Menopause, hormone therapy and diabetes

Abstract

Over the past three decades, the prevalence of diabetes has increased four-fold. Coupled with the global obesity epidemic and aging of the world’s population, a perfect metabolic storm is brewing. The influence of menopause and exogenous estrogen and progestogens must be included in this equation. In this review, criteria for diagnosing diabetes and recommendations for screening are described. The reported effects of menopause on diabetes risk in healthy women are reviewed as well as the relationship between established diabetes and the timing of menopause. The effects of menopausal hormone therapies (MHT) on glucose control in women with diabetes and the effect of MHT on diabetes risk in menopausal women without diabetes are described. Evidence-based strategies to prevent diabetes in midlife women are highlighted. The augmenting effect of diabetes on chronic health concerns of aging women, such as cardiovascular disease, osteoporosis, and cancer, along with current recommendations for screening and prevention are presented. Given the current demographics of today’s world, the content of this review may apply to as many as one-third of the average practitioner’s postmenopausal patient population.

Keywords:

• Menopause
• menopausal hormone therapy
• diabetes
• glucose control

Acknowledgements

This invited review is based upon the author’s presentation titled 'Menopause, Hormones, and Diabetes', at the 2nd Scientific Conference of SIGMA, the Canadian Menopause Society, September 12, 2015, Toronto.

Conflict of interest

The author reports no conflicts of interest. The author alone is responsible for the content and writing of this paper.

Source of funding

Nil.