Study Examines Post-Menopausal Symptoms among Women Veterans with and without Type 2 Diabetes
BACKGROUND:
Little is known about menopausal symptom patterns in women with type 2 diabetes, an increasingly common chronic health condition during middle age. Prior studies suggest that chronic disease can adversely affect the postmenopausal experience, but the interaction between diabetes and menopause has not been evaluated in the U.S. population where diabetes rates are pronounced. This cross-sectional retrospective study sought to describe the postmenopausal symptom experience in women with type 2 diabetes – and to examine the association between glucose control and symptom severity. Using VA data, investigators identified 327 women Veterans who were placed into three categories: no diabetes (n=90); diabetes with optimal or better glucose control (n=135); and diabetes with suboptimal or worse glucose control (n=102). Postmenopause was defined as amenorrhea for >12 months or hysterectomy with or without ovariectomy, and currently not taking hormones. Self-administered surveys were mailed to all study participants and included information on: menopause status, postmenopausal symptom experience, health status, comorbid conditions, diabetes symptoms and self-management behaviors, sociodemographics, body mass index (BMI), and current medications.
FINDINGS:
- Despite higher BMI and increased comorbidities in women Veterans with diabetes compared to those without diabetes, the pattern of menopause symptoms did not differ by group. Symptom severity scores were highest for muscle and joint aches, followed by hot flashes and trouble sleeping, while headaches received the lowest severity scores. Measures of mental health (i.e., anxiety, depressed mood) were similar across groups.
- Among women Veterans with diabetes, worse glucose control, smoking, and a diagnosis of altered mood demonstrated a positive association with perceived menopause symptom severity, even after adjusting for other covariates.
- Women without diabetes were younger, of lower BMI, had fewer self-reported comorbid conditions, and reported better physical health.
LIMITATIONS:
- Retrospective self-report of symptoms and age of menopause are prone to bias.
- The cross-sectional design precluded assessment of the temporal relationship of symptoms with menopause or diabetes.
IMPLICATIONS:
- Targeting glucose control may improve postmenopausal experiences of women with diabetes.
AUTHOR/FUNDING INFORMATION:
This study was partly funded through VA HSR&D's Quality Enhancement Research Initiative (QUERI, RRP 07-354). Dr. Krein is part of Diabetes-QUERI and HSR&D's Center for Clinical Management Research in Ann Arbor, MI.
Rouen P, Krein S, and Reame N. Postmenopausal Symptoms in Female Veterans with Type 2 Diabetes: Glucose Control and Symptom Severity. Journal of Women’s Health. June 2015;24(6):496-505.
