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Menopause and Diabetes Mellitus

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Diabetes in Women

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Around the time of menopause, there are important changes in body composition and insulin sensitivity, which may impact both the risk for diabetes mellitus as well as glycemic control in individuals with established diabetes. Furthermore, these parameters may be affected by the use of hormone replacement therapy, a common treatment for menopausal vasomotor symptoms. Changes in body composition, beyond changes in weight, occur around the time of menopause, and these alterations in body composition have been correlated with changes in insulin resistance and glucose tolerance. Several studies have suggested that hormone therapy use reduces diabetes risk in postmenopausal women. Clinicians must keep these metabolic changes in mind when caring for postmenopausal women with and without diabetes.

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References

  1. Soules MR, Sherman S, Parrott E, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Fertil Steril 2001;76:874–8.

    Article  CAS  PubMed  Google Scholar 

  2. Gold EB, Bromberger J, Crawford S, et al. Factors associated with age at natural menopause in a multiethnic sample of midlife women. Am J Epidemiol 2001;153:865–74.

    Article  CAS  PubMed  Google Scholar 

  3. Nelson HD. Menopause. Lancet 2008;371:760–70.

    Article  PubMed  Google Scholar 

  4. Bulun SE, Adashi EY. The physiology and pathology of the female reproductive axis. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, eds. Williams textbook of endocrinology. 10th ed. Philadelphia, PA: Saunders, 2003:587–664.

    Google Scholar 

  5. Hall JE. Neuroendocrine physiology of the early and late menopause. Endocrinol Metab Clin North Am 2004;33:637–59.

    Article  CAS  PubMed  Google Scholar 

  6. Welt CK, Jimenez Y, Sluss PM, Smith PC, Hall JE. Control of estradiol secretion in reproductive ageing. Hum Reprod 2006;21:2189–93.

    Article  CAS  PubMed  Google Scholar 

  7. Burger HG, Dudley EC, Robertson DM, Dennerstein L. Hormonal changes in the menopause transition. Recent Prog Horm Res 2002;57:257–75.

    Article  CAS  PubMed  Google Scholar 

  8. Rannevik G, Jeppsson S, Johnell O, Bjerre B, Laurell-Borulf Y, Svanberg L. A longitudinal study of the perimenopausal transition: altered profiles of steroid and pituitary hormones, SHBG and bone mineral density. Maturitas 1995;21:103–13.

    Article  CAS  PubMed  Google Scholar 

  9. Welt CK, McNicholl DJ, Taylor AE, Hall JE. Female reproductive aging is marked by decreased secretion of dimeric inhibin. J Clin Endocrinol Metab 1999;84:105–11.

    Article  CAS  PubMed  Google Scholar 

  10. Santoro N, Brown JR, Adel T, Skurnick JH. Characterization of reproductive hormonal dynamics in the perimenopause. J Clin Endocrinol Metab 1996;81:1495–501.

    Article  CAS  PubMed  Google Scholar 

  11. Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005;90:3847–53.

    Article  CAS  PubMed  Google Scholar 

  12. Basaria S, Dobs AS. Clinical review: controversies regarding transdermal androgen therapy in postmenopausal women. J Clin Endocrinol Metab 2006;91:4743–52.

    Article  CAS  PubMed  Google Scholar 

  13. Korytkowski MT, Krug EI, Daly MA, Deriso L, Wilson JW, Winters SJ. Does androgen excess contribute to the cardiovascular risk profile in postmenopausal women with type 2 diabetes? Metabolism 2005;54:1626–31.

    Article  CAS  PubMed  Google Scholar 

  14. Jackson SL, Scholes D, Boyko EJ, Abraham L, Fihn SD. Urinary incontinence and diabetes in postmenopausal women. Diabetes Care 2005;28:1730–8.

    Article  PubMed  Google Scholar 

  15. Dorman JS, Steenkiste AR, Foley TP, et al. Menopause in type 1 diabetic women: is it premature? Diabetes 2001;50:1857–62.

