Menopause hormone therapy and type 2 diabetes risk and prognosis: systematic review and meta-analyses
Authors' conclusion
MHT showed small beneficial associations with glucose metabolism among women with and without type 2 diabetes, while the effect size was generally too small to be clinically significant.
Study context
- Population
- Postmenopausal women or women undergoing the menopausal transition, with or without T2D; 15 countries49 articles (33 RCTs, 16 cohort)
- Participants
- 1,472,277 women
- Comparison
- Menopause hormone therapy (MHT) users vs non-users
- Outcome
- Women without T2D: glucose metabolism and new-onset T2D
Methodological detailsrandom-effects models, RoB 2 and ROBINS-I risk of bias, Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty of evidence, Seven studies at low risk of bias
- Random-effects models
- RoB 2 and ROBINS-I risk of bias
- GRADE certainty of evidence
- Seven studies at low risk of bias
Pooled result
As reported in the abstract
MHT vs Non-MHTRR new-onset T2D (95% CI)
14 studies, N=1,450,134; very low CoE
0.83(0.75–0.92)
- 11 studies, N=4262; high certainty of evidence (CoE)
- MD fasting insulin −5.90 pmol/l (95% CI −8.03 to −3.77)
- 4 studies, N=2883; moderate CoE
- MD HOMA-IR −0.21 (95% CI −0.32 to −0.09)
Further pooled results
| Outcome | Estimate |
|---|---|
| Women with T2D: glycaemia, lipids and BPMHT vs Non-MHT · 16 studies, N=1379; very low CoE | MD FPG −1.07 mmol/l (95% CI −1.86 to −0.28) |
| Women with T2D: glycaemia, lipids and BPMHT vs Non-MHT · 17 studies, N=15,720; −0.50% (−0.76, −0.24%); very low CoE | MD HbA1c −5.47 mmol/mol (95% CI −8.32 to −2.62) |
| Women with T2D: glycaemia, lipids and BPMHT vs Non-MHT · 15 studies, N=907; low CoE | MD cholesterol −0.37 mmol/l (95% CI −0.50 to −0.24) |
| Women with T2D: glycaemia, lipids and BPMHT vs Non-MHT · 16 studies, N=961; low CoE | MD LDL-C −0.33 mmol/l (95% CI −0.54 to −0.13) |
| Women with T2D: glycaemia, lipids and BPMHT vs Non-MHT · 9 studies, N=630; −0.46 kPa; low CoE | MD systolic BP −3.43 mmHg (95% CI −4.88 to −1.98) |
Original publication
Menopause hormone therapy and type 2 diabetes risk and prognosis: systematic review and meta-analyses. Diabetologia. Published 18 September 2026. doi:10.
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