A recent study published in the journal Menopause has found no clinically significant relationship between the age at menopause and the onset of diabetes. Researchers concluded that while postmenopausal women face an increased risk of diabetes, this risk is not linked to the age at which menopause occurs, whether it is natural or surgical. The findings suggest that other factors, primarily related to lifestyle and cardiovascular health, play a more crucial role in diabetes risk.
Understanding the Menopausal Transition
The menopausal transition triggers various metabolic changes that can predispose women to conditions like type 2 diabetes (T2D). According to a review published in Nature Reviews Endocrinology, menopause is associated with an increased risk of upper body fat accumulation and higher incidences of insulin resistance. Furthermore, women with diabetes, particularly those with type 1 diabetes (T1D) or early-onset T2D, may experience menopause earlier than their non-diabetic peers.
The review emphasizes that earlier menopause has been linked to a higher risk of T2D later in life. Additionally, menopausal hormone therapy could potentially reduce this risk and improve glycemic control in women already diagnosed with diabetes. Despite these associations, the recent study highlights a need for further investigation into the causal pathways connecting early or premature menopause with broader health outcomes, including morbidity and mortality.
Key Findings from the Study
The researchers examined data from participants enrolled in the UK Biobank between 2006 and 2010, tracking outcomes until the end of 2023. The study assessed the diagnosis of T1D or T2D over an average follow-up period of approximately 14.5 years. Menopause was categorized into three types: “normal” (older than 45 years), “early” (ages 40 to 45), and “premature” (younger than 40).
Among the 146,764 women analyzed, a total of 6,598 developed diabetes, resulting in a cumulative incidence of 4.5%. The incidence rates were notably higher for women experiencing premature menopause (7.4%), followed by those with early menopause (5.2%) and normal menopause (4.2%). Despite these trends, multivariate analyses indicated no independent association between the age or type of menopause and diabetes onset, with hazard ratios of 1.00 for early menopause and 0.97 for premature menopause, using normal menopause as the baseline reference.
Significantly, the study identified a higher incidence of diabetes in women with various risk factors, including smoking (7.5%), obesity (10.8%), and hypertension (8.1%). Other risk factors included poor dietary habits and family history of diabetes.
The results revealed that any potential association between age at menopause and diabetes onset is likely confounded by other underlying health issues, particularly cardiovascular risk factors that are common among postmenopausal women.
Dr. Stephanie Faubion, medical director for the Menopause Society, commented on the findings, stating, “The results of this study highlight that, although postmenopausal women are at increased risk for diabetes, it does not appear to be related to the age at menopause onset or whether menopause occurs naturally or due to surgery but rather to cardiovascular and lifestyle risk factors.”
She added that this information is reassuring since cardiovascular risk factors are modifiable through lifestyle changes, while the timing of menopause is not.
As research continues, the focus will remain on understanding the intricate relationships among menopause, diabetes, and other health risks, paving the way for better prevention strategies and healthcare interventions for women worldwide.
