Background: In the clinic we observed that during menopause, women with type 1 diabetes (T1DM) often need treatment adaptations to prevent hyperglycemia and hypoglycemia. In healthy postmenopausal women, menopause is associated with decreased insulin-independent glucose uptake and decreased insulin secretion. However, little is known about how menopause affects glycemic control in women with T1DM.

Methods: We developed a cross-sectional survey to explore whether women with T1DM observed changes in glucose regulation after menopause. Qualitative interviews with 3 women with T1DM were conducted to enhance survey quality. Recruitment occurred through hospitals and online platforms for people living with T1DM in the Netherlands. Menopausal symptoms were assessed using the Greene Climacteric Scale. Postmenopausal women (≥1 year of amenorrhea), aged 45-65 with T1DM were included. Women with primary amenorrhea, premenopausal hysterectomy, or a postmenopausal diabetes diagnosis were excluded.

Results: For the interim analysis, 73 questionnaires were analyzed. Of these, 54 (74%) had complete, non-missing data. Participants, aged on average 55 (SD ±5) years, were diagnosed with T1DM at a median age of 22 years (IQR 14-31), and their final menstrual period occurred at a median age of 50 years (IQR 47-53). Twenty-seven participants (37%) had diabetes complications, and 48 (66%) used insulin pumps. Among participants, 35 (48%) reported postmenopausal changes in glucose regulation of whom 23 (32%) reported increased blood glucose, and 12 (16%) reported lower glucose levels. Thirty-three women (45%) reported no change. Thirty participants (41%) experienced more hyperglycemic events and 17 (23%) more hypoglycemic events. Menopausal symptom severity score (mean 17.5 SD ±10) was not associated with observed changes in glucose regulation (adjusted OR 0.98 [95% CI 0.93 – 1.04]).

Conclusion: Roughly half of the participating women with T1DM observed changes in glucose regulation after menopause. Changes in glucose regulation were not associated with the severity of menopausal symptoms.