    Article  CAS  PubMed  Google Scholar 

  16. Strotmeyer ES, Steenkiste AR, Foley TP, Jr, Berga SL, Dorman JS. Menstrual cycle differences between women with type 1 diabetes and women without diabetes. Diabetes Care 2003;26:1016–21.

    Article  PubMed  Google Scholar 

  17. Malacara JM, Huerta R, Rivera B, Esparza S, Fajardo ME. Menopause in normal and uncomplicated NIDDM women: physical and emotional symptoms and hormone profile. Maturitas 1997;28:35–45.

    Article  CAS  PubMed  Google Scholar 

  18. Lopez-Lopez R, Huerta R, Malacara JM. Age at menopause in women with type 2 diabetes mellitus. Menopause 1999;6:174–8.

    CAS  PubMed  Google Scholar 

  19. Eisenbarth GS, Gottlieb PA. Autoimmune polyendocrine syndromes. N Engl J Med 2004;350:2068–79.

    Article  CAS  PubMed  Google Scholar 

  20. Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003;88:2404–11.

    Article  CAS  PubMed  Google Scholar 

  21. Svendsen OL, Hassager C, Christiansen C. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metabolism 1995;44:369–73.

    Article  CAS  PubMed  Google Scholar 

  22. Ley CJ, Lees B, Stevenson JC. Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 1992;55:950–4.

    CAS  PubMed  Google Scholar 

  23. Tremollieres FA, Pouilles JM, Ribot CA. Relative influence of age and menopause on total and regional body composition changes in postmenopausal women. Am J Obstet Gynecol 1996;175:1594–600.

    Article  CAS  PubMed  Google Scholar 

  24. Panotopoulos G, Ruiz JC, Raison J, Guy-Grand B, Basdevant A. Menopause, fat and lean distribution in obese women. Maturitas 1996;25:11–9.

    Article  CAS  PubMed  Google Scholar 

  25. Douchi T, Yamamoto S, Nakamura S, et al. The effect of menopause on regional and total body lean mass. Maturitas 1998;29:247–52.

    Article  CAS  PubMed  Google Scholar 

  26. Wang Q, Hassager C, Ravn P, Wang S, Christiansen C. Total and regional body-composition changes in early postmenopausal women: age-related or menopause-related? Am J Clin Nutr 1994;60:843–8.

    CAS  PubMed  Google Scholar 

  27. Sternfeld B, Bhat AK, Wang H, Sharp T, Quesenberry CP, Jr. Menopause, physical activity, and body composition/fat distribution in midlife women. Med Sci Sports Exerc 2005;37:1195–202.

    Article  PubMed  Google Scholar 

  28. Sowers M, Zheng H, Tomey K, et al. Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab 2007;92:895–901.

    Article  CAS  PubMed  Google Scholar 

  29. Guo SS, Zeller C, Chumlea WC, Siervogel RM. Aging, body composition, and lifestyle: the Fels Longitudinal Study. Am J Clin Nutr 1999;70:405–11.

    CAS  PubMed  Google Scholar 

  30. Iribarren C, Darbinian JA, Lo JC, Fireman BH, Go AS. Value of the sagittal abdominal diameter in coronary heart disease risk assessment: cohort study in a large, multiethnic population. Am J Epidemiol 2006;164:1150–9.

    Article  PubMed  Google Scholar 

  31. Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA 1998;280:1843–8.

    Article  CAS  PubMed  Google Scholar 

  32. Progetto Menopausa Italia Study Group. Determinants of body mass index in women around menopause attending menopause clinics in Italy. Climacteric 2003;6:67–74.

    Google Scholar 

  33. Kritz-Silverstein D, Barrett-Connor E. Long-term postmenopausal hormone use, obesity, and fat distribution in older women. JAMA 1996;275:46–9.

    Article  CAS  PubMed  Google Scholar 

  34. Sites CK, L’Hommedieu GD, Toth MJ, Brochu M, Cooper BC, Fairhurst PA. The effect of hormone replacement therapy on body composition, body fat distribution, and insulin sensitivity in menopausal women: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab 2005;90:2701–7.

