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Diabetes: a metabolic and reproductive disorder in women.
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2019-10-18 , DOI: 10.1016/s2213-8587(19)30345-6
Eleanor P Thong 1 , Ethel Codner 2 , Joop S E Laven 3 , Helena Teede 1
Affiliation  

Reproductive dysfunction is a common but little studied complication of diabetes. The spectrum of reproductive health problems in diabetes is broad, and encompasses delayed puberty and menarche, menstrual cycle abnormalities, subfertility, adverse pregnancy outcomes, and potentially early menopause. Depending on the age at diagnosis of diabetes, reproductive problems can manifest early on in puberty, emerge later when fertility is desired, or occur during the climacteric period. Historically, women with type 1 diabetes have frequently had amenorrhoea and infertility, due to central hypogonadism. With the intensification of insulin therapy and improved metabolic control, these problems have declined, but do persist. Additional reproductive implications of contemporary diabetes management are now emerging, including polycystic ovary syndrome and hyperandrogenism, which are underpinned by insulin action on the ovary. The sharp rise in type 2 diabetes incidence in youth suggests that more women of reproductive age will encounter diabetes-related reproductive problems in their lifetimes. With an ever increasing number of young women living with diabetes, clinicians need to be aware of and equipped for the challenges of navigating reproductive health concerns across the lifespan.

中文翻译:

糖尿病:女性的代谢和生殖疾病。

生殖功能障碍是糖尿病的一种常见但很少研究的并发症。糖尿病中的生殖健康问题范围很广,包括青春期和初潮延迟,月经周期异常,不孕,不良妊娠结局以及可能的更年期提前。根据诊断出糖尿病的年龄,生殖问题可以在青春期早期出现,在需要生育的时候出现,或者在更年期期间出现。从历史上看,由于中枢性腺功能减退症,患有1型糖尿病的妇女经常患有闭经和不孕症。随着胰岛素治疗的加强和代谢控制的改善,这些问题有所减少,但确实存在。现在,现代糖尿病管理对生殖的其他影响正在浮现,包括多囊卵巢综合症和雄激素过多症,这些都受到胰岛素对卵巢的作用所支持。青年人的2型糖尿病发病率急剧上升,表明更多育龄妇女一生中会遇到与糖尿病相关的生殖问题。随着越来越多的年轻女性罹患糖尿病,临床医生需要意识到并应对在整个生命周期中应对生殖健康问题的挑战。
更新日期:2020-01-22
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