Menarche in type 1 diabetes is still delayed despite good metabolic control

OBJECTIVE: To analyze the age at menarche of girls with type 1 diabetes (T1D) whowere diagnosed with the disease before puberty and compare it with that of anage-matched group of normal girls. Previous studies on the appearance of menarcheshowed that the mean age of onset of menarche is delayed in girls affected by T1Dcompared with normal girls.DESIGN: Case-control study.SETTING: Patients and controls in an academic research environment.PATIENT(S): We studied, retrospectively, the charts of 162 consecutive girls withT1D born in a geographically defined region between 1984 and 1994 with a meandisease duration of 3-5 years, all of whom were on intensive insulin therapysince diagnosis of T1D. The control group consisted of 214 normal girls bornbetween 1984 and 1994, who agreed to fill in an anonymous questionnaire regardingage at menarche and other clinical information.INTERVENTION(S): There was no intervention per se in the study. Age at menarcheappears as a dependent variable of body mass index (BMI), HbA1c, and so on.MAIN OUTCOME MEASURE(S): BMI, HbA1c, and duration of T1D at menarche wereconsidered among the potential factors affecting the age of menarche.RESULT(S): Age at menarche in girls with T1D was significantly delayed comparedwith control girls (12.6 +/- 1.5 years vs. 12.25 +/- 1.4 years, respectively).HbA1c levels and BMI did not influence the age at menarche.CONCLUSION(S): Despite intensive insulin therapy and good metabolic control sincediagnosis of T1D, the age at menarche is still delayed in girls who develop T1Dbefore puberty.