Correlation between glycemic control and menstruation in diabetic adolescents

OBJECTIVE: To determine if a correlation exists between the degree of glyce mic control in insulin-dependent diabetic adolescents and menstrual regulat ion. STUDY DESIGN: A retrospective review of charts of diabetic girls aged 10-18 was performed. Office visits were scheduled every three to six months, at which time pubertal development, menstrual function, growth and diabetic co ntrol, including hemoglobin (Hgb) A1C, and complications were assessed. For ty-six patients were eligible for data analysis. Descriptive and inferentia l statistics, including chi(2) and Student t tests, were applied. RESULTS: Thirty-seven (81%) patients had regular menstrual cycles, and nine (19%) had menstrual disturbances, including secondary amenorrhea (one), ol igomenorrhea (seven) and primary amenorrhea followed by oligomenorrhea (one ). There were two pregnancies. Six: patients used hormonal contraception bu t none for menstrual regulation. There was a statistically significant diff erence (P<.05) in mean Hgb A1C concentrations between those with menstrual disturbances (11.4) and those with regular menses (9.7). As Hgb AIC values increased, the percent of patients with menstrual disturbances increased, b ecoming statistically significant when the Hgb A1C was >10 (odds ratio 7.3, 95% confidence interval 1.5-35.6). There was no difference (P>.05) between the two groups with respect to age at menarche (156 vs. 152 months), age a t onset of diabetes (144 vs. 108 months) and interval between diabetes onse t and menarche (54 vs. 41 months). There were no patients in Either group w ith diabetic retinopathy or nephropathy. Four patients were hypersensitive, but there suns no statistically significant difference (P>.05) between gro ups. CONCLUSION: Tighter glycemic control, as measured by Hgb A1C concentrations , corresponded to improved menstrual regulation in adolescent insulin-depen dent diabetics.