Researchers in Canada have examined how menopause may affect women living with type 1 diabetes, finding important differences between postmenopausal and premenopausal participants.
The study analysed data from 211 women aged between 40 and 60 who were part of the BETTER registry. Ninety were postmenopausal and 121 had not yet reached menopause.
The researchers found that postmenopausal women had higher risks of several complications. These included cardiovascular disease, diabetic neuropathy, diabetic retinopathy and falls. They also reported a higher risk of moderate-to-severe depressive symptoms.
The associations were substantial. Compared with premenopausal participants, postmenopausal women had more than three times the risk of cardiovascular disease and more than twice the risk of neuropathy and retinopathy after statistical adjustment.
Falls were also more frequent among postmenopausal women. The researchers suggest that changes associated with ageing and menopause may interact with diabetes-related complications, although the study design cannot establish that menopause itself caused these outcomes.
The findings are relevant because women with type 1 diabetes may face several overlapping health challenges as they move through midlife. Hormonal changes can occur alongside alterations in body composition, bone health, cardiovascular risk and diabetes management.
The study also identified differences in the prescription of some cardiovascular risk-reduction medicines. The authors argue that healthcare strategies may need to pay greater attention to the particular needs of women with type 1 diabetes during and after menopause.
Further research will be needed to determine how diabetes care should be adapted during this stage of life. The findings nevertheless suggest that menopause should be considered when clinicians assess the wider physical and psychological health of women living with type 1 diabetes.