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Oestrogens and insulin secretion.

I F Godsland1

  • 1Department of Endocrinology and Metabolic Medicine, Imperial College London, St Mary's Hospital, UK. i.godsland@imperial.ac.uk

Diabetologia
|September 30, 2005
PubMed
Summary
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Estrogen therapy shows a paradoxical effect on carbohydrate metabolism, potentially reducing type 2 diabetes incidence despite short-term adverse glucose tolerance. Long-term oestrogen use may preserve insulin secretion and glucose homeostasis.

Area of Science:

  • Endocrinology
  • Metabolic Research
  • Hormone Therapy

Background:

  • Oestrogens are often perceived to negatively impact carbohydrate metabolism and increase diabetes risk.
  • Clinical trials suggest postmenopausal oestrogen hormone replacement therapy (HRT) is associated with reduced type 2 diabetes incidence, contrasting with this perception.

Purpose of the Study:

  • To investigate the paradoxical effects of oestrogens on carbohydrate metabolism and glucose homeostasis.
  • To explore the mechanisms underlying oestrogen's influence on insulin secretion, insulin resistance, and diabetes risk.

Main Methods:

  • Review of clinical trial data and animal studies examining oestrogen's effects on glucose tolerance, insulin secretion, and insulin resistance.
  • Analysis of potential mechanisms including glucocorticoid activity and glucagon antagonism.

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Main Results:

  • Short-term, high-dose oestrogen impairs glucose tolerance by suppressing insulin secretion and increasing insulin resistance, potentially via glucocorticoids.
  • Oestrogen also reduces fasting glucose through glucagon antagonism.
  • Long-term oestrogen administration and HRT in animal models and humans show preservation of insulin secretion and protection against diabetes.
  • Oestrogen therapy may increase cardiovascular disease risk, contraindicating its use for diabetes prevention.

Conclusions:

  • Oestrogens exert complex, dose- and duration-dependent effects on carbohydrate metabolism.
  • While short-term administration can be detrimental, long-term oestrogen use may offer protective effects on glucose homeostasis and insulin secretion.
  • Further research into the mechanisms of oestrogen's metabolic effects could yield novel diabetes therapies.