Both Type 1 and Type 2 Diabetes Diagnoses Linked to Early Menopause

Vrati Mehra, MSc

A diagnosis of diabetes, either type 1 or type 2 diabetes, was linked to entering menopause at an earlier age, according to data presented at the North American Menopause Society (NAMS) 2022 Annual Meeting.

An analysis of data representative of more than 1.4 million women, results of the retrospective study suggest a diagnosis of either type 1 diabetes or type 2 diabetes prior to 40 years of age was associated with an increased risk of early menopause, but this was not observed for those diagnosed with gestational diabetes.

“Our large retrospective cohort study shows that, even after adjusting for covariates associated with age at natural menopause, we still find an association between early diagnosis of diabetes and earlier menopause and a later diabetes diagnosis with a later age at menopause as compared to those who did not have diabetes. We hope our work lays the foundation for more research in this area so we can better understand and prevent the long-term impacts of diabetes on the human body and the reproductive system,” said lead investigator Vrati Mehra, MSc, of the University of Toronto, in a statement.

As rates of diabetes continue to rise, not only in the US but across the world, concern has begun to mount related to the long-term prognosis of people with diabetes as the population ages. With this in mind, Mehra and a team of colleagues sought to contribute to the growing evidence base concerning age at natural menopause among women with diabetes.

To do so, investigators designed a retrospective cohort study leveraging data from the Canadian Longitudinal Study on Aging (CLSA). A national longitudinal study of adult development and aging, the CLSA collects data related to the biological, medical, psychological, social, lifestyle, and economic aspects of more than 50,000 people in Canada who were between the ages of 45-85 years when recruited. As part of the CLSA protocol, these individuals will be followed until 2033 or death.

From the CLSA, investigators identified a cohort of 11,436 individuals with a median age at menopause of 52 years for inclusion in their analyses. Of note, this cohort of 11,436 was weighted to represent 1,474,412 females. Using this patient cohort, investigators planned to use Kaplan-Meier cumulative survivorship estimates to calculate median age at menopause according to diabetes subtype and multivariable Cox regression models to estimate associations between different types of diabetes and age at menopause with adjustment for sociodemographic, lifestyle, and premenopausal clinical factors.

Upon analysis, results indicated a diagnosis of type 1 diabetes prior to 30 years of age (HR, 1.55 [95% CI, 1.05-2.29]) and a diagnosis of type 2 diabetes between 30-39 years of age (HR, 1.82 [95% CI, 1.12-2.95]) were both associated with earlier menopause compared to those who did not have a diagnosis of diabetes. Further analysis indicated a diagnosis of type 2 diabetes at an age greater than 50 years was associated with a later age at natural menopause (HR, 0.39 [95% CI, 0.27-0.56]).

“This research adds to the growing evidence relative to the collective toll diabetes takes on the human body. In this case, it shows that young women living with a diagnosis of diabetes are more susceptible to accelerated ovarian aging and early menopause,” added Stephanie Faubion, MD, NAMS medical director, who was not affiliated with the study, in the aforementioned statement.

This study, “The association between diabetes type, age of onset, and age at natural menopause: a retrospective cohort study using the Canadian Longitudinal Study on Aging,” was presented at NAMS 2022.