Younger women who undergo hysterectomy are at risk of developing type 2 diabetes later on in life, suggests a new study presented at the European Association for the Study of Diabetes (EASD) Annual Meeting held in Stockholm, Sweden.¹

To study the risk of new-onset diabetes in women with a history of hysterectomy, researchers recruited 81,144 women from the French E3N prospective cohort study. None of the participants had diabetes at the time of their enrollment. Women who underwent hysterectomy for gynecological cancers were not included.

Over the mean follow-up period of 16.4 years,  4367 women developed new-onset type 2 diabetes. After adjusting for confounders such as age at menarche, menopausal status, HRT, OCPs, physical activity, diet, BMI, smoking habit, the risk of diabetes was increased by 20% among women who had had a hysterectomy with an adjusted hazard ratio of 1.18. HRT, diet or physical activity had no impact on this association. The risk persisted regardless of the indication for the hysterectomy (aHR 1.19). While the risk did increase among women in whom hysterectomy was done without oophorectomy (HR 1.13), the risk of diabetes rose significantly when oophorectomy was done (HR 1.23).

When age-wise risk was analyzed, younger women (≤50 years) were at a greater risk for incident diabetes compared to women older than 50 years. The aHR for hysterectomy before the age of 40 years and those aged 40-50 years was 1.27, while for women >50 years, the aHR was 1.06 compared to women in the same age groups who did not undergo the procedure.

This study has shown an association between hysterectomy and risk of incident diabetes particularly among women younger than 50 years of age.

The authors note that the risk remained elevated regardless of whether oophorectomy was performed or not performed alongside, though the risk increased further when oophorectomy was done. They have called for further studies to investigate the mechanisms for this association.

These findings are indicative of hysterectomy as a risk factor for diabetes and suggest that women with a history of hysterectomy, in particular those younger than 50 years, should be regularly screened for diabetes.

Reference

1. Bonnet F, et al. Abstract #151. Risk of incident diabetes after hysterectomy: results from the E3N cohort study. EASD58th Annual Meeting 2022. Available at: https://www.abstractsonline.com/pp8/#!/10613/presentation/593.