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Physical and psychosocial complications faced by postmenopausal women with type 1 diabetes: a cross-sectional BETTER
Anne Bonhoure1, Jane E Yardley2, Valérie Boudreau3
1Montreal Clinical Research Institute, Montreal, Quebec, Canada; Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Aims:
Few studies have examined menopause's impact on health outcomes in women living with Type 1 diabetes mellitus (T1D). We compared physical, diabetes-related, and psychosocial outcomes between premenopausal and postmenopausal women with T1D.
Methods:
A cross-sectional analysis of 211 women aged 40-60 years from the BETTER registry (121 premenopausal; 90 postmenopausal). Outcomes included physical complications (retinopathy, neuropathy, cardiovascular disease [CVD], falls), diabetes management (HbA1c, insulin doses, hypoglycemia, medication), and psychosocial outcomes (depressive symptoms, fear of hypoglycemia [FOH]). Overlap weighting balanced covariates between groups; weighted regression models estimated associations as risk ratios (RR) for binary and mean differences (MD) for continuous outcomes (95% CI).
Results:
In weighted models, postmenopausal women had higher risks of CVD (RR 3.31 [1.07-10.23]), neuropathy (RR 2.22 [1.17-4.21]), retinopathy (RR 2.20 [1.15-4.23]), falls (RR 2.64 [1.73-4.03]), and moderate-to-severe depressive symptoms (RR 1.48 [1.01-2.17]), and lower odds of antihypertensive (RR 0.57 [0.38-0.84]) and lipid-lowering prescriptions (RR 0.68 [0.54-0.86]), and elevated diabetes distress (RR 0.80 [0.68-0.95]). Insulin doses, HbA1c, hypoglycemia frequency, and FOH did not differ.
Conclusions:
Postmenopausal women with T1D showed less favourable physical and psychosocial health profiles than premenopausal women, underscoring the need for prospective studies to clarify these associations.
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