Delayed menarche in young German women with type 1 diabetes mellitus: recent results from the DPV diabetes documentation and quality management system

Rohrer, Tilman; Stierkorb, Eva; Grabert, M.; Holterhus, Paul‐Martin; Kapellen, Thomas; Knerr, Ina; Mix, Monika; Holl, Reinhard W.

doi:10.1007/s00431-007-0590-0

Cited by 28 publications

(26 citation statements)

References 34 publications

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“…We can only assume comparable pubertal stages if groups are matched for age. T1D patients have previously been described to have a normal onset of puberty and normal sexual maturation [51], and even if we consider a possible delay of menarche of 0.5 years [52], still most patients would be above the threshold for delayed puberty. We could not compare obese T1D patients with the mainly obese T2D patients, as the sample of obese (BMI >97th percentile) T1D patients was too small to allow sensible comparisons.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes

et al. 2017

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Background and Aim: The hepatokine fetuin A is upregulated in the metabolic syndrome and in type 2 diabetes (T2D), while its role in adolescent type 1 diabetes (T1D) is unclear. We assessed the relationship between circulating fetuin A levels and metabolic control, comorbidities, and complications in adolescent T1D patients. Methods: We studied the relationship between serum fetuin A and clinical diabetes-related data from the DPV registry (Diabetes-Patienten-Verlaufsdokumentation) in 172 adolescent T1D patients with early-onset (<5 years) long-standing (>10 years) T1D. Fetuin A levels were further compared between adolescent T1D and T2D patients. Results: Serum fetuin A levels in T1D patients (mean 0.267 ± 0.043 g/L) did not correlate with age, diabetes duration, gender, body mass index (BMI), glycated hemoglobin, serum lipid levels, blood pressure, celiac or thyroid disease, nephropathy, or retinopathy. An association of fetuin A levels with insulin requirements was only evident within the subgroup of overweight T1D patients (r_s = 0.439, p = 0.028, n = 25, BMI >90th percentile), disappearing after adjustment for multiple testing. Adolescent T1D patients showed distinctly lower fetuin A levels than patients with T2D (p ≤ 0.001). Conclusion: Overall, we did not observe a clinically relevant association of fetuin A levels with surrogate parameters for insulin sensitivity in our juvenile T1D cohort. A correlation with insulin requirements was detectable in overweight patients only. We hypothesize that multiple factors, such as obesity, puberty, inadequate metabolic control, and hepatic steatosis, have to add up before a clinically relevant effect of fetuin A on insulin sensitivity becomes evident.

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Section: Discussionmentioning

confidence: 99%

Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes

et al. 2017

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“…Previous studies have demonstrated that the age of menarche is still delayed in girls with type 1 diabetes (1–5). However, none have compared age of menarche of young adolescents with type 1 diabetes with adult women with type 1 diabetes to see if the delay in menarche has decreased over the past several decades.…”

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confidence: 99%

Menarchal Timing in Type 1 Diabetes Through the Last 4 Decades

2010

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OBJECTIVEWe sought to examine whether age at menarche has changed over the past 4 decades by comparing age at menarche by year of diagnosis with type 1 diabetes.RESEARCH DESIGN AND METHODSThis work consisted of a cross-sectional study of age at menarche in two cohorts: adolescents (ages 11–24 years, n = 228) and adults (ages 19–55 years, n = 290, enrolled in the Coronary Artery Calcification in Type 1 Diabetes study).RESULTSThe adolescent cohort reported a younger age of menarche than the adult women with type 1 diabetes (12.69 ± 0.08 vs. 13.22 ± 0.12 years, mean ± SE, P < 0.001). Age at menarche was later in both adolescent girls and adult women with type 1 diabetes diagnosed before menarche (12.82 ± 1.16 and 13.7 ± 2.23 years) than for individuals diagnosed after menarche (12.12 ± 1.25 and 12.65 ± 1.38 years, P < 0.001 for both). Age at menarche was then examined by decade of type 1 diabetes diagnosis (1970–1979, 1980–1989, 1990–1999, and 2000–2009). Age at menarche significantly declined over the 4 decades (P = 0.0002). However, the delay in menarche among girls diagnosed with type 1 diabetes before menarche compared with those diagnosed after menarche was also significant across all decades (P < 0.0001) and did not change significantly over time (P = 0.41 for interaction of cohort and diagnosis premenarche).CONCLUSIONSAge at menarche has declined over the past 4 decades among girls with type 1 diabetes, but a delay in age at menarche remains among individuals diagnosed before menarche compared with individuals diagnosed after menarche.

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“…Most of these studies as well as a study by Kjaer et al[7] suggest that T1DM is associated with delay in menarche especially when diabetes is diagnosed before menarche, rather than after. In support of this hypothesis, duration of diabetes is positively correlated with age at menarche [10, 14, 17, 18]. …”

Section: Resultsmentioning

confidence: 93%

“…Of note, glucose control, as reflected by hemoglobin A1C (HbA1C), is inconsistently associated with delay in menarche. Rohrer et al found that a 1% increase in HbA1C resulted in a 0.07 year delay in menarche[17]. However, Schweiger et al found no correlation between HbA1c and menarche (r = 0.01, p = 0.91)[10], and Picardi et al also observed that even among girls with well controlled diabetes (mean HA1C <7.5%), age at menarche was still delayed[14].…”

Section: Resultsmentioning

confidence: 99%

Ovarian aging in women with diabetes: An overview

2017

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Type 2 diabetes is a global epidemic, and the prevalence and incidence of type 1 diabetes are increasing. The negative effects of diabetes on kidneys, nerves, and vessels are well established. The effect of diabetes on reproductive function is less well understood, but important to characterize, given the increasing numbers of young women with diabetes. In this review, we summarize the available literature on how women with diabetes experience ovarian aging, from menarche to menopause. We report that women with type 1 diabetes appear more likely to have ovarian dysfunction, manifested by delayed menses, menstrual irregularities, and possibly earlier menopause. Studies of women with type 2 diabetes are inconsistent but suggest increased anovulation and earlier menopause. Differences in reproductive aging between women with type 1 and type 2 diabetes raise questions about potential differences in the mechanisms contributing to ovarian aging. Although there is shared glycemic dysregulation, fundamental differences in insulin presence and processing distinguish the two diseases. This review suggests that insulin, age at diagnosis, and weight play a role in ovarian dysfunction. More long-term studies are needed to evaluate the multitude of factors that may disrupt hypothalamic, pituitary, and ovarian function in women with diabetes.

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Delayed menarche in young German women with type 1 diabetes mellitus: recent results from the DPV diabetes documentation and quality management system

Abstract: Age at menarche is delayed in type 1 diabetes mellitus. The delay increases with relative T1DM duration and poor quality of glycemic control.

Cited by 28 publications

References 34 publications

Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes

Relationship of Serum Fetuin A with Metabolic and Clinical Parameters in German Children and Adolescents with Type 1 Diabetes

Menarchal Timing in Type 1 Diabetes Through the Last 4 Decades

Ovarian aging in women with diabetes: An overview

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