ArticleWomen's health (London, England)
Trends in type 2 diabetes, prediabetes, and hyperglycemic recognition among menopausal women: A 20-year analysis of sociodemographic disparities.
Article in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BackgroundMenopausal hormonal and metabolic changes may increase susceptibility to type 2 diabetes (T2D), yet long-term national trends and socio-demographic disparities in both T2D burden and hyperglycemia recognition among menopausal women remain insufficiently characterized.ObjectivesTo examine 20-year trends in T2D, prediabetes, and recognition of prediabetes- or diabetes-range hyperglycemia among U.S. menopausal women and to assess sociodemographic disparities associated with abnormal glycemic status.DesignRepeated cross-sectional analysis of continuous National Health and Nutrition Examination Survey (NHANES) cycles (2003-2023).MethodsThe analytic sample included 3,574 naturally menopausal women aged ≥45 years with fasting plasma glucose, HbA1c, and diabetes questionnaire data. T2D and prediabetes were defined using ADA-aligned biomarker thresholds. Hyperglycemia was operationalized specifically as biomarker-defined prediabetes- or diabetes-range hyperglycemia (fasting plasma glucose ≥100 mg/dL or HbA1c ≥5.7%). Recognition status was categorized as recognized hyperglycemia, unrecognized hyperglycemia, or normoglycemia based on glycemic biomarkers and self-reported prior clinician communication of diabetes or borderline diabetes. Survey-weighted prevalence estimates, trend models across cycles, and multinomial/survey logistic regression assessed associations with race/ethnicity, education, marital status, employment, and poverty-to-income ratio (PIR).ResultsOverall crude prevalence was 13.7% for diabetes and 34.8% for prediabetes. From 2003 to 2023, diabetes rose modestly from 11.3% to 11.9% (p<.001), while prediabetes increased substantially from 24.3% to 35.2% (p<.001). Unrecognized hyperglycemia increased from 23.9% to 32.9% (p<.001). Higher odds of diabetes were observed for non-Hispanic Black (OR=4.03) and Hispanic/Latina women (OR=2.81) versus non-Hispanic White women, for ≤high school education (OR=2.77) versus ≥4-year degree, for disability (OR=1.46) and retirement (OR=1.50) versus employment, and for PIR<1.3 (OR=1.54) versus PIR>3.5; marital status was not associated. Similar patterns were observed for recognized and unrecognized hyperglycemia.ConclusionAmong menopausal women, prediabetes and unrecognized hyperglycemia increased over two decades, with pronounced disparities by race/ethnicity and socioeconomic position. Integrating routine glycemic screening and tailored, culturally responsive prevention efforts into menopausal care may reduce unrecognized abnormal glycemic status and related inequities.
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