Weight reduction and improved glycaemic control following oestrogen replacement: individualising diabetes care in women

Post‐menopausal oestrogen deficiency symptoms may cause mood disturbances and affect compliance, yet clinicians are reluctant to prescribe oestrogen replacement in view of adverse risks.

A 51‐year‐old woman was referred with poor glycaemic control. Compliance with diet and medications was poor. Intercurrent problems included depression, dyslipidaemia and severe vasomotor symptoms following hysterectomy one year prior.

HbA_1c was 12.4%; fasting total cholesterol 5.92mmol/L (NR 2.5–5). The patient was prescribed oestrogen replacement and no adjustments were made to diet or insulin. Over several months, mood and energy improved and weight fell from 110kg to 81kg, HbA_1c dropped to 7.6%, cholesterol was 2.56mmol/L and insulin dosage halved.

The impact of menopausal symptoms on health and wellbeing is often underestimated. In selected post‐menopausal women with type 2 diabetes, short‐term treatment with hormone replacement therapy may be useful if benefits obtained outweigh potential risks. Copyright © 2010 John Wiley & Sons.