Irregular menstrual cycles linked to type 2 diabetes risk.





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When blood sugar regulation is impaired, despite the availability of insulin, type 2 diabetes is suspected. Type 2 diabetes is characterized by elevated blood sugar and impaired insulin response. It is a non-ketotic form of diabetes. People with type 2 are not dependent on insulin to survive. The pathophysiology of type 2 diabetes is not fully understood. Three physiological abnormalities typically occur in type 2: insulin resistance, increased glucose production in the liver (hepatic gluconeogenesis), and poor beta cell function. These can occur individually or in combination.

Type 2 diabetes appears to be caused by genetic defects that at first make a person not respond to the actions of insulin and, over time, the beta cells in the pancreas will stop releasing insulin. However, new evidence points to diet and lifestyle as important factors that may be responsible for the development of the disease. A person over the age of 45 and overweight is a prime candidate for developing type 2 diabetes.

A recent study published in a November issue of JAMA, identified long or highly irregular menstrual cycles as a risk factor for Diabetes type 2. Infrequent periods have been linked to insulin resistance and glucose intolerance, but it has never been directly identified as a risk factor for diabetes mellitus type 2. The subjects of this study included 101,073 women who reported their normal menstrual cycle pattern at 18 to 22 years on the baseline. The women were grouped into 5 categories depending on the length of their cycle. There were 507 cases of type 2 diabetes during 564,333 person-years. Compared with women who had a normal menstrual cycle (26 to 31 days), the diabetes was multivariate risk was 2.08 in women who had irregular cycles. The results were adjusted for body mass index at age 18, among other variables. Risk of type 2 diabetes in correlation with irregular cycles was higher in obese subjects, but also was increased in non-obese women as well. The authors concluded that, "Women with long or highly irregular menstrual cycles have a significantly increased risk for developing type 2 DM [diabetes mellitus] that is not completely explained by obesity."1


1. Solomon CG, et al. Long or Highly Irregular Menstrual Cycles as a Marker for Risk of Type 2 Diabetes Mellitus. JAMA. Nov 2001; 286:2421-2426.