Frequent, persistent hot flashes associated with 50% increased risk for diabetes
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Key takeaways:
- Women with a trajectory of persistent hot flashes have a 50% greater risk for developing type 2 diabetes.
- Women reporting frequent hot flashes may be good candidates for diabetes prevention programs.
Women with frequent and persistent hot flashes and night sweats during the menopause transition are at increased risk for developing diabetes compared with women who do not experience vasomotor symptoms, researchers reported.
“Our study advanced the evidence on a known risk factor for older women by following their symptoms over many years,” Monique Hedderson, PhD, a research scientist and associate director of women’s and children’s health at Kaiser Permanente Division of Research in Northern California, told Healio. “This kind of research is important to expand our understanding of health risks related to menopause, which is historically understudied.”
Researchers assessed the associations of frequency and trajectories of vasomotor symptoms with incident type 2 diabetes during the menopause transition using data from 2,761 women who participated in the prospective Study of Women’s Health Across the Nation (SWAN). Women were pre- or perimenopausal at baseline and were followed for 13 years, with a mean baseline age of 46 years (49% white; 27% Black). At each follow-up visit, women reported how often they experienced hot flashes or night sweats in the past 2 weeks; researchers defined women as having diabetes if they reported use of diabetes medications, reported a diagnosis of diabetes at two visits or had a fasting glucose of at least 126 mg/dL.
The findings were published in JAMA Network Open.
At baseline 28% of women reported hot flashes 1 to 5 days per 2-week period; 10% reported hot flashes 6 or more days per week and 62% reported no vasomotor symptoms. During follow-up, 12.2% of women developed type 2 diabetes.
Researchers found that, compared with reports of no hot flashes, more frequent time-varying vasomotor symptoms were associated with a 45% increased risk for incident type 2 diabetes (HR = 1.45; 95% CI, 1.11-1.95). Women reporting infrequent hot flashes had a 30% greater risk for developing diabetes during follow-up compared with women reporting no vasomotor symptoms (HR = 1.3; 95% CI, 1-1.7), with results persisting after adjusting for multiple factors including race, baseline age and education, time-varying BMI, physical activity score and menopause transition stage.
The researchers identified four trajectories of hot flashes:
- consistently low probability of vasomotor symptoms (26%);
- persistently high probability of vasomotor symptoms (31%);
- early onset, initial high probability of vasomotor symptoms that decreased over time (25); and
- late onset, initial low probability of vasomotor symptoms that increased over time (19%).
Researchers also noted that five women (0.2%) fell into a fifth “unknown” category.
Compared with women who reported consistently low vasomotor symptoms, those with persistently high symptoms had a 50% greater risk for developing type 2 diabetes (HR = 1.5; 95% CI, 1.12-2.02).
Results were similar for both reported hot flashes and night sweats, according to the researchers.
“Clinicians should be aware that women who experience frequent hot flashes and night sweats that persist for a long period of time may represent a high-risk group that would benefit from diabetes prevention programs,” Hedderson told Healio. “We need to understand the biologic mechanism that is causing some women to experience frequent hot flashes and night sweats and how that is related to cardiometabolic health.”
For more information:
Monique Hedderson, PhD, can be reached at m.hedderson@kp.org; X (Twitter): @mhedders.