Endocrine System - DM1

Patterns:

  • Endocrine and metabolic abnormalities in myotonic dystrophy type 1 (DM1) are well documented.

  • Hyperinsulinemia following glucose ingestion show glucose and glycated hemoglobin (HbA1c) values typical of prediabetes or impaired glucose tolerance.

  • Increased incidence of thyroid, parathyroid and gonadal dysfunction, along with abnormal blood levels of some adrenal hormones.

  • Gonadal insufficiency contributes to problems of erectile dysfunction, infertility, and diminished ovarian reserve.

  • Women may experience reduced fertility, spontaneous abortion and stillbirth, and they may have a somewhat higher rate of excessively painful and irregular menstruations than the general population.

Symptoms:

  • Painful or irregular menses.

  • Erectile dysfunction.

Diagnosis:

  • Discuss the following tests with your doctor:

    • Liver enzymes and bilirubin levels.

    • Thyroid function - TSH and free T4 levels.

    • Hyperlipidemia.

    • Reproductive and fertility/infertility history - irregular menses; ovarian cysts; endometriosis.

Treatment:

  • Refer to OB-GYN specialist as appropriate.

  • Family planning.

  • Refer to genetic counselor or other specialists as indicated.

  • Minoxidil (Rogaine) for hair loss.

  • Lifestyle changes in diet and exercise and appropriate use of medications to normalize blood glucose and insulin levels for treatment of insulin resistance.

  • Consider possible cardiovascular side-effects with some erectile dysfunction medications.