{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:16:37Z","timestamp":1778750197165,"version":"3.51.4"},"reference-count":100,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,27]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Hyperandrogenism with or without polycystic ovarian syndrome is seen in adolescents with type 1 diabetes (T1D), especially those with suboptimal control.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess the effect of metformin on hyperandrogenism and ovarian function in adolescents with T1D.<\/jats:p><\/jats:sec>Methods<\/jats:title>This prospective study included 28 T1D females showing signs of hyperandrogenism. History taking (detailed diabetes history and menstrual history) and anthropometric measurements (weight, height, body mass index [BMI], waist and hip circumference) were initially performed, and then the patients were assessed for the manifestations of hyperandrogenism (acne, hirsutism as well as pelvic ultrasound [U\/S] for ovarian morphology). Biochemical evaluation for ovulation (progesterone assessment during the luteal phase), sex steroids (estradiol, testosterone, dehydroepiandrosterone sulfate [DHEAS] and androstenedione), prolactin, glycemic control (hemoglobin A1c<\/jats:sub>[HbA1c<\/jats:sub>]) and gonadotropin levels (follicle stimulating hormone [FSH] and luteinizing hormone [LH]) was done. Patients were subjected to 500 mg metformin twice daily orally for 1 year, and then the patients were re-evaluated for clinical and biochemical parameters.<\/jats:p><\/jats:sec>Results<\/jats:title>Metformin therapy resulted in a significant reduction in weight (p\u2009=\u20090.001), BMI (p\u2009=\u20090.002), acne (p\u2009=\u20090.008), hirsutism score (0.007), LH (p\u2009=\u20090.008), testosterone (p\u2009<\u20090.001) and androstenedione levels (p\u2009=\u20090.028) in adolescent girls with T1D. Regarding menstrual irregularities, there was a significant reduction in the number of patients with oligomenorrhea (68%) with a p value of <0.001. However, there were no significant reduction in the daily insulin requirements (p\u2009=\u20090.782) or HbA1c<\/jats:sub>(p\u2009=\u20090.068). Nausea and\/or abdominal pain were the commonly reported side effects of metformin (64%).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Metformin as an insulin sensitizing agent improved the BMI and cycle regularity together with clinical and biochemical hyperandrogenism in T1D adolescent girls. However, it did not improve their glycemic control.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpem-2018-0430","type":"journal-article","created":{"date-parts":[[2019,4,21]],"date-time":"2019-04-21T09:01:12Z","timestamp":1555837272000},"page":"461-470","source":"Crossref","is-referenced-by-count":6,"title":["Effect of metformin on clinical and biochemical hyperandrogenism in adolescent girls with type 1 diabetes"],"prefix":"10.1515","volume":"32","author":[{"given":"Mona","family":"Hafez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha","family":"Musa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaimaa","family":"Elbehairy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahar Abdel","family":"Atty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menna","family":"Elbarbary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maha","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref931","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000355513","article-title":"Metformin for the treatment of hyperandrogenism in adolescents with type 1 diabetes mellitus","volume":"80","year":"2013","journal-title":"Horm Res Paediatr"},{"key":"ref281","first-page":"4182","article-title":"High prevalence of the polycystic ovary syndrome and hirsutism in women with type 1 diabetes mellitus","volume":"85","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1159\/000375530","article-title":"The diagnosis of polycystic ovarian syndrome during adolescence","volume":"83","year":"2015","journal-title":"Horm Res Pediatr"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/humupd\/dms024","article-title":"Female reproduction and type 1 diabetes: from mechanisms to clinical findings","volume":"18","year":"2012","journal-title":"Hum Reprod Update"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1159\/000375530","article-title":"The diagnosis of polycystic ovarian syndrome during adolescence","volume":"83","year":"2015","journal-title":"Horm Res Pediatr"},{"key":"ref141","first-page":"43","article-title":"A critical notice of Brown on \u201cthe age at menarche\u201d","volume":"21","year":"1967","journal-title":"Br J Prev Soc Med"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/cen.12238","article-title":"Heart rate variability in pubertal girls with type 1 diabetes: its relationship with glycaemic control, insulin resistance and hyperandrogenism","volume":"80","year":"2014","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref481","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1210\/er.2002-0015","article-title":"Insulin-lowering agents in the management of polycystic ovary syndrome","volume":"24","year":"2003","journal-title":"Endocr Rev"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.2337\/dc07-0475","article-title":"Continuing stability of center differences in pediatric diabetes care: do advances in diabetes treatment improve outcome? The Hvidoere Study Group on Childhood Diabetes","volume":"30","year":"2007","journal-title":"Diabetes Care"},{"key":"ref121","first-page":"580","article-title":"Use of metformin