PMID- 30314563 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20181211 IS - 1873-4111 (Electronic) IS - 0378-5122 (Linking) VI - 117 DP - 2018 Nov TI - Menopause and diabetes: EMAS clinical guide. PG - 6-10 LID - S0378-5122(18)30539-5 [pii] LID - 10.1016/j.maturitas.2018.08.009 [doi] AB - INTRODUCTION: Whether menopause increases the risk of type 2 diabetes mellitus (T2DM) independently of ageing has been a matter of debate. Controversy also exists about the benefits and risks of menopausal hormone therapy (MHT) in women with T2DM. AIMS: To summarise the evidence on 1) the effect of menopause on metabolic parameters and the risk of T2DM, 2) the effect of T2DM on age at menopause, 3) the effect of MHT on the risk of T2DM, and 4) the management of postmenopausal women with T2DM. MATERIALS AND METHODS: Literature review and consensus of experts' opinions. RESULTS AND CONCLUSION: Metabolic changes during the menopausal transition include an increase in and the central redistribution of adipose tissue, as well as a decrease in energy expenditure. In addition, there is impairment of insulin secretion and insulin sensitivity and an increase in the risk of T2DM. MHT has a favourable effect on glucose metabolism, both in women with and in women without T2DM, while it may delay the onset of T2DM. MHT in women with T2DM should be administered according to their risk of cardiovascular disease (CVD). In women with T2DM and low CVD risk, oral oestrogens may be preferred, while transdermal 17beta-oestradiol is preferred for women with T2DM and coexistent CVD risk factors, such as obesity. In any case, a progestogen with neutral effects on glucose metabolism should be used, such as progesterone, dydrogesterone or transdermal norethisterone. Postmenopausal women with T2DM should be managed primarily with lifestyle intervention, including diet and exercise. Most of them will eventually require pharmacological therapy. The selection of antidiabetic medications should be based on the patient's specific characteristics and comorbidities, as well on the metabolic, cardiovascular and bone effects of the medications. CI - Copyright (c) 2018 Elsevier B.V. All rights reserved. FAU - Slopien, Radoslaw AU - Slopien R AD - Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Wender-Ozegowska, Ewa AU - Wender-Ozegowska E AD - Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland. FAU - Rogowicz-Frontczak, Anita AU - Rogowicz-Frontczak A AD - Department of Diabetology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Meczekalski, Blazej AU - Meczekalski B AD - Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Zozulinska-Ziolkiewicz, Dorota AU - Zozulinska-Ziolkiewicz D AD - Poznan University of Medical Sciences, Poznan, Poland. FAU - Jaremek, Jesse D AU - Jaremek JD AD - Poznan University of Medical Sciences, Poznan, Poland. FAU - Cano, Antonio AU - Cano A AD - Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain. FAU - Chedraui, Peter AU - Chedraui P AD - Instituto deInvestigacion e Innovacion de SaludIntegral (ISAIN), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador. FAU - Goulis, Dimitrios G AU - Goulis DG AD - Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. FAU - Lopes, Patrice AU - Lopes P AD - Nantes, France Polyclinique de l'Atlantique Saint Herblain, F 44819 St Herblain, France; Universite de Nantes, F 44093 Nantes Cedex, France. FAU - Mishra, Gita AU - Mishra G AD - School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia. FAU - Mueck, Alfred AU - Mueck A AD - University Women's Hospital of Tuebingen, Calwer Street 7, 72076 Tuebingen, Germany. FAU - Rees, Margaret AU - Rees M AD - Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. FAU - Senturk, Levent M AU - Senturk LM AD - Istanbul University Cerrahpasa School of Medicine, Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology, IVF Unit, Istanbul, Turkey. FAU - Simoncini, Tommaso AU - Simoncini T AD - Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy. FAU - Stevenson, John C AU - Stevenson JC AD - National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London SW3 6NP, UK. FAU - Stute, Petra AU - Stute P AD - Department of Obstetrics and Gynecology, University Women's Hospital, Bern, Switzerland. FAU - Tuomikoski, Pauliina AU - Tuomikoski P AD - Helsinki University and Helsinki University Hospital, Eira Hospital, Helsinki, Finland. FAU - Paschou, Stavroula A AU - Paschou SA AD - Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Greece. FAU - Anagnostis, Panagiotis AU - Anagnostis P AD - Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. FAU - Lambrinoudaki, Irene AU - Lambrinoudaki I AD - Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Greece. Electronic address: ilambrinoudaki@med.uoa.gr. LA - eng PT - Journal Article DEP - 20180823 PL - Ireland TA - Maturitas JT - Maturitas JID - 7807333 SB - IM MH - *Diabetes Mellitus, Type 2/epidemiology/etiology/metabolism/therapy MH - Estrogen Replacement Therapy/adverse effects MH - Female MH - Humans MH - Incidence MH - *Menopause/metabolism MH - Risk Factors OTO - NOTNLM OT - Menopausal hormone therapy OT - Menopause OT - Type 2 diabetes mellitus EDAT- 2018/10/14 06:00 MHDA- 2018/12/12 06:00 CRDT- 2018/10/14 06:00 PHST- 2018/10/14 06:00 [entrez] PHST- 2018/10/14 06:00 [pubmed] PHST- 2018/12/12 06:00 [medline] AID - S0378-5122(18)30539-5 [pii] AID - 10.1016/j.maturitas.2018.08.009 [doi] PST - ppublish SO - Maturitas. 2018 Nov;117:6-10. doi: 10.1016/j.maturitas.2018.08.009. Epub 2018 Aug 23.