Intensified treatment of pregnant insulin-dependent diabetic women

Jovanovič, Lois

doi:10.1530/acta.0.111s0077

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Spontaneous abortions (4), stillbirths, and congenital anomalies (5) characterize the reproductive histories of type 1 diabetic women with poor glycemic control. With advances in intensive insulin therapy, women with type 1 diabetes are now able to maintain better glycemic control and have successful pregnancies and healthy children (6,7). However, little is known about late reproductive events, such as the menopause transition, among women with type 1 diabetes.…”

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confidence: 99%

Menopause in Type 1 Diabetic Women

et al. 2001

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Women with type 1 diabetes have a delayed menarche and a greater prevalence of menstrual disorders than women without diabetes. However, little is known about the menopause transition among type 1 diabetic women. The Familial Autoimmune and Diabetes (FAD) Study recruited both adult individuals who were identified from the Children's Hospital of Pittsburgh Type 1 Diabetes Registry for the years 1950 -1964 and their family members. Unrelated nondiabetic control probands and their relatives were also evaluated. Women with type 1 diabetes (n ‫؍‬ 143) compared with nondiabetic sisters (n ‫؍‬ 186) or unrelated control subjects (n ‫؍‬ 160) were more likely to have an older age at menarche (13.5, 12.5, and 12.6 years, respectively, P < 0.001), more menstrual irregularities before 30 years of age (45.7, 33.3, and 33.1%, respectively, P ‫؍‬ 0.04), and a younger age at menopause (41.6, 49.9, and 48.0 years, respectively, P ‫؍‬ 0.05). This resulted in a 6-year reduction in the number of reproductive years (30.0, 37.0, and 35.2 years, respectively, P ‫؍‬ 0.05) for women with type 1 diabetes. Risk factors univariately associated with earlier menopause included type 1 diabetes (hazard ratio [HR] 1.99, P ‫؍‬ 0.04), menstrual irregularities before 30 years of age (HR 1.87, P ‫؍‬ 0.04), nulliparity (HR 2.14, P ‫؍‬ 0.01), and unilateral oophorectomy (HR 6.51, P < 0.0001). Multivariate analysis confirmed that type 1 diabetes (HR 1.98, P ‫؍‬ 0.056), menstrual irregularities by 30 years of age (HR 2.36, P ‫؍‬ 0.01), and unilateral oophorectomy (HR 9.76, P < 0.0001) were independent determinants of earlier menopause in our cohort. We hypothesize that an earlier menopause, which resulted in a 17% decrease in reproductive years, is a major unstudied complication of type 1 diabetes.

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confidence: 99%