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HRT may cut risk of type 2 diabetes by 35%. (Women with Heart Disease).
NEW YORK -- Hormone replacement therapy has been shown to prevent the development of type 2 diabetes in a large, randomized, double-blind, placebo-controlled trial of postmenopausal women with coronary heart disease.
But it may nor matter much.
The findings come from the 2,029 of 2,763 postmenopausal women with coronary heart disease in the Heart and Estrogen/Progestin Replacement Study (HERS) who did not have diabetes at baseline. Over a mean follow-up of 4.1 years, the cumulative incidence of diabetes was 6.2% in those assigned to HRT, compared with 9.5% in those assigned to placebo, for a 35% reduction in risk in the HRT arm (Ann. Intern. Med. 138[1]:1-9, 2003).
HERS data published last summer showed that HRT use did not reduce the risk of cardiovascular events and was associated with increased risks for venous thromboembolism and biliary tract surgery (JAMA 288[1]:49-66, 2002). Two months later, the Women's Health Initiative demonstrated that HRT was associated with pulmonary embolism, deep vein thrombosis, stroke, breast cancer, and cardiovascular disease in initially healthy postmenopausal women (JAMA 288[3]:321-33, 2002).
Thus, "I don't think we can conclude [the diabetes finding] is good news. [HRT] has a modest effect on glucose, but what effect it has on the patient otherwise I think is suspect," HERS coinvestigator Dr. Elizabeth Barrett-Connor said at a conference sponsored by the American Diabetes Association.
She did note, however, that the new finding may give an extra boost to women who choose to use HRT to treat severe menopausal symptoms despite these risks. "Some women will tell you life isn't worth living without estrogen," noted Dr. Barrett-Connor, professor and chief of the division of epidemiology at the University of California, San Diego.
Still, extreme caution is essential in using HRT in women with diabetes or impaired glucose tolerance, since it raises the risk of problems for which those patients are already more vulnerable, such as venous thromboembolism and pulmonary embolism. If the decision is ...
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Source: HighBeam Research, HRT may cut risk of type 2 diabetes by 35%. (Women with Heart...