Esther M. Speksnijder, Amsterdam UMC, University of Amsterdam, Department of Endocrinology & Metabolism, Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands, e.m.speksnijder@amsterdamumc.nl; Suat Simsek, Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands; Peter H. Bisschop, Amsterdam UMC, University of Amsterdam, Department of Endocrinology & Metabolism, Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands; Dirk Jan Stenvers, Amsterdam UMC, University of Amsterdam, Department of Endocrinology & Metabolism, Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Endocrinology & Metabolism, De Boelelaan 1117, Amsterdam, The Netherlands; Sarah E. Siegelaar, Amsterdam UMC, University of Amsterdam, Department of Endocrinology & Metabolism, Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands.

Background: In healthy women, menopause is associated with decreased insulin-independent glucose uptake and decreased insulin secretion. However, little is known about the impact of menopause on glycaemic control in women with type 1 diabetes mellitus (T1DM).

Methods: We developed a cross-sectional survey to explore whether women with T1DM observed changes in glucose regulation after menopause. Postmenopausal women (≥1 year of amenorrhea) with T1DM were included. Women with primary amenorrhea, premenopausal hysterectomy, or a postmenopausal diabetes diagnosis were excluded.

Results: 155 questionnaires were included. Of these, 126 (81%) had complete, non-missing data. Participants had a mean age of 55 years (±SD 4), had a mean T1DM duration of 30 years (±SD 13), and had their final menstrual period at a median age of 51 years (IQR 48-53). 102 participants (66%) used insulin pumps, and 51 participants (33%) had diabetes complications. Among participants, 104 (67%) reported moderate to severe postmenopausal changes in glucose regulation. 62 (40%) participants reported increased blood glucose levels, 30 (19%) reported lower glucose levels, and 62 (40%) reported no change in blood glucose levels. 79 participants (51%) experienced more fluctuations in glucose levels, and 27 (17%) experienced less fluctuations. Ninety-one participants (59%) had poor sleep quality. Menopausal symptom severity score (mean 18.6 ±SD 9.9) was comparable to the healthy Dutch population, and was associated with perceived changes in glucose regulation (adjusted OR 1.04 [95% CI 1.01 – 1.07], p = 0.02) and with poor sleep quality (adjusted OR 1.13 [95% CI 1.07 – 1.19], p <0.01).

Discussion/Conclusion: Two-thirds of the participating women with T1DM observed changes in glucose regulation after menopause consisting of both hyper- and hypoglycaemia. Changes in reported glucose regulation were associated with the severity of menopausal symptoms.