Lower Diabetes Risk with Hormone Replacement Therapy: An Encore for Estrogen?
Authors: Peter W.F. Wilson
Journal: Annals of Internal Medicine (2003)

Editorials7 January 2003Lower Diabetes Risk with Hormone Replacement Therapy: An Encore for Estrogen?Peter W.F. Wilson, MDPeter W.F. Wilson, MDFrom Boston University School of Medicine; Boston, MA 02118Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-1-200301070-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, Kanaya and colleagues (1) report a lower risk for new-onset type 2 diabetes mellitus in postmenopausal women receiving combined estrogenprogestin hormone replacement therapy (HRT). This news from the Heart and Estrogen/progestin Replacement Study (HERS) is encouraging because it comes from a well-conducted substudy within a clinical trial that has focused largely on cardiovascular outcomes. At the start of the study, the postmenopausal participants had fasting glucose levels measured and were categorized as normal, having impaired fasting glucose, or having diabetes. They were followed for the development of new type 2 diabetes mellitus over 4 years. Daily treatment ...References1. Kanaya AM, Herrington D, Vittinghoff E, Lin F, Grady D, Bittner V, . Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003;138:1-9. LinkGoogle Scholar2. Espeland MA, Hogan PE, Fineberg SE, Howard G, Schrott H, Waclawiw MA, . Effect of postmenopausal hormone therapy on glucose and insulin concentrations. PEPI Investigators. Postmenopausal Estrogen/Progestin Interventions. Diabetes Care. 1998;21:1589-95. [PMID: 9773716] CrossrefMedlineGoogle Scholar3. Crawford LM. From the Food and Drug Administration. JAMA. 2002;288:1579. [PMID: 12350176] MedlineGoogle Scholar4. Lobo RA, Bush T, Carr BR, Pickar JH. Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins, coagulation factors, and carbohydrate metabolism. Fertil Steril. 2001;76:13-24. [PMID: 11438314] CrossrefMedlineGoogle Scholar5. Karjalainen A, Paassilta M, Heikkinen J, Backstrom AC, Savolainen M, Kesaniemi YA. Effects of peroral and transdermal oestrogen replacement therapy on glucose and insulin metabolism. Clin Endocrinol (Oxf). 2001;54:165-73. [PMID: 11207630] CrossrefMedlineGoogle Scholar6. Friday KE, Dong C, Fontenot RU. Conjugated equine estrogen improves glycemic control and blood lipoproteins in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab. 2001;86:48-52. [PMID: 11231977] MedlineGoogle Scholar7. Sargeant LA, Wareham NJ, Khaw KT. Hormone replacement therapy and glucose tolerance in EPIC-Norfolk: a population-based study. Diabetes Metab Res Rev. 2000;16:20-5. [PMID: 10707035] CrossrefMedlineGoogle Scholar8. Darko DA, Dornhorst A, Kennedy G, Mandeno RC, Seed M. Glycaemic control and plasma lipoproteins in menopausal women with Type 2 diabetes treated with oral and transdermal combined hormone replacement therapy. Diabetes Res Clin Pract. 2001;54:157-64. [PMID: 11689270] CrossrefMedlineGoogle Scholar9. Adeghate E, Ponery AS. The effect of 17 -estradiol on weight, blood glucose and plasma insulin levels in diabetic rats. Gynecol Endocrinol. 2001;15:433-8. [PMID: 11826767] MedlineGoogle Scholar10. Borthwick EB, Houston MP, Coughtrie MW, Burchell A. The antihyperglycemic effect of estrone sulfate in genetically obese-diabetic (ob/ob) mice is associated with reduced hepatic glucose-6-phosphatase. Horm Metab Res. 2001;33:721-6. [PMID: 11753757] CrossrefMedlineGoogle Scholar11. Goodman-Gruen D, Barrett-Connor E. Sex hormone-binding globulin and glucose tolerance in postmenopausal women. The Rancho Bernardo Study. Diabetes Care. 1997;20:645-9. [PMID: 9096996] CrossrefMedlineGoogle Scholar12. Rubin GL, Zhao Y, Kalus AM, Simpson ER. Peroxisome proliferator-activated receptor ligands inhibit estrogen biosynthesis in human breast adipose tissue: possible implications for breast cancer therapy. Cancer Res. 2000;60:1604-8. [PMID: 10749129] MedlineGoogle Scholar13. Bulun SE, Zeitoun K, Sasano H, Simpson ER. Aromatase in aging women. Semin Reprod Endocrinol. 1999;17:349-58. [PMID: 10851574] CrossrefMedlineGoogle Scholar14. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403. [PMID: 11832527] CrossrefMedlineGoogle Scholar15. Tuomilehto J, Lindstrm J, Eriksson JG, Valle TT, Hmlinen H, Ilanne-Parikka P, . Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-50. [PMID: 11333990] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Boston University School of Medicine; Boston, MA 02118Grant Support: By National Institutes of Health/National Heart, Lung, and Blood Institute contract N01-HC-38038, National Institutes of Health grant AR/AG 41398, and a grant from Roche Laboratories.Disclosures:Consultancies, Honoraria, Grants received.Corresponding Author: Peter W.F. Wilson, MD, Boston University School of Medicine, 715 Albany Street, Robinson B-611, Boston, MA 02118; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGlycemic Effects of Postmenopausal Hormone Therapy: The Heart and Estrogen/progestin Replacement Study: A Randomized, Double-Blind, Placebo-Controlled Trial Alka M. Kanaya , David Herrington , Eric Vittinghoff , Feng Lin , Deborah Grady , Vera Bittner , Jane A. Cauley , and Elizabeth Barrett-Connor Metrics Cited bySex Differences in Age-Associated Type 2 Diabetes in Rats—Role of Estrogens and Oxidative StressOrganocatalytic Synthesis of 4-Aryl-1,2,3,4-tetrahydropyridines from Morita-Baylis-Hillman Carbonates through a One-Pot Three-Component CyclizationEstrogens, lipoproteins, and cardiovascular risk factors: an update following the randomized placebo-controlled trials of hormone-replacement therapyPreventing Type II Diabetes MellitusHormone replacement therapy update: who should we be prescribing this to now?The Effects of Transdermal Estradiol Alone or with Cyclical Dydrogesterone on Markers of Cardiovascular Disease Risk in Postmenopausal Women with Type 2 Diabetes: A Pilot StudyMinder diabetes door hormoonsubstitutie in de menopauze?HERS data show lower risk of diabetes 7 January 2003Volume 138, Issue 1Page: 69-70KeywordsClinical trialsEstrogen replacement therapyEstrogensGlucoseHeartHormone replacement therapyInsulinObesityRisk managementType 2 diabetes ePublished: 7 January 2003 Issue Published: 7 January 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...