Mortality and hormone-related exposures in women with diabetes

OBJECTIVE - Hormone-related events and exposures are related to mortality a nd especially to cardiovascular disease in women. We evaluated whether such exposures influenced risk in a well-defined group of women with diabetes. RESEARCH DESIGN AND METHODS - Women with younger- and older-onset diabetes who were identified during a population-based study were queried about numb er of pregnancies, age at menarche, use of oral contraceptives, use of estr ogen replacement therapy, and menopausal status at examinations in 1984-198 6. Analyses are limited to women aged greater than or equal to 18 years (n = 398 and 542 in those with younger- and older-onset diabetes, respectively ), Cohort mortality was monitored carefully, and causes of death were abstr acted from death certificates. RESULTS - There were 58 deaths in the first group and 338 deaths in the sec ond group since the 1984-1986 examination. The number of pregnancies was si gnificantly associated with all-cause mortality (hazard ratio, 0.96 [95% CI 0.92-1.00]) in older-onset women only. CONCLUSIONS - These data suggest and are compatible with the notion that th e hormone exposures examined are unrelated to cardiovascular mortality in w omen with diabetes, with the exception of a minimal effect of the number of pregnancies in older-onset women. Whether there is a difference in these e xposure-outcome relationships between women with diabetes and those without diabetes is uncertain and requires further investigation.