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Does menstruation play a part in diabetes diagnosis? | RACGP

Female doctor delivering insulin injection to diabetic patient

RACGP interviewed me with colleague Dr Gary Deed to comment on this recently published research which draws a connection between menstruation and blood glucose levels.

My comments in a nut shell:

  1.  We should manage women’ s health better. It starts by applying a gender and interesectional  lens to health,  educating the public and the health sector around menstrual patterns and taking a thorough menstrual history. Irregular and sparse periods might point to a higher risk for PCOS  in women and therefore early intervention, can prevent the long term sequelae and address the disparity in cardiovascular risk factor management between men and women.
  2. Screening for DM during the perimenopause, fits in well with our existing Red Book guidelines for preventative health – regarding the  40-43 year old, fasting blood glucose screen and the 45-49 fasting lipids and  health screen. Undertaking these screens routinely at these stages in life, will help capture  women under 50 with T2D  who may not be being diagnosed early enough.


  • women under 50 with Type 2 Diabetes ( T2D) tend to receive a diagnosis of diabetes later in life than men
  • PCOS ( polycystic ovarian syndrome)is under-diagnosed
  • 1 in 8 women of reproductive age have PCOS
  • PCOS takes 7-12 years to diagnose
  • PCOS is associated with increased insulin resistance  and this might have implications for their health, rather than menstruation itself



RACGP Article – ‘Does menstruation play a part in diabetes diagnosis?’ [EXTRACT]

Researchers have suggested lowering HbA1c cut-offs for premenopausal women, but Australian GPs say more investigation is needed.

The threshold for diagnosis of type 2 diabetes should be lowered for women under 50 because menstruation may be affecting their blood sugar.

That is according to fresh research out of the UK, suggesting differences in HbA1c levels due to haemoglobin replacement linked to menstrual blood loss could result in missed diabetes diagnoses, with the authors proposing that a lower diagnosis point may be appropriate.

To reach their findings, the researchers examined HbA1c testing across seven laboratory sites representing 5% of the UK’s population, finding that women younger than 50 years had an HbA1c distribution ‘markedly lower’ than in men, by a mean of 1.6 mmol/mol. In these women, average HbA1c levels fell behind by around five years compared to men in the same age group.

‘Early identification of diabetes in women has the potential to improve health outcomes in the longer term,’ they concluded.

But in Australia, two experts are not convinced by the study’s findings.

By Morgan Liotta

Continue Reading the full RACGP article – ‘Does menstruation play a part in diabetes diagnosis?’ >>

Source article and photo credit: RACGP

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