PMID- 31239121
OWN - NLM
STAT- MEDLINE
DCOM- 20191028
LR  - 20191028
IS  - 1873-4111 (Electronic)
IS  - 0378-5122 (Linking)
VI  - 126
DP  - 2019 Aug
TI  - Therapeutic strategies for type 2 diabetes mellitus in women after menopause.
PG  - 69-72
LID - S0378-5122(19)30128-8 [pii]
LID - 10.1016/j.maturitas.2019.05.003 [doi]
AB  - As type 2 diabetes mellitus (T2DM) is affected by both chronological and ovarian 
      ageing, it is common in postmenopausal women. This review analyses and critically 
      appraises the literature regarding the optimal therapeutic strategies for T2DM in 
      women after menopause. Lifestyle interventions, including changes in dietary 
      habits and physical exercise in everyday life targeting a modest weight loss 
      (5%), represent the cornerstone of management. Limited intake of alcohol and 
      sodium, as well as smoking cessation, are additional lifestyle changes for both 
      endothelial and bone health. Regarding medications, postmenopausal women should 
      be initially treated with metformin, concurrently with lifestyle intervention. If 
      glycosylated haemoglobin (HbA(1c)) remains over the target level (usually >/=7%), 
      dipeptidyl peptidase-4 inhibitors (DPP-4i) or glucagon-like peptide-1 receptor 
      agonists (GLP-1RA) should be preferred. Thiazolidinediones (TZDs) and 
      canagliflozin should be avoided in postmenopausal women with increased fracture 
      risk. Insulin should be used with caution to avoid hypoglycaemia. Bariatric 
      surgery is a well established and effective therapeutic option for both weight 
      loss and glycaemic control in very obese patients with T2DM; however, metabolic 
      benefits should be balanced against nutritional deficiencies that often present 
      after surgery. Proper control of hypertension, with avoidance of hypotension, is 
      of great importance as a measure against falls. Annual tests for retinopathy and 
      neuropathy are crucial for the same reason. Menopausal hormone therapy (MHT) has 
      a beneficial effect on glucose homeostasis, reduces the risk of new-onset T2DM 
      and improves glucose control in women with T2DM. T2DM has been considered a 
      cardiovascular disease equivalent, which meant that postmenopausal women with the 
      disease could not take MHT but current evidence supports an individualised 
      approach to this issue. Therapeutic strategies for women with T2DM after 
      menopause should aim to maximise benefits for metabolic, cardiovascular and bone 
      health with the minimum of adverse effects, bearing in mind that most women will 
      spend more than one-third of their life being of postmenopausal status.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Paschou, Stavroula A
AU  - Paschou SA
AD  - Division of Endocrinology and Diabetes, Second Department of Obstetrics and 
      Gynecology, Medical School, National and Kapodistrian University of Athens, 
      Athens, Greece. Electronic address: s.a.paschou@gmail.com.
FAU - Marina, Ljiljana V
AU  - Marina LV
AD  - Department for Obesity, Reproductive and Metabolic Disorders, Clinic for 
      Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, 
      Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
FAU - Spartalis, Eleftherios
AU  - Spartalis E
AD  - Laboratory of Experimental Surgery and Surgical Research, Medical School, 
      National and Kapodistrian University of Athens, 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, Thessaloniki, 
      Greece.
FAU - Alexandrou, Andreas
AU  - Alexandrou A
AD  - First Department of Surgery, Laiko General Hospital, Medical School, National and 
      Kapodistrian University of Athens, Athens, Greece.
FAU - Goulis, Dimitrios G
AU  - Goulis DG
AD  - Unit of Reproductive Endocrinology, First Department of Obstetrics and 
      Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 
      Greece.
FAU - Lambrinoudaki, Irene
AU  - Lambrinoudaki I
AD  - Division of Endocrinology and Diabetes, Second Department of Obstetrics and 
      Gynecology, Medical School, National and Kapodistrian University of Athens, 
      Athens, Greece.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190514
PL  - Ireland
TA  - Maturitas
JT  - Maturitas
JID - 7807333
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Estrogen Replacement Therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Life Style
MH  - *Postmenopause
OTO - NOTNLM
OT  - Anti-diabetic medications
OT  - Hormone replacement therapy
OT  - Menopausal hormone therapy
OT  - Menopause
OT  - Type 2 diabetes mellitus
EDAT- 2019/06/27 06:00
MHDA- 2019/10/29 06:00
CRDT- 2019/06/27 06:00
PHST- 2019/02/28 00:00 [received]
PHST- 2019/05/03 00:00 [revised]
PHST- 2019/05/13 00:00 [accepted]
PHST- 2019/06/27 06:00 [entrez]
PHST- 2019/06/27 06:00 [pubmed]
PHST- 2019/10/29 06:00 [medline]
AID - S0378-5122(19)30128-8 [pii]
AID - 10.1016/j.maturitas.2019.05.003 [doi]
PST - ppublish
SO  - Maturitas. 2019 Aug;126:69-72. doi: 10.1016/j.maturitas.2019.05.003. Epub 2019 
      May 14.