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The onset of puberty in adolescents with type 1 diabetes mellitus in comparison to a group of non-diabetic teenagers in Erbil City: A cross-sectional comparative study

Ali Shakir Dauod
Department of Community Medicine, College of Medicine, Hawler Medical University, Kurdistan Region, Iraq.
Aziz Muzafar Jafaar
Department of Internal Medicine, College of Medicine , Hawler Medical University, Kurdistan Region, Iraq.
Nawa Mohammed Abdullah
Department of Community Medicine, College of Medicine, Hawler Medical University, Kurdistan Region, Iraq.
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Copyright (c) 2026 Ali Shakir Dauod, Aziz Muzafar Jafaar, Nawa Mohammed Abdullah (Author)

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Abstract

Background and objective: Puberty and type 1 diabetes (T1DM) have a complex relationship. This study aims to determine the prevalence of delayed puberty among a sample of type 1 diabetes adolescents and compare it to a non-diabetic group.

Methods: A cross-sectional comparative study design was used to compare the data between January 1st, 2024, and July 31, 2024, included 380 participants, a convenient sample of 134 type 1 diabetic adolescents aged 9-16 years who were enrolled in Galyawa Specialized Diabetic Center and outpatient endocrinology at Rapareen Teaching Hospital in Erbil City, and 246 healthy adolescents in the same age range who attended Brayaty and Shady primary health care. Pubertal stage was determined by Tanner criteria. Anthropometry, BMI Z-score, and HbA1c were recorded.

Results: Mean age was 13.3 ± 1.7 years in both groups. Delayed puberty (Tanner stage < II at ≥13 y in girls or ≥14 y in boys) occurred in 53.7 % of diabetics versus 11.8 % of non-diabetics (P <0.001). The prevalence of delayed puberty among diabetic girls and boys (65.7% and 40.6%) was significantly higher than among the non-diabetic group (13.4% and 9.3%). Diabetic adolescents had significantly lower height-for-age Z-scores (< –2 SD) than non-diabetics (P <0.001). HbA1c level was not associated with pubertal delay.

Conclusion: more than half of the diabetics had delayed puberty, but there was no significant relationship between HbA1c and delayed puberty. Individuals with type 1 diabetes are shorter than non-diabetics. This study raised the importance of that the health practitioners, adolescents with type 1 diabetes and their caregivers should be informed about the possible outcomes of type 1 diabetes in adolescents.

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How to Cite
Shakir Dauod, A. ., Muzafar Jafaar, A. ., & Mohammed Abdullah, N. (2026). The onset of puberty in adolescents with type 1 diabetes mellitus in comparison to a group of non-diabetic teenagers in Erbil City: A cross-sectional comparative study. Zanco Journal of Medical Sciences (ZJMS), 30(1), 105–120. https://doi.org/10.15218/zjms.2026.008

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