Pubertal Development in Children Diagnosed with Diabetes Mellitus Type 1 before Puberty - 01/01/15

Doi : 10.1016/j.jpag.2014.08.009

K.C.X. Pereira, MD ^1,^⁎ , B.S. Pugliese, MD ¹, M.M. Guimarães, MD, PhD ¹, M.P. Gama, ScD ²
¹ Department of Endocrinology, Federal University of Rio de Janeiro – UFRJ, Rio de Janeiro, Brazil
² Department of Statistical, Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro – UFRJ, Rio de Janeiro, Brazil

^∗Address correspondence to: K.C.X. Pereira, MD, Federal University of Rio de Janeiro – UFRJ, Street Belisario Tavora, 221/304, Laranjeiras, Rio de Janeiro-RJ, Brazil 22245070

Abstract

Study Objective

To investigate an association between pubertal development and timing of menarche with glycemic control, disease duration, and body mass index (BMI) in patients diagnosed with diabetes mellitus type 1 (DM1) before puberty.

Design

Retrospective study.

Setting

The study was performed at the diabetes outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira–IPPMG of the Federal University of Rio de Janeiro–UFRJ.

Participants

A total of 131 children, 61 girls and 70 boys, diagnosed with DM1 before puberty participated in the study.

Main Outcome Measures

The study investigated how age at puberty onset relates to mean glycated hemoglobin (HbA1c) before puberty, BMI percentile, and disease duration; how puberty duration relates to mean HbA1c before and during puberty and to disease duration; and how timing of menarche relates to mean HbA1c before puberty, BMI percentile, and disease duration.

Results

Age at puberty onset was positively correlated with mean HbA1c before puberty (r = 0.204, R² = 0.042; P = .019) and disease duration (r = 0.451, R² = 0.203; P < .0001), and negatively correlated with BMI percentile (r = −0.289, R² = 0.084; P = .001). Timing of menarche was negatively correlated with BMI percentile (r = −0.556, R² = 0.310; P < .001).

Conclusions

Children with longer disease duration began puberty later than those diagnosed more recently. Girls in higher BMI percentiles reached menarche sooner.

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Key Words : Diabetes mellitus type 1, Puberty, Glycemic control, Menarche