Email this article Effect of diabetes compensation on ovarian function recovery in women of reproductive age with type 1 diabetes mellitus
- Authors: Tolpygina M.G.1, Tarasova M.A.1, Borovik N.V.1, Misharina E.V.1, Tiselko A.V.1
-
Affiliations:
- Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Issue: Vol 67, No 5 (2018)
- Pages: 42-49
- Section: Articles
- URL: https://journals.rcsi.science/jowd/article/view/10667
- DOI: https://doi.org/10.17816/JOWD67542-49
- ID: 10667
Cite item
Full Text
Abstract
Hypothesis/aims of study. The adverse effects of type 1 diabetes mellitus on the female reproductive system have been proved by many studies. There is still conflicting literature on the impact of diabetes and other factor compensation on ovarian function in women with type 1 diabetes mellitus.
Study design, materials and methods. The current analysis was undertaken to study the effects of diabetes compensation on ovarian function in women with type 1 diabetes mellitus. In order to this, 180 individuals aged 20 to 40 years were examined. The main group consisted of 112 diabetic patients with primary ovarian insufficiency, the comparison group included 68 women with type 1 diabetes mellitus and a normal ovulatory cycle. After 18–24 months following the therapy aimed to compensate diabetes, 63 patients with ovarian insufficiency were re-examined. The examination included determination of blood glucose, glycated hemoglobin (HbA1c), FSH, LH, prolactin, estradiol, total and free testosterone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, dihydrotestosterone, progesterone, and sex hormone-binding globulin (SHBG) levels, as well as ultrasound examination in the first and second phases of the menstrual cycle.
Results. Association of ovarian insufficiency with HbA1c level and the dose of insulin was found. Patients in the main group experienced a decrease in FSH and SHBG levels, an increase in the ovarian volume and the number of antral follicles compared to those in diabetic patients with a normal ovulatory cycle. In patients with decompensated diabetes and ovarian insufficiency, after the compensation of diabetes, the recovery of the ovulatory cycle was observed in 61.8 % of cases.
Conclusion. Ovarian function in women with type 1 diabetes mellitus depends on HbA1c level and the dose of insulin. Diabetes compensation in women with type 1 diabetes mellitus contributes to the recovery of ovulation in 61.8 % of cases.
Full Text
##article.viewOnOriginalSite##About the authors
Margarita G. Tolpygina
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Author for correspondence.
Email: chetmar@mail.ru
MD, Post-Graduate Student
Russian Federation, Saint PetersburgMarina A. Tarasova
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: tarasova@ott.ru
MD, PhD, DSci (Medicine), Professor, Honoured Scholar of the Russian Federation
Russian Federation, Saint PetersburgNatalia V. Borovik
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: borovik1970@yandex.ru
MD, PhD
Russian Federation, Saint PetersburgElena V. Misharina
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: mishellena@gmail.com
MD, PhD, Senior Researcher
Russian Federation, Saint PetersburgAlyona V. Tiselko
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: alenadoc@mail.ru
MD, PhD, Senior Researcher
Russian Federation, Saint PetersburgReferences
- Deltsidou A, Lemonidou C, Zarikas V, et al. Oligomenorrhoea in adolescents with type 1 diabetes mellitus: relationship to glycaemic control. Eur J Obstet Gynecol Reprod Biol. 2010;153(1):62-66. doi: 10.1016/j.ejogrb.2010.07.027.
- Gaete X, Vivanco M, Eyzaguirre FC, et al. Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus. Fertil Steril. 2010;94(5):1822-1826. doi: 10.1016/j.fertnstert.2009.08.039.
- Schroeder B, Hertweck SP, Sanfilippo JS, Foster MB. Correlation between glycemic control and menstruation in diabetic adolescents. J Reprod Med. 2000;45(1):1-5.
- Kjaer K, Hagen C, Sando SH, Eshoj O. Epidemiology of menarche and menstrual disturbances in an unselected group of women with insulin-dependent diabetes mellitus compared to controls. J Clin Endocrinol Metab. 1992;75(2):524-529. doi: 10.1210/jcem.75.2.1639955.
- Adcock CJ, Perry LA, Lindsell DRM, et al. Menstrual Irregularities are more Common in Adolescents with Type 1 Diabetes: Association with Poor Glycaemic Control and Weight Gain. Diabet Med. 1994;11(5):465-470. doi: 10.1111/j.1464-5491.1994.tb00307.x.
- Сибирская Е.В. Механизмы нарушений менструального цикла у больных сахарным диабетом 1-го типа: Дис. … канд. мед. наук. - М., 2007. [Sibirskaya EV. Mekhanizmy narusheniy menstrual’nogo tsikla u bol’nykh sakharnym diabetom 1 tipa. [dissertation] Moscow; 2007. (In Russ.)]
