Postmenopausal Symptoms in Female Veterans with Type 2 Diabetes: Glucose Control and Symptom Severity.
BACKGROUND
While type 2 diabetes mellitus (DM) is a common condition of midlife women, few studies have examined its influence on the symptom features of menopause. To explore this relationship, we conducted a study of symptom patterns of diabetic patients using a random sample of female veterans receiving care in the Veterans Affairs Healthcare system.


METHODS
A cross-sectional comparison was conducted with three groups of postmenopausal respondents (ages 45-60 years) to a mailed national survey who also consented to clinical data access: no diabetes (n=90), diabetes with better glucose control (hemoglobin A1c [HbA1c]≤7%, n=135) and diabetes with worse glucose control (HbA1c>7%, n=102).


RESULTS
Respondents, on average, were obese (body mass index: 33.9±0.4 kg/m(2)), 11.30±0.2 years postmenopause, with more than one chronic illness. Despite higher body mass index and increased comorbidities in women with diabetes compared with nondiabetic women, measures of mental health (anxiety, depressed mood, stress) were similar across groups. The pattern of menopause symptoms did not differ by group. Muscle aches/joint pain was the most prevalent symptom (78.6%), followed by vasomotor symptoms (74.4%). Respondents with elevated HbA1c demonstrated higher total menopausal symptom severity scores (DM-HbA1c>7: 15.4±0.8 vs. DM-HbA1c≤7%: 12.2±0.8 vs. No diabetes: 12.3±0.8; p=0.006) than the other two groups.


CONCLUSIONS
In postmenopausal female veterans with diabetes, glucose control is associated with the severity of those symptoms commonly attributed to menopause. Joint pain is an important part of the postmenopausal symptom complex in this population.
1 McAuley School of Nursing, University of Detroit Mercy , Detroit, Michigan.
Patricia A
PA
Rouen
2 Center for Clinical Management Research , Veterans Affairs Healthcare System, Ann Arbor, Michigan.|3 School of Nursing, University of Michigan , Ann Arbor, Michigan.|4 Department of Internal Medicine, University of Michigan Medical School , Ann Arbor, Michigan.
Sarah L
SL
Krein
5 School of Nursing, Columbia University School of Nursing , New York, New York.
Nancy E
NE
Reame
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D018771:Arthralgia / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
D006442:Glycated Hemoglobin