Like a fingerprint, menopause is unique for every woman. Take hot flashes and night sweats. For some women, the “lucky few,” they are momentary and mild—or don’t happen at all—but for many women they are bothersome and last for years…even decades. For some women, they are truly severe and debilitating.

Your pattern for these symptoms, it turns out, may be a road map for your risk of type 2 diabetes.

Background: The risk of developing type 2 diabetes increases after a woman hits menopause (average age 51). Simply getting older is one reason—after all, risk for men also rises with age. But there is growing evidence that the pattern of hormonal disturbances related to the menopause transition—as revealed by “vasomotor” symptoms such as hot flashes and/or night sweats—also plays a role. Certain patterns signal increased risk for diabetes that develops later on, often years after symptoms subside.

Study: Researchers used data from the large Women’s Health Initiative that included about 150,000 middle-aged women who did not have diabetes at the beginning of the study. The women were followed for an average of 13 years and reported if, when and how long they endured hot flashes and night sweats…and whether they were diagnosed with diabetes. In analyzing the data, the researchers controlled for obesity and other known risk factors for diabetes.

Results: Over those 13 years, more than 18,000 of the women developed diabetes. The risk of being diagnosed with diabetes was associated with the presence and duration of vasomotor symptoms, but especially their severity…

  • Women who reported mild vasomotor symptoms were 13% more likely to develop diabetes than women with no vasomotor symptoms. But women with moderate symptoms were at 29% increased risk—and those with severe symptoms were at 48% increased risk—compared with women who had no such symptoms.
  • Women whose vasomotor symptoms started only after menopause were at 12% increased risk, compared with women who did not have vasomotor symptoms.
  • Women who had night sweats but no hot flashes were at 20% increased risk. Those with both symptoms were at 22% increased risk, on average.
  • Each five-year increase in vasomotor symptom duration increased diabetes risk by 4%.

Surprising finding: Among white women, for each incremental increase in severity, risk for diabetes increased by 15%. But among black women, risk increased by only 7%. The reasons aren’t clear.

Bottom line: This research reinforces the potential to use menopausal symptoms to understand risks for chronic disease—and to leverage the menopause transition to take steps to protect yourself.

While even a large observational study such as this one can’t establish cause and effect, the researchers argue that a major way these symptoms contribute to diabetes is by interrupting sleep. Insomnia and other chronic sleep problems are well-established risk factors for diabetes. Night sweats in particular can wreck sleep, which may explain why night sweats were a risk factor for diabetes even when there were no hot flashes.

Although genetics plays a role in the risk of developing adult-onset diabetes, diabetes is a largely preventable illness, with poor diet and lack of activity playing key roles in its development. Women with persistent and, especially, severe hot flashes and/or night sweats may want to ask their health-care providers to check them for diabetes. Preventive steps include minimizing menopausal weight gain with reduced intake of calories and refined carbohydrates…making time for both aerobic and strength-building exercise…and getting adequate sleep of at least seven hours a night.

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