| Abstract | UVOD: Dijabetes melitus tip 1 (DM1) je kronična bolest u kojoj imunosno razaranje β-stanica gušterače dovodi do nedostatka inzulina. U djevojčica s DM1 opisuje se odgođena pojava menarhe koja je povezana s lošom metaboličkom kontrolom bolesti, ukupnom dnevnom dozom inzulina i trajanjem dijabetesa.
CILJ: Cilj rada je opisati osobitosti DM1 u korelaciji s pojavom menarhe u djevojčica koje boluju od DM1.
METODE: Provedena je retrospektivna presječna studija na 108 djevojčica (prosječne dobi 16,12±1,97 godina), kojima je dijagnosticiran DM1 (prosječna dob dijagnoze je 8,76±3,4 godina) i koje su imale menarhe u vrijeme provođenja studije. Podaci su prikupljeni iz medicinske dokumentacije.
REZULTATI: Prosječna dob menarhe u našem uzorku je 12,63±1,14 godina. Dijagnoza DM1 je postavljena prije menarhe u 93/108 (86,1%) pacijentica (prosječna dob 8,03 godine, raspon 0,75-14,0 godina). Podjelom pacijentica na one kojima je dijagnoza postavljena prije i poslije 10 godina, nema razlike u dobi pojave menarhe. Djevojčice kojima je dijagnoza DM1 postavljena prije pojave menarhe imaju kasniju pojavu menarhe (12,79 naspram 11,62 godina), međutim uzorak u drugoj skupini je mali. U skupini pacijentica kojima je dijagnoza postavljena prije menarhe, djevojčice koje koriste inzulinsku pumpu imaju nižu dob menarhe u usporedbi s djevojčicama koje koriste pen-injektore (12,51 naspram 13,02 godina, t(91) = 2,427, p = 0,009). Dijabetička ketoacidoza (DKA) prilikom dijagnoze je zabilježena u 30/93 pacijentica te ova skupina ima nižu dob menarhe (12,28 naspram 13,03 godina, t(88) = -3,358, p < 0,01).
ZAKLJUČAK: Unatoč boljoj skrbi o pacijentima s DM1 i dalje je prisutan negativan utjecaj DM1 na pubertetski razvoj i reproduktivno zdravlje. |
| Abstract (english) | BACKGROUND: Type 1 diabetes mellitus (DM1) is a chronic disease in which immune destruction of pancreatic β-cells results in insulin deficiency. Girls with DM1 have been reported with delayed onset of menarche, in relation to premenarchal onset of DM1, inadequate metabolic control, insulin dosage, and duration of diabetes.
AIM: The aim of this study was to describe the characteristics of DM1 in correlation with the onset of menarche in girls with DM1.
METHODS: We conducted a retrospective cross-sectional study on 108 girls (mean age 16.12±1.97 years), previously diagnosed with DM1 (mean age at diagnosis 8.76±3.49 years), who achieved menarche at the time of the study. The data were collected from the medical records.
RESULTS: The average age of menarche in our study sample is 12.63±1.14 years. Of 108 patients, 93 (86.1%) were diagnosed with DM1 prior to menarche (mean age 8.03 years, range 0.75-14.0 years). When stratified according to diabetes onset before (61/108) or after the age of 10 years, there was no significant difference in age of menarche. Girls with premenarchal DM1 diagnosis have delayed menarchal age as compared to those with later DM1 development (12.79 vs. 11.62 years), but the second subgroup sample was small. Among girls with premenarchal diabetes development, girls using insulin pumps had earlier menarche than those using multiple daily injections (12.51 vs. 13.02 years, t(91) = 2.427, p = 0.009). Diabetic ketoacidosis (DKA) at diagnosis was found in 30/93 patients; this subgroup has earlier age of menarche (12.28 vs. 13.03 years, t(88) = -3.358, p < 0.01).
CONCLUSION: Despite better medical care for patients with DM1, the negative impact of DM1 on pubertal development and reproductive health is still present. |
