Menopause and Diabetes Risk Along with Trajectory of β-Cell Function and Insulin Sensitivity: A Community-Based...

Area of Science:

• Endocrinology
• Reproductive Health
• Metabolic Syndrome

Background:

• The link between menopause and diabetes risk remains incompletely understood, with prior research suggesting only a weak association.
• This study investigates the dynamic changes in diabetes risk, pancreatic beta-cell function, and insulin sensitivity throughout menopausal transitions.

Purpose of the Study:

• To analyze how diabetes risk, beta-cell function, and insulin sensitivity change across different menopausal stages.
• To determine the relationship between these physiological changes and the risk of developing diabetes.

Main Methods:

• A 16-year community-based cohort study involving 1224 women and 6684 visits.
• Analysis of diabetes risk across premenopausal, perimenopausal, and postmenopausal phases.
• Assessment of beta-cell function and insulin sensitivity indices, adjusted for age at menopause and obesity using generalized estimating equations and linear mixed models.

Main Results:

• Diabetes incidence was 18.6%; annual diabetes risk increased premenopausally (OR 1.03) and decreased postmenopausally (OR 0.96).
• Women with incident diabetes exhibited declining insulin sensitivity and beta-cell function, leading to reduced disposition indices.
• Significant changes in insulin sensitivity, particularly before diabetes onset, markedly elevated diabetes risk (OR 1.88).

Conclusions:

• Premenopausal periods are associated with increased diabetes risk, irrespective of menopausal age or obesity.
• A sequential decline in insulin sensitivity followed by beta-cell function is linked to diabetes risk.
• Findings clarify menopause-related diabetes risk and insulin dynamics, highlighting the need for proactive health management during menopausal transition.