Menstrual Cycle Disturbances in Diabetic Women in Kinshasa, DRC

Objectives: This paper is intended to describe 1) the level of diabetes control and 2) related disturbances of the menstrual cycle among diabetic women in Kinshasa.
Study Design: It is a prospective, observational, case control study carried out from 1st till 31st July 2012 in a medical centre of Salvation Army, in Kinshasa, DR Congo, mostly giving low cost diabetic healthcare. Post menarche, non pregnant and non lactating diabetic women aged from 15 years up to 35 years attending a routine monthly visit were consecutively recruited after consent. The controls were enrolled consecutively after each case among non diabetic women. Fasting plasma glucose for patients and random plasma glucose values for controls were measured. Gynecologic antecedents including menstrual irregularities were recorded.
Statistical Analysis: Mean values are presented with standard deviations. Chi-square and student’s t-test were used for comparison of characteristics’ proportions and means of patients and controls. Odds ratio was used to seek for influence of diabetes on disturbances. Results are given with 95% confidence interval (CI), and p<0.05 as significant.
Results: During the period of study 35 patients and 35 controls were recruited. The mean glucose blood concentration of patients (232.5±4.8mg/dL vs 82.7±15.6mg/dL) is a marker of overall poor diabetes control. Late menarche was significantly more frequent in cases than in controls (p=0.01; CI=8.5-48). As of menstrual troubles, differences appeared for amenorrhea (p=0.000; CI=23.3-62.5) and spaniomenorrhea (p=0.03; CI=2.4-43.3), more frequent among patients.
Conclusions: Mean blood glucose concentration of diabetic women of the study averages 232.5mg/dL. Amenorrhea and spaniomenorrhea that characterize cycle disturbances in these patients could thus be regarded as need for better control of the illness and good contraception. Such a suboptimal diabetes management is expected to increase the burden of the illness not only in terms of chronic complications but also in reproductive health of the community.