Type 1 Diabetes Shortens Reproductive Lifespan in Women

Women with type 1 diabetes had a shorter reproductive life span than their counterparts without diabetes, according to the results of a new study.

An analysis of data from the Pittsburgh Epidemiology of Diabetes Complications (EDC) and Study of Women’s Health Across the Nation (SWAN) studies, results indicate women with type 1 diabetes before menarche had a shorter reproductive period than women without diabetes.

"This study found that women with the onset of type 1 diabetes before menarche were at increased risk for a shorter reproductive lifespan. Thus, these women are not only at risk for premature ovarian aging because of early onset type 1 diabetes, they are also at increased risk for cardiovascular disease, osteoporosis, and early mortality because of early natural menopause. Understanding these risks and targeting appropriate risk-reducing strategies are key to optimizing the health and quality of life of these women,” said Stephanie Faubion, MD, medical director of the North American Menopause Society, in a statement.

While the role of insulin in regulating female reproductive function has been well-documented, investigators identified what they saw as a gap in knowledge related to the onset of type 1 diabetes and the age of natural menopause. With this in mind, a team of 8 investigators from the University of Pittsburgh birthed the current study with the aim of filling that knowledge gap.

To do so, investigators designed the current study to use data from the Pittsburgh EDC study for women with type 1 diabetes and the SWAN study for women without diabetes. From the Pittsburgh EDC study, investigators identified 105 women diagnosed with childhood-onset type 1 diabetes between 1950-1980. From the SWAN study, investigators identified a reference cohort of 175 women with no diabetes.

Of note, women were excluded if they did not reach natural menopause, if they underwent a hysterectomy or oophorectomy before menopause, or received sex hormone therapy during the menopausal transition. For the purpose of analysis, historical and Women’s Ischemic Syndrome Evaluation hormonal algorithms were used to assess menopause status of participants. For both studies, length of reproductive lifespan was calculated by subtracting the age at menarche from the age at natural menopause.

Compared to those without diabetes, women in the type 1 diabetes cohort were younger, more likely to be white, more likely to be never smokers, have a lower BMI, and higher levels of HDL-C (P <.05). In adjusted analyses, women with type 1 diabetes were older at menarche our younger at natural menopause. Further analysis suggested women with type 1 diabetes experienced 2.5 fewer reproductive years than their counterparts without diabetes. Investigators pointed out findings from these analyses were restricted to a subgroup of 80 women who were diagnosed with type 1 diabetes before reaching menarche.

“The present study identified the subgroup of women with type 1 diabetes who have a high likelihood of experiencing early age at natural menopause so that efforts to unearth the biologic rationale and target potential prevention practices would be better focused,” wrote investigators.

This study, “Women with Type 1 diabetes (T1D) experience a shorter reproductive period compared with nondiabetic women: the Pittsburgh Epidemiology of Diabetes Complications (EDC) study and the Study of Women’s Health Across the Nation (SWAN),” was published in the Journal of the North American Menopause Society.