ESPE Abstracts

Background: In the past, the majority of the pacients with Type 1 Diabetes (DM1) had late puberty due to hipogonadotropic hipogonadism as a result of insulin deficiency. However, the use of intensive insulin therapy nowadays, results in higher BMI what can lead to an earlier puberty. Insulin administered subcutaneously is not processed by the liver, which implies increased exposure to this hormone in the ovary leading to greater activation of theca and granulosa cells. Our purpose is to evaluate if puberty is earlier in females with DM1 as respect to females without DM1.

Methods: The study population included are 100 girls with DM1 born between 1997 and 2007 followed up in the Paediatric Endocrinology unit of a single tertiary health care centre. We analyzed the auxological characteristics, insulin dose, HbA1c at diagnosis, start of breast bud and menarche and compared them with girls without DM1 (data extracted from the literature). We also compared girls with diagnosis before and after the start of breast bud. Data analysis is conducted using SPSS Software, version 20.0. Results are presented as mean (standard deviation) and correlation analyses performed using the Pearson and ANOVA tests

Results: Mean age at diagnosis is 7,28 years (3,6). At the moment of diagnosis 13,7% of the females are overweight and 3,2% obese. Overweight and Obese females decreased to 6,3% and 1,3% respectively at the moment of Tanner 2. (P< 0,001) During menarquie levels of overweight increased to 12,8% although obesity was maintained 1% in this stage (P=0,054) Tanner 2 stage begins at 10,66 years (1,1), not earlier than compared with the Spanish population without DM1 (10,4 years). No cases were found of precocious puberty. A moderate correlation exists (r= 0,4) between BMI and earlier Tanner 2 (P<0,001). No significant relation was found with the dose of insulin, duration of the illness and HbA1c. Menarche occurs at 12,74 years (1,11), at a similar age than in Spanish population (12,6 years). It exists a minor correlation (r= 0,03; P<0,05) between higher BMI and earlier menarquie, also seen in DM1 females with a diagnosis after the Tanner2. No differences between diagnosis before and after Tanner 2 were found. 1-The single variable determinant of early puberty in girls with DM1 is a high BMI. 2-Weight control in girls with DM1 is determinant for puberty control. Since our population does not have high BMI, early puberty is not observed, on the contrary to data from literature.