in pediatric age","volume":"12","year":"2011","journal-title":"Pediatr Diabetes"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12905-015-0228-8","article-title":"Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey","volume":"15","year":"2015","journal-title":"BMC Womens Health"},{"key":"ref711","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1016\/j.fertnstert.2011.09.023","article-title":"Ovarian hyperandrogenism in adolescents and young women with type I diabetes is primarily related to birth weight and body mass index","volume":"96","year":"2011","journal-title":"Fertil Steril"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/pedi.12337","article-title":"Insulin resistance, role of metformin and other non-insulin therapies in pediatric type 1 diabetes","volume":"17","year":"2016","journal-title":"Pediatr Diabetes"},{"key":"ref791","first-page":"4182","article-title":"High prevalence of the polycystic ovary syndrome and hirsutism in women with type 1 diabetes mellitus","volume":"85","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/j.2040-1124.2011.00171.x","article-title":"Factors associated with basal insulin dose in Japanese children and young adult type 1 diabetics","volume":"3","year":"2012","journal-title":"J Diabetes Investig"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00125-009-1636-9","article-title":"The use of metformin in type 1 diabetes: a systematic review of efficacy","volume":"53","year":"2010","journal-title":"Diabetologia"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/humupd\/dms024","article-title":"Female reproduction and type 1 diabetes: from mechanisms to clinical findings","volume":"18","year":"2012","journal-title":"Hum Reprod Update"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"639","DOI":"10.2337\/dc15-2577","article-title":"Type 1 diabetes and polycystic ovary syndrome: systematic review and meta-analysis","volume":"39","year":"2016","journal-title":"Diabetes Care"},{"key":"ref261","first-page":"490","article-title":"Growth and body composition in children with type 1 diabetes mellitus","volume":"50","year":"2006","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"ref601","first-page":"139","article-title":"Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation","volume":"85","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"ref311","first-page":"178","article-title":"The prevalence of hirsutism and polycystic ovary syndrome in women with type 1 diabetes mellitus","volume":"5","year":"2009","journal-title":"GINECO.RO"},{"key":"ref991","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1210\/er.2002-0015","article-title":"Insulin-lowering agents in the management of polycystic ovary syndrome","volume":"24","year":"2003","journal-title":"Endocr Rev"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1757-2215-2-5","article-title":"Does metformin affect ovarian morphology in patients with polycystic ovary syndrome? A retrospective cross-sectional preliminary analysis","volume":"2","year":"2009","journal-title":"J Ovarian Res"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2337\/diacare.24.7.1297","article-title":"Identification of the source of androgen excess in hyperandrogenic type 1 diabetic patients","volume":"24","year":"2001","journal-title":"Diabetes Care"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"639","DOI":"10.2337\/dc15-2577","article-title":"Type 1 diabetes and polycystic ovary syndrome: systematic review and meta-analysis","volume":"39","year":"2016","journal-title":"Diabetes Care"},{"key":"ref951","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1507\/endocrj.EJ15-0548","article-title":"A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin","volume":"63","year":"2016","journal-title":"Endocr J"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/1477-7827-12-98","article-title":"Metformin induces a prompt decrease in LH-stimulated testosterone response in women with PCOS independent of its insulin-sensitizing effects","volume":"12","year":"2014","journal-title":"Reprod Biol Endocrinol"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0015-0282(01)02941-7","article-title":"Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome","volume":"77","year":"2002","journal-title":"Fertil Steril"},{"key":"ref831","first-page":"121","article-title":"Hyperandrogenism in adolescent girls with type 1 diabetes mellitus treated with intensive and continuous subcutaneous insulin therapy","volume":"64","year":"2013","journal-title":"Endokrynol Pol"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1038\/nrendo.2010.49","article-title":"Adjunct therapy for type 1 diabetes mellitus","volume":"6","year":"2010","journal-title":"Nat Rev Endocrinol"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/pedi.12203","article-title":"Current use of metformin in addition to insulin in pediatric patients with type 1 diabetes mellitus: an analysis based on a large diabetes registry in Germany and Austria","volume":"16","year":"2015","journal-title":"Pediatr Diabetes"},{"key":"ref751","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/j.2040-1124.2011.00171.x","article-title":"Factors associated with basal insulin dose in Japanese children and young adult type 1 diabetics","volume":"3","year":"2012","journal-title":"J Diabetes Investig"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/cen.12238","article-title":"Heart rate variability in pubertal girls with type 1 diabetes: its relationship with glycaemic control, insulin resistance and