Effects of low-dose continuous combined hormone replacement therapy on glucose homeostasis and markers of cardiovascular risk in women with type 2 diabetes.
BACKGROUND
Low-dose hormone replacement therapy (HRT) has attracted interest for the treatment of postmenopausal symptoms in diabetes because of concerns about increased risk of coronary heart disease (CHD) and stroke with conventional HRT containing conjugated equine oestrogens (CEEs) and medroxyprogesterone acetate (MPA).


OBJECTIVE
We assessed the effects on glucose homeostasis and cardiovascular risk factors of continuous oral 17beta oestradiol (1 mg) and norethisterone (0.5 mg) in postmenopausal women with type 2 diabetes.


METHODS
Double-blind, randomized placebo-controlled trial.


METHODS
Hyperinsulinaemic isoglycaemic clamp and cardiovascular risk factors were assessed before and after 3 months of treatment.


RESULTS
Twenty-eight women completed the study. HRT decreased fasting glucose compared with placebo [-9.4% with HRT vs.+2.3% for placebo, 95% confidence interval (CI) -23.2 to -0.3] and total cholesterol (-13.7 vs.+1.0%, 95% CI -22.4 to -3.1%) No significant effect was seen on metabolic clearance rate of glucose, glycated haemoglobin (HbA1c), triglycerides, high density lipoprotein (HDL)-cholesterol or C-reactive protein (CRP).


CONCLUSIONS
In women with type 2 diabetes, low-dose HRT decreased fasting glucose and total cholesterol without detectable adverse effects on glucose clearance, triglycerides and CRP as reported with conventional HRT.
Kernohan
A F B
AF
Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. afbk1h@clinmed.gla.ac.uk
Sattar
N
N
Hilditch
T
T
Cleland
S J
SJ
Small
M
M
Lumsden
M A
MA
Connell
J M C
JM
Petrie
J R
JR
D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004958:Estradiol / Q000008:administration & dosage* / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D006706:Homeostasis; D006801:Humans; D007004:Hypoglycemic Agents; D007328:Insulin; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage* / Q000627:therapeutic use; D017698:Postmenopause / Q000097:blood*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides; D004958:Estradiol; D002097:C-Reactive Protein; D002784:Cholesterol; D009640:Norethindrone