Project summary
During menopause, falling oestrogen levels can make it harder to keep blood sugar levels steady. Dr Ruth Brauer will explore whether hormone replacement therapy (HRT) can help women with diabetes manage their blood sugars, or delay the development of type 2 in those at high risk. She’ll also shine a light on whether some women face unfair inequities in menopause care, helping to improve support for everyone. This project could transform how menopause care supports women with or at risk of diabetes, during what can be a challenging stage of life.
Background to research
During menopause, levels of reproductive hormones such as oestrogen and progesterone fall, which can affect blood sugar levels and make diabetes harder to manage. While for women with prediabetes, who have a high risk of type 2, the hormonal changes could increase their chances of developing the condition.
Hormone replacement therapy (HRT) is a common and effective treatment for menopause symptoms, replacing declining hormones. There’s some evidence that HRT may help protect against type 2 diabetes in women with prediabetes, and may improve blood sugar control and reduce diabetes complications in women living with type 1 or 2 diabetes. But the evidence isn’t strong enough yet to be certain.
We also know that women from minority ethnic backgrounds and women living in more deprived areas often face inequities in care. What we don’t know is whether these inequities also affect women with prediabetes or diabetes during the menopause, and whether this has consequences for their health.
Research aims
Dr Ruth Brauer aims to build a clearer understanding of how menopause care can better support the health of women with or at risk of diabetes using real-word data from UK GP surgeries.
First, Dr Brauer and team will find out whether HRT can help prevent or delay type 2 diabetes. They’ll study women aged 40–65 with prediabetes and see whether those prescribed HRT are less likely to go on to develop type 2 diabetes.
Next, they’ll see whether HRT affects blood sugar levels and diabetes complications. For women aged 40–65 living with type 1 or 2 diabetes, they’ll examine whether taking HRT changes their risk of severe blood sugar highs or lows or long-term complications, like stroke or heart attack.
They’ll also look closely at how factors like age, bodyweight, ethnicity, and deprivation influence these outcomes, and whether unfair differences in menopause care might be affecting women’s risk of diabetes complications.
Potential benefit to people with diabetes
This research could reshape menopause care to make it fairer and more effective for women living with type 1, type 2 or prediabetes. By showing whether HRT could support blood sugar control during the menopause, this work could open the door to new evidence-based treatment options that better protect women from the harm of diabetes.
It will also reveal which women benefit most or aren’t getting the same access to care, helping to reduce inequities and guide tailored care.
