Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45–60 years old in Taiwan

Sep 29, 2026

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Background: Among women after menopause, diabetes mellitus becomes more common. The study examines how changes in insulin resistance (IR), glucose effectiveness (GE), and the first and second phases of insulin secretion (FPIS and SPIS) contribute to glucose intolerance and diabetes risk during the perimenopausal period. Methods: A cross-sectional design enrolled 4,194 nondiabetic women aged 45–60 years; IR, FPIS, SPIS, and GE were computed from demographic and biochemical data using published equations. Results: Older women showed lower GE and higher SPIS, while IR and FPIS did not vary. Conclusion: SPIS increase may offset GE decline, potentially explaining higher diabetes incidence around menopause.

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Abstract

INTRODUCTION

METHODS

Study participants

J Chin MedAssoc Original article Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45–60 years old in Taiwan Chen-Yu Wanga, Chung-Ze Wub,c, Fang-Yu Chend, Dee Peid, Li-Ying Huangd,* aDepartment of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; bDivision of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, ROC; cDivision of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; dDivision of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC Abstract Background: In women after menopause, the incidence of diabetes mellitus increases. Increased insulin resistance (IR), decreased glucose effectiveness (GE), and the first and second phases of insulin secretion (FPIS and SPIS), are the four most important factors that trigger glucose intolerance and diabetes (diabetogenic factor [DF]) . In the cross-sectional study, we enrolled nondiabetic women between the ages of 45 and 60 years to observe the changes in DFs during the perimenopausal period and to elucidate the underlying mechanisms of diabetes in menopausal women. Methods: We randomly enrolled 4194 women who underwent health checkups. Using demographic and biochemical data, IR, FPIS, SPIS, and GE were calculated using previously published equations. The relationship between the DFs and age was evaluated using a simple correlation. Results: Body mass index, blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, triglyceride, and SPIS were higher, and GE was lower in older women (≥52 years old) . A significant decrease in GE and increased SPIS were observed with age. However, no changes were observed in IR or FPIS. Conclusion: The IR and FPIS did not change during perimenopause. Increased SPIS may compensate for the decrease in GE, which is probably one of the reasons for the higher incidence of diabetes in menopausal women. Keywords: Insulin resistance; Insulin secretion; