Increased fat distribution during menopause has long been shown to increase insulin resistance and the risk of diabetes. A new study based on data from the Women’s Health Initiative (WHI) shows that being metabolically unhealthy increases diabetes risk, even in women of normal weight. Results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

As women age and transition through menopause, the prevalence of diabetes increases. More specifically, postmenopausal women who have increased abdominal fat are at risk for type 2 diabetes because of the development of insulin resistance and glucose intolerance. Recent studies have suggested that even women of normal weight may be at increased risk of diabetes if they are metabolically unhealthy. Metabolic health is based on the combined levels of blood sugar, triglycerides, and high-density lipoprotein cholesterol, as well as blood pressure and waist circumference.

In this newest study, researchers sought to determine the relationship between various metabolic weight categories and diabetes risk in the postmenopausal women who participated in the WHI. They concluded that metabolically unhealthy women of normal weight, as well as metabolically healthy women who are overweight, had about a two-fold increased risk for developing diabetes. This confirmed that even women of normal weight could be at risk of diabetes, depending on their metabolic health. In comparison, women who were metabolically unhealthy and overweight were four times more likely to develop the disease.

Findings were published in the article “Incidence of diabetes according to metabolically healthy or unhealthy normal weight or overweight/obesity in postmenopausal women: the Women’s Health Initiative.”

“This study provides evidence that being of normal weight yet metabolically unhealthy is associated with increased risk for diabetes. Educating women about the importance of maintaining a healthy weight and controlling cardiometabolic risk factors for diabetes and heart disease is important,” says Dr. Stephanie Faubion, NAMS medical director.