and retarded by chronic disease as like Diabetes Mellitus (DM). According to International Diabetes Federation Atlas in 2013 approximately 5, 00, 000 known cases of children with T1DM (0–14 years) worldwide, where 50-60% of cases are diagnosed before the age of 15. Insulin deficiency in T1DM presented with age in childhood and visible peaks at the time of puberty can affected growth and puberty onset delay. We analysed data from literature by compare cases of growth and puberty delay in people with T1DM if there any majority of applicable mechanisms of growth and puberty retardation which are related with disease specific mechanisms.

Material and methods: A case-control study with 20 type 1 Diabetes Mellitus patients, who were 14-18 years old on the other hand 20 healthy age-matched participants were included as a control group. The stage of sexual maturation - Tanner’s stage, hormonal profile - follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone measured and the growth parameters, including the weight, height, and BMI respectively for both groups.

Results: The major criteria, its impact on linear growth, development and puberty onset, especially in those with poor glycemic control. T1DM was a cause of retardation of puberty as about one-quarter (25%) of the boys were sexually immature by Tanner’s chart (did not reach stage V) comparing with control group, where 90% of volunteers were sexually mature regarding their age. Moreover, prolactin, testosterone, BMI, height and weight parameters were low in diabetic group comparing with control. Authors proposed well known fact the insulin affects central nervous system and involved reproduction. It is tend to be consequences of hypoinsulinemia or delayed release of GnRH, with subsequent delayed release of sex hormones. IGF-1 stimulates growth and puberty, also directly regulates GnRH which was in the decreased range because of hypoinsulinemia. When main risk factors were calculated poor glycemic control, low FSH and LH to cause pubertal and normal growth delay in these patients.

Conclusion: Children and adolescent with T1DM those with poor glycemic control showed remarkably delayed puberty (90%) and lower growth (25%) parameters, also accompanied with lower sex hormones level. Adequate insulin therapy with education should be necessary part of treatment in patients with T1DM.