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Conjugated Equine Estrogen Improves Glycemic Control and Blood Lipoproteins in Postmenopausal Women with Type 2 Diabetes¹

Department of Medicine (K.E.F., C.D.) and General Clinical Research Center (R.U.F.), Tulane University Health Sciences Center, New Orleans, Louisiana 70112

Address all correspondence and requests for reprints to: Karen E. Friday, M.D., 1430 Tulane Avenue, SL53, New Orleans, Louisiana 70112. E-mail: fridayk{at}tulane.edu

The objective of this study was to determine the metabolic effects of estrogen replacement therapy in postmenopausal women with type 2 diabetes. Twenty-five postmenopausal, type 2 diabetic women completed a randomized, blinded, cross-over trial of conjugated equine estrogen, 0.625 mg/day, vs. placebo for 8 weeks, separated by a 4-week washout period.

When compared with 8 weeks of placebo, estrogen reduced fasting serum glucose (7.2 ± 0.3 vs. 8.4 ± 0.4 mmol/L, P = 0.0003), glycated hemoglobin (8.7 ± 0.4% vs. 9.3 ± 0.4%, P = 0.04), total cholesterol (5.27 ± 0.20 vs. 5.50 ± 0.21 mmol/L, P = 0.04), low-density lipoprotein cholesterol (2.47 ± 0.13 vs. 2.69 ± 0.14 mmol/L, P = 0.02), serum apolipoprotein B (114 ± 6 vs. 121 ± 5 mg/dL, P = 0.03), and postprandial glucose area under the curve (by 12%, P = 0.015). Estrogen replacement therapy also increased high-density lipoprotein (HDL) cholesterol (1.27 ± 0.08 vs. 1.1 ± 0.07 mmol/L, P = 0.0002), high-density lipoprotein₂ cholesterol (0.41 ± 0.04 vs. 0.30 ± 0.03 mmol/L, P = 0.0001), and fasting triglyceride (2.17 ± 0.21 vs. 1.94 ± 0.16 mg/dL , P = 0.02) concentrations but not postprandial triglyceride area under the curve (P = not significant).

We conclude that estrogen replacement therapy improves glycemic control, blood lipoproteins, and apolipoprotein B concentrations while modestly increasing triglyceride levels in postmenopausal, type 2 diabetic women.

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