Reproductive health of women with type 1 diabetes

Despite the evident progress achieved in the treatment of type 1 diabetes (T1D) over the past decade and due to the active implementation of innovative technologies, the prevalence of reproductive system disorders among young women with T1D remains quite high and is about 40%. A wide range of such disorders include delayed puberty, late menarche, irregular menstrual cycle, infertility, adverse pregnancy outcomes, and early menopause. In addition, according to available scientific data, patients with T1D have a higher incidence of such gynecological diseases as polycystic ovarian syndrome, endometriosis, uterine fibroids, hyperplastic lesions of the endometrium and mammary glands. The leading pathogenetic factor of emerging reproductive disorders is chronic hyperglycemia, as well as marked glycemic variability. To ensure timely prevention and development of a comprehensive approach to the treatment of gynecological and reproductive diseases, a broader understanding of the clinical features of reproductive disorders and the pathogenetic mechanisms of their development is required. The aim of this review was to systematize the available knowledge on the characteristics of reproductive health of women with T1D and to analyze current preventive and therapeutic strategies for reproductive dysfunction. Key words: insulin therapy, type 1 diabetes, reproductive system, ovarian hyperandrogenism