hyperandrogenism","volume":"80","year":"2014","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref761","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.diabres.2012.12.025","article-title":"Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus","volume":"100","year":"2013","journal-title":"Diabetes Res Clin Pract"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.4158\/EP15748.DSC","article-title":"American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome \u2013 Part 1","volume":"21","year":"2015","journal-title":"Endocr Pract"},{"key":"ref91","first-page":"139","article-title":"Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation","volume":"85","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.beem.2006.02.004","article-title":"Diagnosis of hyperandrogenism: clinical criteria","volume":"20","year":"2006","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref631","first-page":"580","article-title":"Use of metformin in pediatric age","volume":"12","year":"2011","journal-title":"Pediatr Diabetes"},{"key":"ref651","first-page":"43","article-title":"A critical notice of Brown on \u201cthe age at menarche\u201d","volume":"21","year":"1967","journal-title":"Br J Prev Soc Med"},{"key":"ref821","first-page":"178","article-title":"The prevalence of hirsutism and polycystic ovary syndrome in women with type 1 diabetes mellitus","volume":"5","year":"2009","journal-title":"GINECO.RO"},{"key":"ref691","first-page":"9473158","article-title":"Lipid profile in adolescent girls with type 1 diabetes mellitus and hyperandrogenemia","volume":"2016","year":"2016","journal-title":"Int J Endocrinol"},{"key":"ref1011","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1757-2215-2-5","article-title":"Does metformin affect ovarian morphology in patients with polycystic ovary syndrome? A retrospective cross-sectional preliminary analysis","volume":"2","year":"2009","journal-title":"J Ovarian Res"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1530\/EJE-11-0670","article-title":"High prevalence of hirsutism and menstrual disorders in obese adolescent girls and adolescent girls with type 1 diabetes mellitus despite different hormonal profiles","volume":"166","year":"2012","journal-title":"Eur J Endocrinol"},{"key":"ref271","first-page":"277","article-title":"Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey","volume":"30","year":"2017","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.4103\/2230-8210.155402","article-title":"Puberty and type 1 diabetes","volume":"19","year":"2015","journal-title":"Indian J Endocrinol Metab"},{"key":"ref171","first-page":"1391","article-title":"Optimal age of sexual maturation in Egyptian children","volume":"14","year":"2008","journal-title":"East Mediterr Health J"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0015-0282(16)53510-9","article-title":"Dysregulation of cytochrome P 450, 17\u03b1 as the cause of polycystic ovarian syndrome","volume":"53","year":"1990","journal-title":"Fertl Steril"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1210\/jc.2013-2669","article-title":"No phenotypic differences for polycystic ovary syndrome (PCOS) between women with and without type 1 diabetes mellitus","volume":"99","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref701","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1210\/jc.2013-2669","article-title":"No phenotypic differences for polycystic ovary syndrome (PCOS) between women with and without type 1 diabetes mellitus","volume":"99","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref941","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.numecd.2013.04.016","article-title":"In PCOS patients the addition of low-dose spironolactone induces a more marked reduction of clinical and biochemical hyperandrogenism than metformin alone","volume":"24","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/pedi.12493","article-title":"The effect of adding metformin to insulin therapy for type 1 diabetes mellitus children: a systematic review and meta-analysis","volume":"18","year":"2017","journal-title":"Pediatr Diabetes"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1210\/jc.2003-031780","article-title":"Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study","volume":"89","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"ref321","first-page":"121","article-title":"Hyperandrogenism in adolescent girls with type 1 diabetes mellitus treated with intensive and continuous subcutaneous insulin therapy","volume":"64","year":"2013","journal-title":"Endokrynol Pol"},{"key":"ref781","first-page":"277","article-title":"Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey","volume":"30","year":"2017","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref981","first-page":"148","article-title":"Metformin versus Chang Gung Med J Vol. 29 No. 5 September\u2013October 2006 Hsin-Shih Wang Metformin and PCOS 447 ethinyl estradiol-cyproterone acetate in the treatment of nonobese women with polycystic ovary syndrome: a randomized study","volume":"88","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1089\/dia.2014.0190","article-title":"Efficacy and safety of metformin for patients with type 1 diabetes mellitus: a meta-analysis","volume":"17","year":"2015","journal-title":"Diabetes Technol Ther"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000355513","article-title":"Metformin for the treatment of hyperandrogenism in adolescents with type 1 diabetes mellitus","volume":"80","year":"2013","journal-title":"Horm Res