Hyperandrogenism in adolescent girls with type 1 diabetes mellitus treated with intensive and continuous subcutaneous insulin therapy

Abstract

Introduction: Women with type 1 diabetes mellitus (T1DM) experience high prevalence of hyperandrogenic disorders. The aim of this study was to evaluate hormonal profile with respect to hyperandrogenic disorders in adolescents with T1DM.

Material and methods: Forty seven adolescent girls with T1DM were evaluated and compared to 19 healthy and 21 non-diabetic girls with polycystic ovary syndrome (PCOS). In all subjects, basal and GnRH analogue stimulated androgens, gonadotropins and SHBG were measured and ultrasonography of ovaries was performed.

Results: Girls with T1DM experienced first menses significantly later than healthy controls [13.1 (12.0-14.0) v. 12.0 (11.0-12.0) years, p = 0.02]. Nine (19.2%) of them fulfilled PCOS criteria (T1DM+PCOS). They had significantly mean HbA1c from the diagnosis of T1DM than T1DM girls with no PCOS [6.7 (6.6-7.2) v. 7.3(6.4-7.8)%, p = 0.049]. Hormonal profile, hirsutism score and ovarian volume did not differ significantly between the two groups. HbA1c at the study point and mean HbA1c for the last 12 months correlated negatively with SHBG level (r = -0.5, p = 0.006; r = -0.04, p = 0.02). T1DM+PCOS girls had significantly lower FAI [3.0 (2.6-4.3) v. 8.6 (6.5-10.8), p = 0.04] and ovarian volume than non-diabetic PCOS girls [4.6 (2.7-5.2) v. 7.4 (4.3-10.0) mL, p = 0.007].

Conclusions: Clinical symptoms of PCOS in adolescent girls with T1DM are milder than in non-diabetic peers, probably due to the protective role of higher SHBG resulting in lower free androgen level.