FREQUENT or persistent vasomotor symptoms (VMS) during the menopausal transition (MT) are associated with a 50% increased risk of developing type 2 diabetes (T2D) in women. VMS, including hot flashes and night sweats, are common symptoms during menopause and may be linked to heightened cardiometabolic risks. Although many women experience VMS during menopause, the frequency and patterns vary, and the association between VMS patterns over time and T2D risk has been unclear. This study, led by Monique Hedderson, Kaiser Permanente, Pleasanton, California, USA, aimed to determine whether different frequencies and trajectories of VMS across the MT are associated with the risk of developing T2D.
Researchers analysed data from the Study of Women’s Health Across the Nation (SWAN), a cohort of midlife women assessed at up to 13 annual visits over several clinical sites in the United States. Participants were excluded if they had diabetes, used hormone treatments, or lacked sufficient follow-up data.
A total of 2761 women with diverse racial and ethnic backgrounds were included, with a mean age of 46 years at baseline. Participants reported VMS frequency every two weeks, and diabetes was assessed through self-reports, fasting glucose, and antidiabetic medication use. Four VMS patterns were identified: consistently low, persistently high, early-onset declining, and late-onset increasing. Women with frequent VMS had a higher risk of diabetes than those with no VMS (hazard ratio [HR], 1.45; 95% CI 1.11-1.95). The persistently high VMS trajectory was associated with a 50% increased diabetes risk (HR, 1.50; 95% CI 1.12-2.02).
This study suggests that frequent or persistent VMS during the MT may signal an elevated risk of diabetes, identifying a high-risk group for targeted diabetes prevention. Although limited by exclusion of short-duration cases and absence of haemoglobin A1C testing, these findings underscore the importance of monitoring VMS as part of risk assessment. Clinicians should consider frequent VMS as a potential marker for heightened diabetes risk, potentially prompting early interventions or lifestyle changes to support metabolic health in midlife women. Future research should further explore underlying mechanisms and test preventive strategies in this at-risk group.
Reference
Hedderson M et al. Vasomotor symptom trajectories and risk of incident diabetes. JAMA Netw Open. 2024;7(10):e2443546.
