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Frequent hot flashes linked to diabetes

A greater risk of developing type 2 diabetes was found in those reporting frequent menopause-related symptoms, a Kaiser Permanente study finds.

Women who report having frequent hot flashes and night sweats during menopause were about 50% more likely to develop type 2 diabetes than those who did not have those symptoms, according to research published in JAMA Network Open.

The findings offer insight into an important health risk for midlife women, said lead author Monique Hedderson, PhD, a research scientist with the Kaiser Permanente Division of Research (DOR).

Menopause involves a wide range of physical and emotional changes for women in their 40s and 50s.

“Menopause has been historically understudied,” Hedderson said. “More research is needed to clarify the mechanism underlying vasomotor symptoms (night sweats and hot flashes) and why — when frequent and severe — they associate with adverse health risk.”

The women involved in the research participate in the Study of Women’s Health Across the Nation (SWAN). The Oakland study site at Kaiser Permanente — one of 7 around the country — sees about 330 women.

When first enrolled in SWAN in the mid-1990s, the women were in the first stage of menopause called perimenopause. Typical menopause age is between 42 and 52. They have been followed for almost 30 years, allowing a long-term view of patients’ menopause transitions and details about how frequent their symptoms were and at what age they started.

The recently published study used data from 2,761 SWAN participants who live in various parts of the U.S. and come from racially and ethnically diverse backgrounds. None of the women had a previous diabetes diagnosis. For this analysis, data was tracked for 17 years.

The women’s symptom frequency varied at baseline: 10% reported symptoms 6 or more days per week per two-week period while 28% reported symptoms 1 to 5 days, and 62% reported no symptoms. About 12% of the SWAN participants developed diabetes during the study period.

Over the course of the study, an increasing number of participants reported persistent symptoms — 30% of the total. Those with persistent symptoms had a 50% increased risk of developing diabetes.

Possible explanations

The researchers were not able to explain precisely how vasomotor symptoms might relate to diabetes risk, but it is an area of growing research interest. There is evidence that links hot flashes and night sweats to increased risk of cardiovascular disease, which sometimes goes hand-in-hand with diabetes risk. This could happen through inflammation, poor sleep quality, or increased body fat.

The researchers are focusing on people with more severe hot flashes and night sweats for risk of disease. “While 70% of women will experience vasomotor symptoms at some time during the menopause transition, we’re talking about the smaller proportion of women for whom this is a common and severe problem,” Hedderson said.

The researchers took into account other risk factors for diabetes, such as weight, diet, and physical activity, and still found a unique relationship between night sweats and hot flashes, and diabetes onset.

SWAN investigators hope the study will continue to produce insights into women’s health issues related to aging. “One of our next steps is to look at vasomotor symptoms in relationship to other outcomes such as cognition,” Hedderson said.

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