ABSTRACT
Background: As a chronic disease occurring in childhood, type 1 diabetes is a factor potentially affecting the pubertal development, including age at menarche
Aim of study: To investigate the effect of type 1 diabetes on pubertal development among adolescents; and to investigate their gonadotrophic hormonal profile
Subjects and Methods: Nineteen Egyptian girls aged [13.8- 21.6] years were recruited into the study. Assessment of Pubertal development according to Marshall and Tanner [1969] was performed; and age at menarche was evaluated. Auxological assessment [weight, height, and body mass index] were performed. Laboratory investigations were done, including HbAlc levels and Hormone assays [basal and post stimulation levels]: Serum follicle- stimulating hormone [FSH], luteinizing hormone [LH], and LH/ FSH ratio was calculated
Intervention: Girls underwent GnRH- analogue test with triptorelin [0.1 mg] administered subcutaneously
Results: The mean age at menarche [13.24+ 1.25] yrs, among the 17 [89.5%] postmenarcheal T1DM girls, showed no significant difference [P>0.05] from the normal population; but still 2 [10.5%] girls did not achieve menarche until after the study period was terminated. Moreover, there was a highly significant delay [P< 0.01] in their attainment of adult sexual maturity Tanner stage V [B5, PH5]. Only 3 [15.8%] T1DM girls, had achieved optimal metabolic control, at [< 7.5%], while the remaining 16 [84.2%] had a statistically significant insufficient metabolic control [9.93+ 1.96] [P<0.00]. Also it was found that basal and stimulated LH and FSH levels were significantly decreased in T1DM girls [P<0.000]
Conclusion: Type 1 diabetes could affect pubertal development of girls, in the form of delay in their attainment of adult sexual maturity stages, Tanner Breast stage [B5] and Tanner Pubic Hair development [PH5]; however, their age at menarche, is within the range of normal Egyptian girls. The disease could alter their growth development, with a decrease in their height than the normal population. LH and FSH were significantly decreased than normal reference ranges