Type 2 diabetes risk for women who have a later menopause

Women who experience going through the menopause later in life could have an increased risk of developing type 2 diabetes, according to a recent study.

Researchers in the US found that women with reproductive-period durations of less than 30 years had a 37% increased risk of type 2 diabetes compared with women whose reproductive durations were somewhere in the middle (36 to 40 years).

Among the “surprising” findings in the study, recently published in Menopause, the journal of The North American Menopause Society, were that women with longer reproductive-period durations (45 years or more) were at a 23% higher risk than women with medium-length periods.

Getting regular exercise can help prevent type 2 diabetes developing later in life

Researchers based their findings on results from the recent Women’s Health Initiative (WHI) study of 124,379 postmenopausal women aged 50 to 79 years, who completed questionnaires on demographics, medical and family history, and various lifestyle factors such as physical activity.

JoAnn V Pinkerton, MD, NCMP, Executive Director of The North American Menopause Society, said: “The Women’s Health Initiative provides a unique setting to evaluate the associations between reproductive characteristics and diabetes because of its large size, robust characterisation of reproductive histories, long duration of follow-up, and ability to prospectively ascertain type 2 diabetes.”

Previous studies had shown that women who experienced the menopause early, before the age of 45, could have a higher risk of type 2 diabetes due to a lower levels of the female hormone oestrogen linked to increased body fat, a lower metabolism and higher blood-sugar levels.

The results from this latest study suggested that lifetime oestrogen exposure could play a role in the development of type 2 diabetes, although any link to outside oestrogen was unclear. Understanding who could be at risk of developing type 2 diabetes is important because preventive measures such as weight loss, improved diet, and increased exercise could decrease risk. Reproductive period length and age of the final menstrual period could be important factors to consider when healthcare professionals discuss any possible risk of diabetes with women and whether they need to make lifestyle changes.

Dr Pinkerton added: “The finding that both shorter and longer reproductive durations were associated with risk of diabetes has important implications for women with early or late menopause as well as for those with BRCA gene mutations [a blood test that uses DNA analysis to identify harmful changes (mutations) in either one of the two breast cancer susceptibility genes] considering risk-reducing bilateral oophorectomy [removal of both ovaries and both Fallopian tubes] that would shorten their reproductive time. Given the high prevalence of diabetes in postmenopausal women, those with shorter and longer reproductive periods may benefit from lifestyle counselling. Future research should focus on ways to prevent type 2 diabetes in women at risk as they age.”

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