Specific features of the establishment of puberty in girls with type 1 diabetes mellitus and related disturbances of menstrualand ovarian functions

Abstract

Type 1 diabetes mellitus (DM1) exerts negative impact on the formation and functioning of the reproductive system in young girls. The time of onset(especially in the prepubertal period) and duration of DM1 as well as the lack of metabolic control may cause delay of puberty, affect the age of menarche,and increase the frequency of menstrual disturbances (largely in the form oligo- and amenorrhoea). Despite extensive research devoted to thisproblem, the main cause of reproductive dysfunction in such patients remains unclear even though DM1 is known to negatively affect performanceof the hypothalamo-pituitary axis. Pathogenetic mechanisms behind reproductive disturbances include suppression of GnRH pulses due to enhancedcentral dopamine and opiate activity, decreased expression of insulin receptors on neural cells, and altered plasma leptin level. Pituitary may be affectedboth by hypothalamic activity and by lipid free radical oxidation products decreasing production of tropic hormones (LH and FSH).

Keywords

• type 1 diabetes mellitus
• reproductive system
• puberty