Pituitary Responsiveness to Luteinizing Hormone-releasing Hormone in Insulin-dependent Diabetes Mellitus

Impaired fertility and menstrual disturbances are common in diabetes mellitus. In order to study the effect of diabetes on gonadotropin secretion by the pituitary gland, twenty premenopausal diabetic females and seven diabetic males were investigated using luteinizing hormone-releasing hormone (LH-RH). Although the gonadotropes responded to LH-RH in the patients studied, a relative impairment was apparent when compared to normal matched control groups. In the female diabetic patients there was no difference in the gonadotropin responses obtained in those with oligomenorrhea or amenorrhea when compared to those with normal menses. A significant inverse relationship was found between the maximum rise in plasma luteinizing hormone and the fasting plasma glucose. These findings suggest an influence of glucose metabolism on pituitary gonadotropin function. However, the reduced gonadotropin response is unlikely to be the sole cause of the abnormal gynecologic function.