Age, type of menopause not associated with diabetes onset

There is no direct relationship between diabetes and the timing and type of menopause, and it is instead affected by lifestyle factors, according to recent research published in Menopause. This contradicts previous research, which found a 4% lower risk of diabetes for each additional year before the onset of menopause.

A team of researchers, including corresponding author Jose Antonio Quesada, Ph.D., Miguel Hernandez University, in Alicante, Spain, used data from the UK Biobank database, which contains health data for 502,129 volunteer participants, ages 40 and older, living in the UK at the time of enrollment.

They identified 146,764 menopausal women, followed them for more than 14 years and found that just 4.5% (6,598) of them developed diabetes.

When broken down by menopause age and type (surgical or natural), cumulative rates of women with normal menopause were 4.5%, compared with 6.6% in women who had surgical menopause.

In addition, 5.2% of women who had early menopause developed diabetes, compared with 7.4% of those with premature menopause and 4.2% of those with a normal age of menopause.

“Although our initial findings are suggestive of an association between early menopause and a higher incidence of diabetes, the multivariate analysis indicates that this relationship is confounded by other underlying factors,” Quesada and his colleagues write.

Specifically, 60% of the sample were either overweight or obese, 25% slept less than seven hours a day and 20.4% had a poor diet.

This finding is significant because early menopause (before the age of 45) is associated with a higher risk of coronary heart disease and stroke and later menopause onset is associated with a higher risk of altered glucose metabolism.

Menopause at any age is associated with an increase in fat, especially in the trunk, caused by the drop in estrogen levels that cause this transition. Increased body fat in this region is also associated with insulin resistance.

“The results of this study highlight that, although postmenopausal women are at increased risk for diabetes, it does not appear to be related to the age at menopause onset or whether menopause occurs naturally or due to surgery but rather to cardiovascular and lifestyle risk factors,” Stephanie Faubion, M.D., MBA, FACP, MSCP, IF, medical director for The Menopause Society, said in a news release. “This is somewhat reassuring in that cardiovascular risk factors, such as hypertension and hyperlipidemia, can be controlled, and lifestyle factors, such as smoking, diet and exercise, are modifiable, whereas age at menopause is not.”

The study arrives as rates of type 2 diabetes continue to climb globally, particularly among aging populations, making the identification of preventable risk factors a growing priority. While menopause remains a significant biological milestone, the research suggests it should be viewed as part of a broader health profile rather than a standalone predictor of disease.

“More studies are needed to elucidate the causal pathways between early or premature menopause and its association with morbidity and mortality in order to implement more appropriate prevention and screening measures in this important segment of the population,” Quesada and his team conclude in the study.