- Šnajderová M, Martínek J, Hořejší J, et al. Premenarchal and postmenarchal girls with insulin-dependent diabetes mellitus: Ovarian and other organ-specific autoantibodies, menstrual cycle. J Pediat Adolesc Gynecol. 1999;12(4):209-214. doi: 10.1016/s1083-3188(99)00023-6.
- Мешкова И.П., Григорян О.Р., Зилов А.В., и др. Роль аутоантител к ткани яичников и надпочечников в патогенезе нарушений менструального цикла у девушек, больных сахарным диабетом 1-го типа // Проблемы репродукции. - 2000. - Т. 6. - № 5. - С. 11-15. [Meshkova IP, Grigoryan OR, Zilov AV, et al. Rol’ autoantitel k tkani yaichnikov i nadpochechnikov v patogeneze narusheniy menstrual’nogo tsikla u devushek, bol’nykh sakharnym diabetom 1 tipa. Modern reproductive technologies. 2000;6(5):11-15. (In Russ.)]
- Reinauer C, Bollow E, Frohlich-Reiterer E, et al. Polycystic Ovary Syndrome (PCOS) in Juvenile and Adult Type 1 Diabetes in a German/Austrian Cohort. Exp Clin Endocrinol Diabetes. 2017;125(10):661-668. doi: 10.1055/s-0043-104701.
- Kim C, Miller RS, Braffett BH, et al. Ovarian markers and irregular menses among women with type 1 diabetes in the Epidemiology of Diabetes Interventions and Complications study. Clin Endocrinol (Oxf). 2018;88(3):453-459. doi: 10.1111/cen.13546.
- Айламазян Э.К., Аржанова О.Н., Коган И.Ю., Абашова Е.И. Сахарный диабет и репродуктивная система женщины: руководство для врачей / Под ред. Э.К. Айламазяна. - М.: ГЭОТАР-Медиа, 2017. [Aylamazyan EK, Arzhanova ON, Kogan IY, Abashova EI. Ed by E.K. Aylamazyan. Sakharnyy diabet i reproduktivnaya sistema zhenshchiny: rukovodstvo dlya vrachey. Moscow: GEOTAR-Media; 2017. (In Russ.)]
- Шалина М.А. Состояние костной ткани у женщин с сахарным диабетом 1-го типа: Дис. … канд. мед. наук. - СПб., 2007. [Shalina MA. Sostoyaniye kostnoy tkani u zhenshchin s sakharnym diabetom 1 tipa. [dissertation] Saint Petersburg; 2007. (In Russ.)]
- Soto N, Iniguez G, Lopez P, et al. Anti-Mullerian hormone and inhibin B levels as markers of premature ovarian agingand transition to menopause in type 1 diabetes mellitus. Hum Reprod. 2009;24(11):2838-2844. doi: 10.1093/humrep/dep276.
- Kim C, Dunn RL, Braffett B, et al. Ovarian reserve in women with Type 1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study. Diabet Med. 2016;33(5):691-692. doi: 10.1111/dme.13072.
- la Marca A, Morgante G, De Leo V. Evaluation of hypothalamic pituitary adrenal axis in amenorrhoeic women with insulin-dependent diabetes. Hum Reprod. 1999;14(2):298-302. doi: 10.1093/humrep/14.2.298.
- O’Hare JA, Eichold BH, Vignati L. Hypogonadotropic secondary amenorrhea in diabetes: Effects of central opiate blockade and improved metabolic control. Am J Med. 1987;83(6):1080-1084. doi: 10.1016/0002-9343(87)90945-4.
- Подзолкова Н.М., Глазкова О.Л., Пинегин Б.В., и др. Особенности менструальной функции больных сахарным диабетом 1-го типа // Гинекология. - 2005. - Т. 7. - № 3. - С. 23-30. [Podzolkova NM, Glazkova OL, Pinegin BV, et al. Osobennosti menstrual’noy funktsii bol’nykh sakharnym diabetom 1 tipa. Gynecologiya. 2005;7(3):23-30. (In Russ.)]
- Boering M, van Dijk PR, Logtenberg SJ, et al. Effects of intraperitoneal insulin versus subcutaneous insulin administration on sex hormone-binding globulin concentrations in patients with type 1 diabetes mellitus. Endocr Connect. 2016;5(3):136-142. doi: 10.1530/EC-16-0006.
- Kvasnickova H, Hampl R, Vondra K. DHEA, DHEAS and prolactin correlate with glucose control parameters in women of fertile age with type-1 diabetes mellitus. Physiol Res. 2015;64 Suppl 2:S255-258.
- Zachurzok A, Deja G, Gawlik A, et al. Hyperandrogenism in adolescent girls with type 1 diabetes mellitus treated with intensive and continuous subcutaneous insulin therapy. Endokrynol Pol. 2013;64(2):121-128.
