The association of increased total glycosylated hemoglobin levels with delayed age at menarche in young women with type 1 diabetes.

Abstract

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. 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. 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. This study was performed in 28 counties in south-central Wisconsin. 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. There were no interventions. The main outcome measure was age at menarche. 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. Age at menarche was moderately delayed in young women with type 1 diabetes. Delayed menarche could potentially be minimized with improved GHb levels.