<b>The Effect of Postmenopausal Hormone Therapy on Glucose Regulation in Women with Type 1 or Type 2 Diabetes: A Systematic Review and Meta-analysis</b>

Abstract

<p>BACKGROUND</p><p>Blood glucose regulation in women with diabetes mellitus may change during and after menopause, which could be attributed, in part, to decreased estrogen levels.</p><p>PURPOSE</p><p>To determine the effect of postmenopausal hormone therapy (HT) on HbA1c, fasting glucose, postprandial glucose, and use of glucose lowering drugs in women with type 1 and type 2 diabetes.</p><p>DATA SOURCES</p><p>A systematic search was conducted in Medline, Embase, Scopus, the Cochrane Library, and the clinicaltrials.gov registry to identify randomized-controlled trials (RCTs).</p><p>STUDY SELECTION</p><p>We selected RCTs on the effect of HT containing estrogen therapy in postmenopausal women (≥12 months since final menstrual period) with type 1 or type 2 diabetes.</p><p>DATA EXTRACTION</p><p>Data were extracted for the following outcomes: HbA1c, fasting glucose, postprandial glucose, and the use of glucose lowering medication.</p><p>DATA SYNTHESIS</p><p>Nineteen RCTs were included (12 parallel-group trials and 7 crossover trials), with a total of 1,412 participants, of which 4.0% had type 1 diabetes. HT reduced HbA1c (mean difference -0.56% [95% CI -0.80, -0.31], -6.08 mmol/mol [95% CI -8.80, -3.36]) and fasting glucose (mean difference -1.15 mmol/L [95% CI -1.78, -0.51]).</p><p>LIMITATIONS</p><p>Fifty percent of included studies were at high risk of bias.</p><p>CONCLUSIONS</p><p>When postmenopausal HT is being considered for menopausal symptoms in women with type 2 diabetes, HT is expected to have a neutral to beneficial impact on glucose regulation. Evidence for the effect of postmenopausal HT in women with type 1 diabetes was limited.</p>