Youth with gender dysphoria may be at increased risk for developing type 1 diabetes, a new observational study showed.
The study of more than 2000 people aged 10 to 21 years at a single institution, published online November 22 in Pediatrics Diabetes by Santhi N. Logel, MD, and colleagues.
The prevalence of type 1 diabetes among youth with gender dysphoria staggering nine times higher than in those without it.
The prevalence of type 1 diabetes and youth identify as transgender, nonbinary, or broad gender / does not fit has increased in recent years.
In the United States, type 1 diabetes is estimated to be present in 1.9 to 2.4 per 1000 population and gender alternative youth around 7 per 1000 population, said Logel, of the division of pediatric endocrinology and diabetes at the School of Medicine and Public Health at the University of Wisconsin-Madison, and a co-author.
However, “There is no correlation was reported between type 1 diabetes and gender identity in adolescents,” the researchers wrote.
However, a study of adults, published in 2017 found a prevalence 2.3 times higher than type 1 diabetes patients in the clinic transgender.
“Given the challenges overlapping type 1 diabetes and transgender, nonbinary and comprehensive gender / does not match his face, identify the relationship between type 1 diabetes and [gender identity] Further understanding of the two populations could explain this complex,” they said.
The relationship may be due to the effect of stress hormones on beta cell function and / or from increased assurance for medical visits more often among youth with type 1 diabetes and gender dysphoria, they speculate.
The support of the health care provider is important, the authors stress.
In a 2015 survey of transgender individuals, 33% who see a health care provider reported at least one negative experience associated with their gender identity, and 23% reported seeing a health care provider to avoid for fear of persecution.
Nine-fold increase in T1D between Youth With Gender Dysphoria
Of the 749 284 10-21 year-old patients seen at the University of Wisconsin Hospital and Clinics in 2007-2017, a total of 2017 diagnosed with type 1 diabetes, or $ 2.69 per 1000 population, and 315 were diagnosed with gender dysphoria, or 0.42 per 1000 population.
Both diagnoses present in eight patients.
The prevalence of type 1 diabetes was 24.77 per 1000 population in gender dysphoric group compared with 2.68 per 1000 population at nongender dysphoric group, a highly significant difference of 9.4-fold (P <0.0001).
Most patients with both conditions were diagnosed with type 1 diabetes prior to presenting at the clinic sexes, with an average age of 9.9 and 13 years, respectively (although most report that feelings of gender dysphoria started early).
The group with gender dysphoria, three were identified as transfeminine, three as transmasculine, one as gender fluid, and one as a gender neutral. hormonal treatment including puberty-blocking therapy gonadotropic-agonists in four and gender confirms estrogen hormone and testosterone in two in two.
glycemic control from gender dysphoria initially improved after the first clinic visit on average 5 months in five patients, but there is no sustained improvement in A1c.
The finding that initially improved glycemic control but it can not be maintained “shows that reducing stress for initiation confirms gender hormone therapy leads to short-term improvements in diabetes control in adolescents with type 1 diabetes and gender dysphoria,” Logel and colleagues wrote.
known psychiatric diagnoses including anxiety in six, depression in four, and substance abuse in one. Two have thoughts of suicide, and two had attempted suicide with an overdose of insulin.
“To our knowledge, this is the first study in adolescents that shows a possible association between type 1 diabetes and gender dysphoria. Future research will include evaluating biomarkers of stress in adolescents with type 1 diabetes and gender dysphoria and determining the prevalence of gender dysphoria in other chronic autoimmune diseases,” the researchers conclude.