A study has found a link between Type 2 diabetes and irregular menstruation with the potential to become PCOS.
A recent study published in The Journal of Clinical Endocrinology & Metabolism has found a link between Type 2 Diabetes and irregular menstruation in cis girls. The study is called the “Treatment Options for Type 2 Diabetes in Youth” and was conducted by Megan M. Kelsey, MD, MS, an associate professor of pediatric endocrinology at the University of Colorado School of Medicine. The study was conducted to “test treatment options for [Type 2 Diabetes] in children,” and was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.
Andjela Drincic, MD, an associate professor of internal medicine at the University of Nebraska Medical Center, states that Type 1 diabetes is an autoimmune disease, caused when the immune system “attack cells in the pancreas that make insulin.” Little to no insulin is produced by the body. While a cause of Type 1 diabetes isn’t known, it is likely genetic. With type 2, the body either resists insulin or doesn’t produce enough insulin to create normal levels of glucose. Type 2 is not an autoimmune disorder and can be caused by a number of factors.
Type 2 diabetes used to be categorized as a disease only adults got, but over the last few decades has drastically increased in children. Cis men and cis women develop Type 2 diabetes at similar rates. However, girls are much more likely to develop it than boys are, comprising two-thirds of all diabetic children. Researchers still aren’t sure why that is.
One theory is that it could be caused by high rates of polycystic ovary syndrome (PCOS). Between 10 and 20 percent of cis women have PCOS, which “is known to impact both sex hormones and insulin sensitivity and put women at risk for developing” Type 2 diabetes. Dr. Kelsey concedes that, at this point in time, “While we know that [PCOS] leads, down the line, to increased risk for diabetes, we don’t know what the prevalence of polycystic ovarian syndrome is in girls who are diagnosed with diabetes early.” This is because PCOS is only diagnosed after a child has had their period for at least two years, meaning that many of the girls in the study were still too young to give a formal diagnosis. Samples were collected to check for signs of future PCOS.
Roughly 21 percent of the girls that participated in the study showed signs of menstrual dysfunction. According to the Cleveland Clinic, menstrual dysfunction is a general term for a number of menstrual irregularities. These include:
- Amenorrhea – an absence of a period
- Oligomenorrhea – 35 or more days between periods
- Polymenorrhea – 21 days or less between periods
- Menorrhagia – heavy periods of 80 mL or more
- Metrorrhagia – irregular bleeding between periods
- Menometrorrhagia – combination of metrorrhagia and menorrhagia; heavy and irregular periods
These menstrual irregularities are “suggestive of PCOS,” meaning that the girls likely have it or will develop it, but are still too young to diagnose. Also, according to Dr. Kelsey, infrequent and “irregular periods can lead to endometrial hyperplasia, which can cause heavy and painful periods.” It also increases the risks of “fatty liver disease, fertility problems, and long-term risk for endometrial cancer” in the future.
The girls in the study experiencing irregular menstruation were also shown to have higher levels of testosterone in their systems than those that didn’t experience irregular menstruation. Higher than normal levels of testosterone in cis women is one of the main indications of PCOS. The drug metformin is used the only treatment for both Type 2 diabetes in adolescents and is also used to treat PCOS. Since the study participants were already taking metformin for diabetes, it could very well have been inadvertently treating PCOS symptoms in some of the patients.
Dr. Kelsey talks of the importance of getting to the bottom of the connection between irregular menstruation and Type 2 diabetes in young girls. “This study showed that despite aggressive treatment of diabetes, that menstrual dysfunction was still present, so it’s really important to assess girls with [Type 2 diabetes] for menstrual dysfunction and treat it.”
When asked about what she hopes to achieve with her research, Dr. Kelsey says that she hopes “to find ways to better target early prevention of diabetes, by treating kids at risk for diabetes while they are going through puberty.”