Menopause and Diabetes Risk Along with Trajectory of β-Cell Function and Insulin Sensitivity: A Community-Based Cohort Study.
Level 3 - non-randomized controlled study
Prospective community-based cohort study with longitudinal follow-up
PubMed 40361840 · doi:10.3390/healthcare13091062
What was done
A community-based cohort study analyzed data from 6,684 visits among 1,224 women over a 16-year follow-up period. Researchers evaluated changes in diabetes risk, beta-cell function, and insulin sensitivity across menopausal stages: premenopausal (3 or more years before menopause), perimenopausal (2 years before to 1 year after), and postmenopausal (2 or more years after menopause). Generalized estimating equations and linear mixed models were applied, adjusting for covariates including age at menopause and obesity.
What was found
The overall diabetes incidence was 18.6%. The odds ratio (OR) of diabetes increased annually during the premenopausal phase (OR 1.03, 95% CI 1.02–1.04) and decreased during the postmenopausal phase (OR 0.96, 95% CI 0.95–0.97). Incident diabetes cases demonstrated declines in both insulin sensitivity and beta-cell function, lowering the disposition index over time. A large drop in insulin sensitivity immediately prior to diabetes onset significantly raised diabetes risk (OR 1.88, 95% CI 1.33–2.67).
Why it matters
The findings indicate that diabetes risk accelerates during the transition prior to menopause rather than after it, independently of age at menopause and obesity. This shifts the clinical window for glycemic surveillance and preventive metabolic intervention to the premenopausal and perimenopausal periods.
Limits
The abstract lacks specific geographic and demographic details regarding the cohort population. Specific metrics used to define beta-cell function, insulin sensitivity, and disposition index are not described in the abstract. Residual confounding from unmeasured dietary or lifestyle factors during the 16-year follow-up cannot be ruled out.
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