168 research outputs found
Type 1 diabetes, obesity and PCOS: Is type 1 stepping into the shoes of type 2 diabetes?
No full text
Type 1 diabetes, obesity and PCOS: Is type 1 stepping into the shoes of type 2 diabetes?
Get PDFComision Nacional de Investigacion Cientifica y Tecnologica (CONICYT)
CONICYT FONDECYT
1170895
Government of Chil
Estrogen and type 1 diabetes mellitus
Get PDFPatients with type 1 diabetes mellitus (T1DM) face an array of difficulties during puberty which tend to be more significant in females. Excessive weight and fat mass gain, deterioration of metabolic control, loss of height gain and delays in pubertal development may complicate adolescence in girls with T1DM. Hypogonadotropic hypogonadism, hypoestrogenism, menstrual irregularities, polycystic ovaries and early menopause have also been described to T1DM women. In spite of the beneficial effects of estrogen with regard to insulin action and secretion In healthy women, it is striking that women with T1DM seem to lose these beneficial metabolic effects of estrogen. Some of the problems observed in T1DM women may in part be due to the relationship between decreased estrogen levels and insulin action. This article reviews the effects of estrogen on insulin sensitivity and secretion in non-diabetic women, as well as estrogen physiology in T1DM women
Testicular function during adolescence in boys with type 1 diabetes mellitus (T1D): absence of hypogonadism and differences in endocrine profile at the beginning and end of puberty
Get PDFAIM: Conflicting results regarding testicular function in adults with type 1 diabetes (T1D) have been reported, but little is known about Leydig and Sertoli cell function during puberty in boys treated with multiple daily insulin doses. Our aim was to assess testicular function in boys with T1D. METHODS: Pubertal boys with T1D (n = 71) and healthy control boys (Control group; n = 104) who were 10-18 years were studied. Both groups were matched by pubertal stage, age, and BMI. Total testosterone (TT), calculated free testosterone (cfT), SHBG, inhibin B, AMH, and gonadotropin levels were determined. RESULTS: At the beginning of puberty, the T1D group had higher levels of SHBG (p = 0.003) and similar androgen levels than the Control group. At the end of puberty, higher TT, and cfT were observed in T1D compared to the Control group (p < 0.01 and p < 0.001, respectively). Gonadotropins and AMH were similar in both groups. Regression analysis showed that T1D was a significant factor, even after adjusting for Tanner stage and BMI-SDS, affecting TT, cFT, and SHBG levels. BMI-SDS was a significant factor affecting TT and SHBG levels. Higher HbA1c had a negative effect on total testosterone and cFT and a positive effect on SHBG levels in T1D boys. CONCLUSION: Adolescents with T1D do not exhibit hypogonadism, as shown by normal gonadotropin, testosterone, inhibin B, and AMH levels. However, in T1D boys, HbA1c and BMI-SDS had a negative association with testosterone levels. Elevated testosterone levels are observed during late puberty, which were not present earlier.Fil: Rocha, Ana. Universidad de Santiago de Chile. Hospital Clinico San Borja Arriaran. Instituto de Investigaciones Materno Infantil; ChileFil: Iñiguez, German. Universidad de Santiago de Chile. Hospital Clinico San Borja Arriaran. Instituto de Investigaciones Materno Infantil; ChileFil: Godoy, Claudia. Hospital Sótero del Río. Unidad de Endocrinología; ChileFil: Gaete, Ximena. Universidad de Santiago de Chile. Hospital Clinico San Borja Arriaran. Instituto de Investigaciones Materno Infantil; ChileFil: Lopez, Patricia. Universidad de Santiago de Chile. Hospital Clinico San Borja Arriaran. Instituto de Investigaciones Materno Infantil; ChileFil: Loreti, Nazareth. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Campo, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Rey, Rodolfo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Codner, Ethel. Universidad de Santiago de Chile. Hospital Clinico San Borja Arriaran. Instituto de Investigaciones Materno Infantil; Chil
Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review
Get PDFPolycystic ovary syndrome (PCOS) is one of the most common endocrine conditions in women. PCOS may be more challenging to diagnose during adolescence due to an overlap with the physiological events of puberty, which are part of the diagnostic criteria in adult women. This review focuses on the evidence available in relation to PCOS diagnostic criteria for adolescents. Adolescent PCOS should be diagnosed using two main criteria irregular -menstrual cycles (relative to number of years post-menarche) and hyperandrogenism (clinical and/or biochemical); after excluding other conditions that mimic PCOS. Accurate definitions of the two main criteria will decrease challenges/controversies with the diagnosis and provide timely diagnosis during adolescence to establish early management. Despite the attempts to create accurate diagnostic criteria and definitions, this review highlights the limited research in this area, especially in the follow up of adolescents presenting with one diagnostic feature that are called “at risk of PCOS”. Studies in adolescents continue to use the Rotterdam diagnostic criteria that uses pelvic ultrasound. This is inappropriate, because previous and emerging data that show many healthy adolescents have polycystic ovarian morphology in the early years post-menarche. In the future, anti-Müllerian hormone levels might help support PCOS diagnosis if adolescents meet two main criteria
Premature thelarche from phenotype to genotype
Get PDFPremature thelarche is a benign condition, which has been described as a "variant of puberty". Early breast development is especially prevalent during the first year of life, when the gonadal axis is usually active. Ultrasensitive bioassays have described higher estrogen levels in these girls compared to controls. Some cases of premature thelarche may also exhibit increased growth velocity and/or bone age, despite prepubertal gonadotropin secretion. These cases have been labeled as exaggerated thelarche and may represent an intermediate state between benign premature thelarche and precocious puberty. Several factors have been associated with the etiology of premature thelarche, such as endocrine disruptors, and genetic and nutritional factors. Recently, it has been shown that some girls with exaggerated or fluctuating thelarche may have an activating mutation in the CNAS gene, which codifies for a subunit of G stimulating protein (Gsα). We discuss the different phenotypes that may be
Contraception and pregnancy in adolescents with type 1 diabetes: a review
Get PDFAdolescence is a critical period for girls with type 1 diabetes mellitus
(T1D). Reproductive issues, such as menstrual abnormalities, risk of an
unplanned pregnancy, and contraception, should be addressed during
this phase of life. This paper reviews several reproductive issues that are
important in the care of adolescents, including pubertal development,
menstrual abnormalities, ovulatory function, reproductive problems, the
effects of hyperglycemia, contraception, and treatment of an unplanned
pregnancy.
A review of the literature was conducted. AMEDLINE search January
1966 to March 2011 was performed using the following MESH terms:
puberty, menarche, ovary, polycystic ovary syndrome, menstruation,
contraception, contraception-barrier, contraceptives-oral-hormonal, sex
education, family planning services, and pregnancy in adolescence.
This literature search was cross-referenced with an additional search
on diabetes mellitus-type 1, diabetes complications, and pregnancy in
diabetes. All published studies were searched regardless of the language of
origin. Bibliographies were reviewed to extract additional relevant sources.Fondo Nacional
de Ciencia y Tecnología (FONDECYT) Grants 1100123 and
105045
- …
