Association Between Hormone Replacement Therapy and Glycemic Control in Postmenopausal Women with Type 2 Diabetes

Abstract Introduction. 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 HbA1C levels are influenced by current HRT among postmenopausal women with type 2 diabetes. Methods. A total of 40 postmenopausal women with type 2 diabetes were enrolled. All of them fulfilled the criteria of natural menopause, with intact uterus, low estrogen levels (E2) and high follicle-stimulating hormone (FSH) levels. Half of them (20 women) were assigned to take HRT (DM-HRT group). The other half (20 women) were assigned to the control group, those who did not take HRT (DM-non HRT group). HRT consisted of 17 β-estradiol (E2) 1 mg and drospirenone (DRSP) 2 mg. Fasting plasma glycemia, insulinemia and HbA1C were followed in both groups throughout 12 months. Results. The mean age was 49 years (SD±3,3) and 48,5 (SD±3.1), respectively. HRT was associated with statistically significant decrease in serum fasting glucose, HbA1C and insulinemia levels in the DM-HRT group. There was no significant reduction in glucose levels and HbA1C together with no significant increase in insulinemia levels in the DM non-HRT group throughout 12 months. Conclusion. HRT was associated with statistically significant decrease of plasma glucose levels and HbA1C level. Larger clinical trials are necessary to understand whether HRT may improve glycemic control in women with diabetes, especially when it is given shortly after entering menopause.