Clinical features of endometriosis in patients with type 1 diabetes mellitus
Bibliographic record
Abstract
BACKGROUND: Endometriosis affects 5–10% of women of reproductive age worldwide. Despite the high prevalence of the disease, its diagnosis is usually delayed for several years and misdiagnosis is common, leading to delay in effective pathogen-based treatment. Early diagnosis and timely treatment of endometriosis are particularly important in patients with type 1 diabetes mellitus, as the longer the disease lasts, the greater the risk of vascular complications and the lower ovarian reserve, thus decreasing the reproductive capacity. AIM: The aim of this study was to analyze the clinical features of endometriosis in patients with type 1 diabetes mellitus allowing for a timely and accurate diagnosis. METHODS: This clinical study included women with endometriosis, type 1 diabetes mellitus, and a combination of the two. The control group consisted of healthy women of reproductive age. The diagnosis of endometriosis was confirmed by laparoscopic surgery and verified by histological examination. Serum anti-Müllerian hormone levels were determined using the immunochemiluminescence method from days 2 to 5 of the menstrual cycle. Glycated hemoglobin levels were measured in patients with type 1 diabetes mellitus. RESULTS: The study included 51 patients with endometriosis, 209 patients with type 1 diabetes mellitus, 79 patients with a combination of these diseases, and 31 conditionally healthy women. In patients with endometriosis combined with type 1 diabetes mellitus, the frequency of abnormal uterine bleeding was 31%, which is higher than in patients with only type 1 diabetes mellitus (11%), but lower than in those with only endometriosis (71%). Dysmenorrhea according to the McGill visual analogue pain scale in patients with endometriosis combined with type 1 diabetes mellitus was 3.9 ± 1.48 points, with endometriosis 7.06 ± 1.27 points, and with type 1 diabetes mellitus 1.2 ± 0.7 points. In patients with endometriosis combined with type 1 diabetes mellitus, there was a decrease in the number of antral follicles (8 ± 3) and anti-Müllerian hormone level (3.12 ± 1.78 ng/ml) compared to patients with type 1 diabetes mellitus (12 ± 4, 3.52 ± 2.0 ng/ml, respectively). The most pronounced decrease in the number of antral follicles (4 ± 2) and anti-Müllerian hormone level (0.94 ± 0.4 ng/ml) was found in patients with endometriosis. The incidence of deep infiltrative endometriosis was higher in patients without diabetes mellitus, occurring in 71% of cases. In patients with endometriosis combined with type 1 diabetes mellitus, it only occurred in 42% of cases. Endometrioid cysts were found in 42% of patients without type 1 diabetes mellitus and in 22% of those with the disease. Repeat surgical interventions were performed in 25% of patients with endometriosis without type 1 diabetes mellitus, compared to only 10% of women with endometriosis combined with type 1 diabetes mellitus. CONCLUSION: Late diagnosis and delayed treatment of endometriosis, which is often asymptomatic when combined with type 1 diabetes mellitus, can lead to a decrease in ovarian reserve and infertility. In patients with type 1 diabetes mellitus, endometriosis should be suspected in the presence of mild pain, abnormal uterine bleeding, decreased anti-Müllerian hormone levels and antral follicle count, and infertility to ensure timely diagnosis and selection of treatment strategies. Diabetic patients require a long period of pre-pregnancy planning in order to compensate for their disease.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.059 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".