Menopausal Symptoms: Possible Link to Diabetes

Vasomotor symptoms—hot flashes, night sweats, and various other symptoms—are quite common. Nearly 80% of postmenopausal women report that they've experienced these annoying, uncomfortable, and often incredibly disruptive changes. Some researchers propose that vasomotor symptoms may signal physiologic processes that might be associated with other related systemic health diagnoses.

A team of researchers from across the nation has looked at vasomotor symptoms and the possibility that in women, they may hint at diabetes and the future. These researchers report that previous studies have looked for relationships between vasomotor symptoms and insulin resistance, but reported mixed results. In a recent study, published in Menopause: The Journal of the North American Menopause Society, the researchers looked for additional information about vasomotor symptoms and incident diabetes.

These researchers used data from the Women's Health Initiative and followed participants for 13 years from 1993 to 2014. This study was extremely large, enrolling 150,000 postmenopausal women. Among these women, one-third reported vasomotor symptoms. Participants were between the ages of 50 and 79, and had experienced menopause naturally or after surgery.

Women who reported any vasomotor symptoms had an 18% increased risk of diabetes. Vasomotor symptoms severity and risk were closely related, with increasing vasomotor symptom severity associated with greater risk. The small subset of women who reported severe vasomotor symptoms were at 1.62 times the risk of incident diabetes. This was true regardless of the woman's weight, which removed the confounding factor of obesity from consideration.

Women who experienced night sweats or whose vasomotor symptoms persisted after menopause or at the highest risk for diabetes. The researchers indicate that the most credible explanation might be that women who experienced night sweats have significant sleep disturbances. Previous study has shown that individuals who have poor quality sleep are at increased risk of diabetes.

The researchers indicate that postmenopausal symptoms represent a duration of discomfort is longer than that experienced by women who report only perimenopausal vasomotor symptoms. They also indicate that early and late vasomotor symptoms may emanate from different physiologies. Women who experience late symptoms may also have differences in estrogen levels that have unknown impact.

The Women's Health Initiative demonstrated that hormonal therapy has a protective effect with regard to diabetes, but hormonal therapy is no longer recommended because of increased risks of breast cancer, cardiovascular disease, and stroke.

In terms of recommendations in clinical settings, the researchers suggest that clinicians counsel women who are in the menopause transition about future diabetes risk. They also advise clinicians to monitor sleep disturbances and recommend proven lifestyle interventions.

Reference

Gray KE, Katon JG, LeBlanc ES, et al. Vasomotor symptom characteristics: are they risk factors for incident diabetes? Menopause. 2017 Dec 4. doi: 10.1097/GME.0000000000001033. [Epub ahead of print]