    Article  CAS  PubMed  Google Scholar 

  35. Kanaya AM, Herrington D, Vittinghoff E, et al. Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2003;138:1–9.

    CAS  PubMed  Google Scholar 

  36. Samaras K, Hayward CS, Sullivan D, Kelly RP, Campbell LV. Effects of postmenopausal hormone replacement therapy on central abdominal fat, glycemic control, lipid metabolism, and vascular factors in type 2 diabetes: a prospective study. Diabetes Care 1999;22:1401–7.

    Article  CAS  PubMed  Google Scholar 

  37. Espeland MA, Stefanick ML, Kritz-Silverstein D, et al. Effect of postmenopausal hormone therapy on body weight and waist and hip girths. Postmenopausal Estrogen-Progestin Interventions Study Investigators. J Clin Endocrinol Metab 1997;82:1549–56.

    Article  Google Scholar 

  38. Haarbo J, Marslew U, Gotfredsen A, Christiansen C. Postmenopausal hormone replacement therapy prevents central distribution of body fat after menopause. Metabolism 1991;40:1323–6.

    Article  CAS  PubMed  Google Scholar 

  39. Salpeter SR, Walsh JM, Ormiston TM, Greyber E, Buckley NS, Salpeter EE. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab 2006;8:538–54.

    Article  CAS  PubMed  Google Scholar 

  40. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006;444:881–7.

    Article  CAS  PubMed  Google Scholar 

  41. Sites CK, Calles-Escandon J, Brochu M, Butterfield M, Ashikaga T, Poehlman ET. Relation of regional fat distribution to insulin sensitivity in postmenopausal women. Fertil Steril 2000;73:61–5.

    Article  CAS  PubMed  Google Scholar 

  42. Campbell AJ, Busby WJ, Horwath CC, Robertson MC. Relation of age, exercise, anthropometric measurements, and diet with glucose and insulin levels in a population aged 70 years and over. Am J Epidemiol 1993;138:688–96.

    CAS  PubMed  Google Scholar 

  43. Barrett-Connor E, Schrott HG, Greendale G, et al. Factors associated with glucose and insulin levels in healthy postmenopausal women. Diabetes Care 1996;19:333–40.

    Article  CAS  PubMed  Google Scholar 

  44. Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003;26:2977–82.

    Article  PubMed  Google Scholar 

  45. Golden SH, Dobs AS, Vaidya D, Szklo M, Gapstur S, Kopp P, Liu K, Ouyang P. Endogenous sex hormones and glucose tolerance status in postmenopausal women. J Clin Endocrinol Metab 2007;92:1289–95.

    Article  CAS  PubMed  Google Scholar 

  46. Oh JY, Barrett-Connor E, Wedick NM, Wingard DL, Rancho Bernardo Study. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study. Diabetes Care 2002;25:55–60.

    Article  CAS  PubMed  Google Scholar 

  47. Stefanick ML. Estrogens and progestins: background and history, trends in use, and guidelines and regimens approved by the US Food and Drug Administration. Am J Med 2005;118(Suppl 12B):64–73.

    Article  PubMed  Google Scholar 

  48. North American Menopause Society. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause Society. Menopause 2007;14:355,69; quiz 370–1.

    Google Scholar 

  49. Keating NL, Cleary PD, Rossi AS, Zaslavsky AM, Ayanian JZ. Use of hormone replacement therapy by postmenopausal women in the United States. Ann Intern Med 1999;130:545–53.

    CAS  PubMed  Google Scholar 

  50. Ferrara A, Karter AJ, Ackerson LM, Liu JY, Selby JV, Northern California Kaiser Permanente Diabetes Registry. Hormone replacement therapy is associated with better glycemic control in women with type 2 diabetes: The Northern California Kaiser Permanente Diabetes Registry. Diabetes Care 2001;24:1144–50.

    Article  CAS  PubMed  Google Scholar 

  51. Crespo CJ, Smit E, Snelling A, Sempos CT, Andersen RE, NHANES III. Hormone replacement therapy and its relationship to lipid and glucose metabolism in diabetic and nondiabetic postmenopausal women: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 2002;25:1675–80.

