Possible altered dopaminergic modulation of pituitary function in normal-menstruating women with insulin dependent diabetes mellitus (IDDM)

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Abstract
In order to assess whether a possible altered dopamine activity in normal-menstruating diabetic patients may influence the pituitary hormone secretion we have measured the basal serum concentrations of Prl, LH and FSH in 28 patients with insulin dependent diabetes mellitus (IDDM) and in 55 normal-menstruating women at day 3 to 6 of the menstrual cycle. In addition basal levels of oestradiol-17β, TSH, thyroxine (T4), triiodothyronine (T3) and resin-T3 uptake (RT3U) were determined in 17 patients with IDDM and in 17 controls. The responses of FSH, LH, Prl, GH and TSH to metoclopramide (MTC) administration (10 mg iv) were studied in 17 patients and 17 controls. In 10 patients with IDDM and 8 controls the short-term variations in pituitary hormones and blood glucose concentration were evaluated. Patients with IDDM had significantly lower basal levels of Prl (P < 0.01) and TSH (P < 0.05) and significantly (P < 0.05) higher basal levels of GH than normal women. No significant (P > 0.05) differences were found regarding basal serum concentrations of FSH, LH, oestradiol, T4, T3 and RT3U. During the 3 h period the mean coefficient of variation of Prl, FSH, LH and GH was not significantly (P > 0.05) different between diabetic patients and controls. Both groups responded significantly (PP < 0.05) lower in patients with IDDM. The Prl response to MTC was not significantly (P > 0.05) different within the two groups. None of the groups responded significantly (P > 0.05) in GH or gonadotrophins to MTC. No significant correlations (P > 0.05) were found between parameters of diabetes regulation and basal or stimulated hormone concentrations. Although, the interpretation of the results may be controversial it is suggested that the hormonal changes in normal-menstruating women with IDDM are to some extent compatible with a raised central dopaminergic activity.