Menopause and diabetes

Abstract

In the last 20 years, the prevalence of type 2 diabetes mellitus (T2DM) has tripled in adults aged 20–79 years, affecting more than 25% of people over 50 years of age and especially women during menopause. After the menopause transition, women gain weight, increasing abdominal fat and decreasing lean body mass, with a significant reduction in energy expenditure. Increased insulin resistance and hyperinsulinism characterize this period, aggravated by an increase in plasma proinflammatory cytokines and free fatty acids, and a state of relative hyperandrogenism. Previous recommendations systematically excluded women with T2DM from menopause hormone therapy (MHT); new evidence confirms that MHT significantly reduces the diagnosis of new-onset T2DM and may be beneficial in terms of glycemic control when used for menopause symptom management in patients with pre-existing T2DM. A comprehensive and individualized approach is considered the first line of management for women during this period, especially in T2DM patients or in women at risk of developing the disease. The objectives of this presentation are to review the etiopathogenic factors involved in the increased incidence of new cases of T2DM during menopause, the impact of menopause on T2DM and the role of MHT.

摘要

在过去的20年里, 2型糖尿病（T2DM）的发病率在20-79岁的成年人中增加了两倍, 50岁以上的人有25%以上受到影响, 尤其是绝经妇女。绝经过渡期后, 女性体重增加, 腹部脂肪增加, 瘦体重减少, 能量消耗明显减少。胰岛素抵抗和高胰岛素症发生率增加是这一时期的特征, 血浆中致炎性细胞因子和游离脂肪酸的增加以及相对高雄激素的状态加剧了这一现象。以前的建议系统地将患有T2DM的妇女排除在绝经后激素治疗（MHT）之外；新的证据证实, MHT可以显著减少新发T2DM的诊断, 并且当用于绝经症状管理时, 对已经患有T2DM的患者的血糖控制可能有益。全面和个体化的方案被认为是这一时期妇女的一线管理, 尤其是T2DM患者或有患病风险的妇女。本报告的目的是回顾绝经期T2DM新病例发生率增加所涉及的致病因素, 绝经对T2DM的影响以及MHT的作用。

Keywords:

• Menopause
• menopause hormone therapy
• type 2 diabetes mellitus
• metabolic syndrome

Potential conflict of interest

Nil.

Source of funding

Nil.