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The Use of HRT in Women with Diabetes

Type 2 diabetes is on the rise in women over 50, in large part because of increasing waist lines.  But menopause itself also causes unfavorable changes in lipid and carbohydrate metabolism which can lead to diabetes in women previously unaffected or which can worsen diabetes in those who already have it.  It has long been known that estrogen replacement therapy may  improve the negative effects of menopause on cholesterol profiles.  There are also several studies showing that HRT can improve carbohydrate metabolism and fat distribution in healthy menopausal women.  So what about the use of estrogen in menopausal women with Type 2 diabetes?

Ironically, surveys show that menopausal women with diabetes are less than half as likely as women without diabetes to use hormone replacement therapy.  This is despite the fact that women with diabetes are at greatly increased risk of heart disease...And this risk is even greater when lipid levels are too high. The main reason for caution in using HRT in menopausal women with diabetes is the risk of raising triglycerides levels, but these can be monitored. According to a recent review of the literature in the Journal of Women's Health  (April 2001), there is an overall beneficial effect of HRT in menopausal women with diabetes. Of course, like many other areas affecting women's health, this is an area in which long-term clinical trial are still needed.

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Created: 8/9/2001  -  Donnica Moore, M.D.

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