Menopause and Type 1 Diabetes
Bridging a Knowledge Gap in Clinical Practice Background
Background
The menopausal transition is a complex and often under-recognised phase in the lives of women with type 1 diabetes (T1D). While hormonal changes are known to affect glucose regulation, there is still limited structured knowledge and guidance available for both patients and healthcare professionals. A recent quality improvement project by diabetes nurse trainee Ruth Houweling, conducted as part of her postgraduate training, provides valuable insight into this gap and highlights opportunities for improving care.
Project Overview
In her project, Ruth combined a literature review with practice-based research within Diabeter and Diabeter Centre Amsterdam (DCA), including surveys among healthcare professionals and benchmarking across institutions . The central question was how care for women with T1D during the menopausal transition can be improved within current clinical practice.
Her findings paint a clear picture. Although healthcare professionals widely recognise that menopause can influence glucose regulation, this topic is not yet discussed in a structured or consistent way during consultations. Knowledge levels were rated as moderate, and both diabetes nurses and physicians reported a lack of practical guidance, experience, and evidence-based recommendations.
Importantly, this is not just a local issue. The project confirmed that across different settings, including DCA and other hospitals, there is no standardised policy or guideline addressing menopause in women with T1D. At the same time, both professionals and patients express a clear need for more information and support
Key INSIGHTS:
- Awareness of the impact of menopause on glucose regulation is present, but not structurally embedded in care
- Knowledge gaps and lack of experience are major barriers in clinical practice
- There is currently no evidence-based guideline or standard approach
- Healthcare professionals strongly express the need for education, tools, and patient information
These findings align closely with the limited available literature, which also points to a lack of robust evidence and highlights the need for further research.
Link to Ongoing Research at DCA
Ruth’s project directly connects to ongoing research efforts at Diabeter Centre Amsterdam. The DAME cohort study explores how glucose regulation changes across different stages of the menopausal transition, while the DAME trial investigates the potential effects of menopausal hormone therapy on glycaemic control and broader metabolic outcomes. Together, these studies aim to generate the evidence that is currently missing in clinical practice—evidence that professionals like Ruth have clearly identified as urgently needed.
Implications
This project highlights an important and growing area in diabetes care. As the population of adult women with T1D increases, so does the relevance of menopause-related challenges. Improving care in this domain will require a combination of increased awareness, better education for healthcare professionals, accessible patient information, and, importantly, high-quality research.
Concluding,
"Improving awareness, knowledge, and access to information on menopause in women with type 1 diabetes is an important first step toward better and more personalised care."