Can Type 1 Diabetes Affect Reproductive Ability in Women?

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Editor: David L. Joffe, BSPharm, CDE, FACA


Author: Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy

According to new studies, women diagnosed with type 1 diabetes tend to have a shorter reproductive timeframe than women without diabetes. 

The research shows that the reproductive timeframe of women with type 1 diabetes is on average 2 and a half years less than other women. It is worth noting that only women who develop the disease before starting menstruation are affected by the decrease in reproductive years. Due to the potentially shortened length of childbearing years, women with type 1 diabetes who want to have children are advised to plan carefully. This study was conducted using the Epidemiology of Diabetes Complications trial and the Study of Women’s Health Across the Nation (SWAN).  

The Epidemiology of Diabetes Complications (EDC) cohort contained 105 females who had type 1 diabetes and were diagnosed at the Children’s Hospital of Pittsburgh from the fifties through the eighties when they were 17 years or younger. The 178 women in this study that were not diagnosed with diabetes came from the Study of Women’s Health Across the Nation. There was a bit of an age gap between the two groups, with the women in the type 1 diabetes group being younger. The type 1 diabetes group also had a smaller population of Black women. Compared to women with diabetes in EDC, the reproductive period in 178 women without diabetes in SWAN was approximately 2.5 years longer after adjustments were modified for confounders due to them having earlier menstruation and later menopause.  

The data shows that the females with type one diabetes from the EDC group began menstruation approximately a year later. Late menstruation was not seen in those diagnosed with type 1 diabetes after starting menstruation, and they had a normal timeframe for reproduction. During the last follow-up, the average age of women with type 1 diabetes was approximately 59 years old. The age of the women without diabetes was 64.0 years old. The data also showed that women with type 1 diabetes used significantly less birth control than women without type 1.  

While research proves that women who develop type one diabetes before puberty have a shortened reproductive timeframe, nobody knows precisely why. More studies need to be conducted to discover the mechanism behind the shortened reproductive period in these women. Although the mechanism is unknown, it is believed that in combination, high blood glucose, endogenous insulin deficiency, and exogenous hyperinsulinemia occurring in women with type 1 may disturb the hypothalamic-pituitary-ovarian axis function. Another possible reason for the shortened reproductive length could be due to high blood glucose and oxidative stress. Both high blood sugar and oxidative stress are believed to result in premature aging of the ovaries.  

Practice Pearls: 

  • Research shows that the reproductive timeframe of women with type 1 diabetes is on average 2 and a half years less than women who were not diagnosed with type 1 diabetes. 
  • Although women with type one diabetes are likely to have less time to reproduce, women diagnosed after puberty will not be affected; only women diagnosed before starting menstruation are affected.  
  • While research proves that women who develop type one diabetes before puberty have a shortened reproductive timeframe, more studies must be done to discover the exact cause. 

 

Miriam E. Tucker, Reproductive Period Shorter in Women with Type 1 Diabetes. Medscape, 17 March 2021.  

Yi, Yan MPH; El Khoudary, Samar R. Ph.D. Women with Type 1 diabetes (T1D) experience a shorter reproductive period compared with nondiabetic women in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study and the Study of Women’s Health Across the Nation (SWAN). Menopause Journal, 01 March 2021. 

 

Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy 



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