Frequency of Delayed Puberty among Adolescent Females with Type 1 Diabetes

Abstract Background Female patients with T1DM may display menstrual disturbances, hyperandrogenism or early menopause at certain moments of their lives, thus representing a significant health problem. Objective To detect the frequency of delayed puberty among a cohort of Egyptian adolescent females with type 1 diabetes mellitus (T1DM). Methods This cross sectional study examined 175 adolescent females with T1DM aged(14-18)years following up at the Pediatric and Adolescents Diabetes Unit, Ain Shams University for delayed puberty. History taking with complete physical examination was done including: Tanner staging (delayed puberty was defined as puberty occurring two standard deviations beyond the mean age). Girls were evaluated for delayed puberty in the following situations: (1) no breast development by age 13, (2) no menarche within 3 years of the larche, (3) no menarche by age 14 with signs of hirsutism, (4) no menarche by age 14 with history or examination suggestive of excessive exercise or eating disorder, and (5) no menarche by age 15 (ACOG committee opinion, 2015). Clinical manifestations of insulin resistance, blood pressure and anthropometric measures were assessed with calculation of the z score for age and gender. Laboratory assessment including fasting glucose, HbA1C, fasting lipid profile was done. Results Delayed puberty was found in 6.3 % of the studied adolescent females with T1DM. Mean age at menarche was 13.2 years and the percentage of tanner V was 28 % of this cohort. Mean age was negatively correlated with delayed puberty, while duration of DM, waist circumference Z score, waist/hip ratio Z score and mean of LDL were positively correlated with delayed puberty. No significant relation was found with HbA1C, fasting glucose, cholesterol, triglyceride, HDL Conclusion Although uncommon, delayed puberty can be seen in girls with T1DM. It is correlated to glycemic control and hyperlipidemia.