Postmenopausal Hot Flashes, Night Sweats May Increase Diabetes Risk

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During menopause, vasomotor symptoms such as hot flashes and night sweats may correlate with risk for incident diabetes.
During menopause, vasomotor symptoms such as hot flashes and night sweats may correlate with risk for incident diabetes.

Postmenopausal women who report consistent hot flashes and night sweats have an increased risk for developing diabetes compared with those not reporting vasomotor symptoms (VMS), according to study findings published in Menopause.

Researchers assessed a total of 150,007 postmenopausal women who participated in the longitudinal Women's Health Initiative from 1993 to 2014. Specifically, investigators evaluated correlations between VMS, including the timing of these symptoms (early [premenopausal or perimenopausal]/late [postmenopausal]) as well as their severity and duration, and incident diabetes at a mean 13.1-year follow-up.

Night sweats and hot flashes were reported in approximately 33% (n=48,787) of the cohort. Participants who reported any VMS during the follow-up period had an 18% increased risk of developing diabetes (hazard ratio [HR], 1.18; 95% CI, 1.14-1.22). The risk for diabetes also increased with increasing severity of VMS: mild severity was associated with a 13% increased risk (HR, 1.13; 95% CI, 1.08-1.17); moderate symptom severity was associated with a 29% risk (HR, 1.29; 95% CI, 1.22-1.36); and severe symptoms were associated with a nearly 50% increased diabetes risk (HR, 1.48; 95% CI, 1.35-1.62).

In addition, longer duration of symptoms also increased diabetes risk by 4% every 5 years (95% CI, 1.03-1.05). Participants who reported night sweats only (HR, 1.20; 95% CI, 1.13-1.26) or night sweats and hot flashes (HR, 1.22; 95% CI, 1.17-1.27) had an approximately 20% average risk for diabetes compared with 8% among those reporting hot flashes only (HR 1.08; 95% CI, 1.02-1.15).

As most of the patients included in this analysis were healthier at baseline compared with the general population, the findings from this study may be difficult to apply to patients with other comorbidities. Also, rather than relying on medical records, most of the cases of diabetes were self-reported, which may have presented data error.

The transition into menopause may represent the "optimal time for clinicians to discuss future diabetes risk and assist patients in decision-making around symptom management," particularly as timely management of VMS can decrease future risk.

Reference

Gray KE, Katon JG, LeBlanc ES, et al. Vasomotor symptom characteristics: are they risk factors for incident diabetes [published online December 4, 2017]. Menopause. doi: 10.1097/GME.0000000000001033

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