Paediatr"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/pedi.12493","article-title":"The effect of adding metformin to insulin therapy for type 1 diabetes mellitus children: a systematic review and meta-analysis","volume":"18","year":"2017","journal-title":"Pediatr Diabetes"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/S0015-0282(00)00501-X","article-title":"Metformin therapy decreases hyperandrogenism and hyperinsulinemia in women with polycystic ovary syndrome","volume":"73","year":"2000","journal-title":"Fertil Steril"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"4742","DOI":"10.1210\/jc.2007-1252","article-title":"Hormonal profile in women with polycystic ovarian syndrome with or without type 1 diabetes mellitus","volume":"92","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1210\/jc.2006-0108","article-title":"Diagnostic criteria for polycystic ovary syndrome and ovarian morphology in women with type 1 diabetes mellitus","volume":"91","year":"2006","journal-title":"J Clin Endocrinol"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.diabres.2012.12.025","article-title":"Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus","volume":"100","year":"2013","journal-title":"Diabetes Res Clin Pract"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.4103\/2230-8210.155402","article-title":"Puberty and type 1 diabetes","volume":"19","year":"2015","journal-title":"Indian J Endocrinol Metab"},{"key":"ref871","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0015-0282(16)53510-9","article-title":"Dysregulation of cytochrome P 450, 17\u03b1 as the cause of polycystic ovarian syndrome","volume":"53","year":"1990","journal-title":"Fertl Steril"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1210\/jc.2006-0108","article-title":"Diagnostic criteria for polycystic ovary syndrome and ovarian morphology in women with type 1 diabetes mellitus","volume":"91","year":"2006","journal-title":"J Clin Endocrinol"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12905-015-0228-8","article-title":"Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey","volume":"15","year":"2015","journal-title":"BMC Womens Health"},{"key":"ref471","first-page":"148","article-title":"Metformin versus Chang Gung Med J Vol. 29 No. 5 September\u2013October 2006 Hsin-Shih Wang Metformin and PCOS 447 ethinyl estradiol-cyproterone acetate in the treatment of nonobese women with polycystic ovary syndrome: a randomized study","volume":"88","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"5305","DOI":"10.1210\/jc.2010-1123","article-title":"Reproductive Medicine Network. Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism","volume":"95","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"ref611","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/1477-7827-12-98","article-title":"Metformin induces a prompt decrease in LH-stimulated testosterone response in women with PCOS independent of its insulin-sensitizing effects","volume":"12","year":"2014","journal-title":"Reprod Biol Endocrinol"},{"key":"ref881","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/pedi.12203","article-title":"Current use of metformin in addition to insulin in pediatric patients with type 1 diabetes mellitus: an analysis based on a large diabetes registry in Germany and Austria","volume":"16","year":"2015","journal-title":"Pediatr Diabetes"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1093\/humupd\/dmp024","article-title":"Visually scoring hirsutism","volume":"16","year":"2010","journal-title":"Hum Reprod Update"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.fertnstert.2011.09.024","article-title":"Consensus on women\u2019s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE\/ASRM-Sponsored, 3rd PCOS Consensus Workshop Group","volume":"97","year":"2012","journal-title":"Fertil Steril"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/S1054-139X(01)00202-6","article-title":"Metformin to restore normal menses in oligo-amenorrheic teenage girls with polycystic ovary syndrome (PCOS)","volume":"29","year":"2001","journal-title":"J Adolesc Health"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.fertnstert.2011.09.024","article-title":"Consensus on women\u2019s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE\/ASRM-Sponsored, 3rd PCOS Consensus Workshop Group","volume":"97","year":"2012","journal-title":"Fertil Steril"},{"key":"ref851","doi-asserted-by":"crossref","first-page":"5305","DOI":"10.1210\/jc.2010-1123","article-title":"Reproductive Medicine Network. Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism","volume":"95","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/pedi.12140","article-title":"Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study","volume":"16","year":"2015","journal-title":"Pediatr Diabetes"},{"key":"ref811","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/jdi.12040","article-title":"Ovarian morphology and prevalence of polycystic ovary syndrome in Japanese women with type 1 diabetes mellitus","volume":"4","year":"2013","journal-title":"J Diabetes Investig"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.4158\/EP15748.DSC","article-title":"American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome \u2013 Part 1","volume":"21","year":"2015","journal-title":"Endocr Pract"},{"key":"ref771","first-page":"490","article-title":"Growth and body composition in children with type 1 diabetes mellitus","volume":"50","year":"2006","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.numecd.2013.04.016","article-title":"In PCOS patients the addition of