Diabetes control doesn’t normalize menstruation

NEW YORK (Reuters Health) - Good metabolic control and intensive insulin treatment doesn’t normalize the onset of menstruation, which is usually delayed in girls with type 1 diabetes compared with girls without the disease, study findings confirm.

Dr. Paolo Pozzilli, at Universita Campus Bio-Medico, in Rome, and colleagues compared the age at onset of menstruation among 162 girls who received intensive insulin therapy and blood sugar control since their type 1 diabetes diagnosis, which was 3 to 5 years earlier. These girls were matched with 214 same-age girls without the disease (the controls).

The findings showed that the diabetic girls began menstruating at a statistically significant older age compared with the controls — 12.6 years compared with 12.25 years, respectively.

These findings confirm previous observations of delayed menstruation among girls with type 1 diabetes, Pozzilli and colleagues report in the medical journal Fertility and Sterility.

Compared with other factors that may influence the onset of menstruation, including body mass, blood sugar control, and duration of diabetes, Pozzilli’s team found that disease duration prior to menstruation most closely correlated with age of menstruation.

Nonetheless, the study group had a short disease duration (3.77 years), suggesting that other factors, such as lean body mass, may be important in explaining their findings.

For example, the loss of body weight associated with a diagnosis of type 1 diabetes may play a substantial role in maturation, the investigators note. While body weight may quickly recover, fat may still be underrepresented and, therefore, impact the onset of menstruation, they surmise.

Further studies should continue to compare associations between body mass, as well as disease duration, and the onset of menstruation among young girls with type 1 diabetes.

SOURCE: Fertility and Sterility, November 2008.

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