    Article  CAS  PubMed  Google Scholar 

  52. Friday KE, Dong C, Fontenot RU. Conjugated equine estrogen improves glycemic control and blood lipoproteins in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2001;86:48–52.

    Article  CAS  PubMed  Google Scholar 

  53. Andersson B, Mattsson LA, Hahn L, et al. Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1997;82:638–43.

    Article  CAS  PubMed  Google Scholar 

  54. Brussaard HE, Gevers Leuven JA, Frolich M, Kluft C, Krans HM. Short-term oestrogen replacement therapy improves insulin resistance, lipids and fibrinolysis in postmenopausal women with NIDDM. Diabetologia 1997;40:843–9.

    Article  CAS  PubMed  Google Scholar 

  55. Palin SL, Kumar S, Sturdee DW, Barnett AH. HRT in women with diabetes – review of the effects on glucose and lipid metabolism. Diabetes Res Clin Pract 2001;54:67–77.

    Article  CAS  PubMed  Google Scholar 

  56. Manwaring P, Morfis L, Diamond T, Howes LG. The effects of hormone replacement therapy on plasma lipids in type II diabetes. Maturitas 2000;34:239–47.

    Article  CAS  PubMed  Google Scholar 

  57. Manning PJ, Allum A, Jones S, Sutherland WH, Williams SM. The effect of hormone replacement therapy on cardiovascular risk factors in type 2 diabetes: a randomized controlled trial. Arch Intern Med 2001;161:1772–6.

    Article  CAS  PubMed  Google Scholar 

  58. Rossi R, Origliani G, Modena MG. Transdermal 17-beta-estradiol and risk of developing type 2 diabetes in a population of healthy, nonobese postmenopausal women. Diabetes Care 2004;27:645–9.

    Article  CAS  PubMed  Google Scholar 

  59. Manson JE, Rimm EB, Colditz GA, et al. A prospective study of postmenopausal estrogen therapy and subsequent incidence of non-insulin-dependent diabetes mellitus. Ann Epidemiol 1992;2:665–73.

    Article  CAS  PubMed  Google Scholar 

  60. Gabal LL, Goodman-Gruen D, Barrett-Connor E. The effect of postmenopausal estrogen therapy on the risk of non-insulin-dependent diabetes mellitus. Am J Public Health 1997;87:443–5.

    Article  CAS  PubMed  Google Scholar 

  61. Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998;280:605–13.

    Article  CAS  PubMed  Google Scholar 

  62. Margolis KL, Bonds DE, Rodabough RJ, et al. Effect of oestrogen plus progestin on the incidence of diabetes in postmenopausal women: results from the Women’s Health Initiative Hormone Trial. Diabetologia 2004;47:1175–87.

    Article  CAS  PubMed  Google Scholar 

  63. Bonds DE, Lasser N, Qi L, et al. The effect of conjugated equine oestrogen on diabetes incidence: the Women’s Health Initiative randomised trial. Diabetologia 2006;49:459–68.

    Article  CAS  PubMed  Google Scholar 

  64. Hsia J, Langer RD, Manson JE, et al. Conjugated equine estrogens and coronary heart disease: the Women’s Health Initiative. Arch Intern Med 2006;166:357–65.

    Article  CAS  PubMed  Google Scholar 

  65. Mosca L, Appel LJ, Benjamin EJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women. American Heart Association scientific statement. Arterioscler Thromb Vasc Biol 2004;24:e29–50.

    Article  CAS  PubMed  Google Scholar 

  66. North American Menopause Society. Recommendations for estrogen and progestogen use in peri-and postmenopausal women: October 2004 position statement of The North American Menopause Society. Menopause 2004;11:589–600.

    Google Scholar 

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Szmuilowicz, E.D., Seely, E.W. (2009). Menopause and Diabetes Mellitus. In: Tsatsoulis, A., Wyckoff, J., Brown, F. (eds) Diabetes in Women. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-250-6_2

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  • DOI: https://doi.org/10.1007/978-1-60327-250-6_2

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