low-dose spironolactone induces a more marked reduction of clinical and biochemical hyperandrogenism than metformin alone","volume":"24","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref841","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1093\/humupd\/dmp024","article-title":"Visually scoring hirsutism","volume":"16","year":"2010","journal-title":"Hum Reprod Update"},{"key":"ref961","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/S1054-139X(01)00202-6","article-title":"Metformin to restore normal menses in oligo-amenorrheic teenage girls with polycystic ovary syndrome (PCOS)","volume":"29","year":"2001","journal-title":"J Adolesc Health"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1507\/endocrj.EJ15-0548","article-title":"A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin","volume":"63","year":"2016","journal-title":"Endocr J"},{"key":"ref921","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/S0015-0282(00)00501-X","article-title":"Metformin therapy decreases hyperandrogenism and hyperinsulinemia in women with polycystic ovary syndrome","volume":"73","year":"2000","journal-title":"Fertil Steril"},{"key":"ref681","first-page":"1391","article-title":"Optimal age of sexual maturation in Egyptian children","volume":"14","year":"2008","journal-title":"East Mediterr Health J"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1530\/EJE-11-0670","article-title":"High prevalence of hirsutism and menstrual disorders in obese adolescent girls and adolescent girls with type 1 diabetes mellitus despite different hormonal profiles","volume":"166","year":"2012","journal-title":"Eur J Endocrinol"},{"key":"ref971","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0015-0282(01)02941-7","article-title":"Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome","volume":"77","year":"2002","journal-title":"Fertil Steril"},{"key":"ref181","first-page":"9473158","article-title":"Lipid profile in adolescent girls with type 1 diabetes mellitus and hyperandrogenemia","volume":"2016","year":"2016","journal-title":"Int J Endocrinol"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1016\/j.fertnstert.2011.09.023","article-title":"Ovarian hyperandrogenism in adolescents and young women with type I diabetes is primarily related to birth weight and body mass index","volume":"96","year":"2011","journal-title":"Fertil Steril"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.2337\/dc07-0475","article-title":"Continuing stability of center differences in pediatric diabetes care: do advances in diabetes treatment improve outcome? The Hvidoere Study Group on Childhood Diabetes","volume":"30","year":"2007","journal-title":"Diabetes Care"},{"key":"ref741","doi-asserted-by":"crossref","first-page":"4742","DOI":"10.1210\/jc.2007-1252","article-title":"Hormonal profile in women with polycystic ovarian syndrome with or without type 1 diabetes mellitus","volume":"92","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1038\/nrendo.2010.49","article-title":"Adjunct therapy for type 1 diabetes mellitus","volume":"6","year":"2010","journal-title":"Nat Rev Endocrinol"},{"key":"ref1001","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1210\/jc.2003-031780","article-title":"Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study","volume":"89","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/jdi.12040","article-title":"Ovarian morphology and prevalence of polycystic ovary syndrome in Japanese women with type 1 diabetes mellitus","volume":"4","year":"2013","journal-title":"J Diabetes Investig"},{"key":"ref521","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.beem.2006.02.004","article-title":"Diagnosis of hyperandrogenism: clinical criteria","volume":"20","year":"2006","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref891","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1089\/dia.2014.0190","article-title":"Efficacy and safety of metformin for patients with type 1 diabetes mellitus: a meta-analysis","volume":"17","year":"2015","journal-title":"Diabetes Technol Ther"},{"key":"ref861","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2337\/diacare.24.7.1297","article-title":"Identification of the source of androgen excess in hyperandrogenic type 1 diabetic patients","volume":"24","year":"2001","journal-title":"Diabetes Care"},{"key":"ref901","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/pedi.12140","article-title":"Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study","volume":"16","year":"2015","journal-title":"Pediatr Diabetes"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/pedi.12337","article-title":"Insulin resistance, role of metformin and other non-insulin therapies in pediatric type 1 diabetes","volume":"17","year":"2016","journal-title":"Pediatr Diabetes"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00125-009-1636-9","article-title":"The use of metformin in type 1 diabetes: a systematic review of efficacy","volume":"53","year":"2010","journal-title":"Diabetologia"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/jpem.2019.32.issue-5\/jpem-2018-0430\/jpem-2018-0430.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2018-0430\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T22:26:49Z","timestamp":1694816809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2018-0430\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,27]]},"references-count":100,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1515\/jpem-2018-0430","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2019,5,27]]}}}