Hormone Replacement Therapy Is Associated With Better Glycemic Control in Women With Type 2 Diabetes

Abstract

OBJECTIVE -In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA 1c levels varied by current HRT among women with type 2 diabetes.RESEARCH DESIGN AND METHODS -In a cohort of 15,435 women with type 2 diabetes who were members of a health maintenance organization, HbA 1c and HRT were assessed by reviewing records in the health plan's computerized laboratory and pharmacy systems. Sociodemographic and clinical information were collected by survey.RESULTS -The mean age was 64.7 years (SD Ϯ 8.7). The study cohort comprised 55% non-Hispanic whites, 14% non-Hispanic blacks, 12% Hispanics, 11% Asians, 4% "other" ethnic groups, and 4% with missing ethnicity data. Current HRT was observed in 25% of women. HbA 1c levels were significantly lower in women currently using HRT than in women not using HRT (age-adjusted mean Ϯ SE: 7.9 Ϯ 0.03 vs. 8.5 Ϯ 0.02, respectively, P ϭ 0.0001). No differences in HbA 1c level were observed between women using unopposed estrogens and women using opposed estrogens. In a Generalized Estimating Equation model, which took into account patient clustering within physician and adjusted for age, ethnicity, education, obesity, hypoglycemic therapy, diabetes duration, self-monitoring of blood glucose, and exercise, HRT remained significantly and independently associated with decreased HbA 1c levels (P ϭ 0.0001).CONCLUSIONS -HRT was independently associated with decreased HbA 1c level. Clinical trials will be necessary to understand whether HRT may improve glycemic control in women with diabetes.

Estrogens and the diabetic kidney

“…46 Similar beneficial effects were observed in healthy postmenopausal women with type 2 DM: treatment with either estrogen alone or with medroxyprogesterone improved glycemic control and lipid metabolism and decreased carotid wall thickness and atherosclerosis. [47][48][49][50][51] In addition, the selective estrogen receptor modulator raloxifene has been found to have favorable effects on concentrations of triglycerides and low-density lipoprotein in women with type 2 DM. 52 Based on these findings, HT appears to be beneficial in type 2 DM; however, very few studies to date have examined the effects of HT on diabetic end-organ complications, including diabetic nephropathy.…”

The Relationship Between Alcohol Consumption and Glycemic Control Among Patients with Diabetes: The Kaiser Permanente Northern California Diabetes Registry

“…The Kaiser Permanente Northern California Diabetes Registry (the "registry"), for which methods have been described previously, 23 …”

Hormone Replacement Therapy and Its Relationship to Lipid and Glucose Metabolism in Diabetic and Nondiabetic Postmenopausal Women

“…Epidemiological research on the potential benefits of HRT use in postmenopausal women with diabetes is also inconclusive (7)(8)(9)(10)(11). Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.…”