The Association of Increased Total Glycosylated Hemoglobin Levels with Delayed Age at Menarche in Young Women with Type 1 Diabetes

• Published in: The journal of clinical endocrinology and metabolism Vol. 90; no. 12; pp. 6466 - 6471
• Main Authors: Danielson, Kirstie K., Palta, Mari, Allen, Catherine, D’Alessio, Donn J.
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01-12-2005; Copyright by The Endocrine Society
• Subjects: Adolescent; Aging; Biological and medical sciences; Blood Glucose - metabolism; Child; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Dose-Response Relationship, Drug; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin - metabolism; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - therapeutic use; Medical sciences; Menarche; Vertebrates: endocrinology; Endocrinopathy; Human; Immunopathology; Type 1 diabetes; Hemoglobin A1c; Young adult; Menarche; Autoimmune disease; Age; Endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2005-0349

Context: Delayed menarche is associated with subsequent reproductive and skeletal complications. Previous research has found delayed growth and pubertal maturation with type 1 diabetes and poor glycemic control. The effect of diabetes management on menarche is important to clarify, because tighter control might prevent these complications.
Objective: The objective of this study was to investigate age at menarche in young women with type 1 diabetes and examine the effect of diabetes management [e.g. total glycosylated hemoglobin (GHb) level, number of blood glucose checks, insulin therapy intensity, and insulin dose] on age at menarche in those diagnosed before menarche.
Design: The Wisconsin Diabetes Registry Project is a follow-up study of a type 1 diabetes population-based incident cohort initially enrolled between 1987 and 1992.
Setting: This study was performed in 28 counties in south-central Wisconsin.
Patients or Other Participants: The study participants were recruited through referrals, self-report, and hospital/clinic ascertainment. Individuals with newly diagnosed type 1 diabetes, less than 30 yr old, were invited to participate. Of 288 young women enrolled, 188 reported menarche by 2002; 105 were diagnosed before menarche.
Interventions: There were no interventions.
Main Outcome Measure: The main outcome measure was age at menarche.
Results: Mean age at menarche was 12.78 yr, compared with 12.54 yr in the United States (P = 0.01). Ages at menarche and diagnosis were not associated. For those diagnosed before menarche, age at menarche was delayed 1.3 months with each 1% increase in mean total GHb level in the 3 yr before menarche.
Conclusions: Age at menarche was moderately delayed in young women with type 1 diabetes. Delayed menarche could potentially be minimized with improved GHb levels.