Hormone replacement therapy is associated with better glycemic control in women with type 2 diabetes - The Northern California Kaiser Permanente Diabetes Registry

OBJECTIVE - In women with diabetes, the changes that accompany menopause ma y further diminish glycemic control. Little is known about how hormone repl acement therapy (HRT) affects glucose metabolism in diabetes. The aim of th is study was to examine whether HbA(1c) levels varied by current HRT among women with type 2 diabetes. RESEARCH DESIGN AND METHODS - In a cohort of 15,435 women with type 2 diabe tes who were members of a health maintenance organization, HbA(1c) and HRT were assessed by reviewing records in the health plan's computerized labora tory and pharmacy systems. Sociodemographic and clinical information were c ollected by survey. RESULTS - The mean age was 64.7 years (SD +/- 8.7). The study cohort compri sed 55% non-Hispanic whites, 14% non-Hispanic blacks, 12% Hispanics, 11% As ians, 4% "other" ethnic groups, and 4% with missing ethnicity data. Current HRT was observed in 25% of women. HbA(1c) levels were significantly lower in women currently using HRT than in women not using HRT (age-adjusted mean +/- SE: 7.9 +/- 0.03 vs. 8.5 +/- 0.02, respectively, P = 0.0001). No diffe rences in HbA(1c) level were observed between women using unopposed estroge ns and women using opposed estrogens. In a Generalized Estimating Equation model, which took into account patient clustering within physician and adju sted for age, ethnicity, education, obesity, hypoglycemic therapy, diabetes duration, self-monitoring of blood glucose, and exercise, HRT remained sig nificantly and independently associated with decreased HbA(1c) levels (P = 0.0001). CONCLUSIONS - HRT was independently associated with decreased HbA(1c) level . Clinical trials will be necessary to understand whether HRT may improve g lycemic control in women with diabetes.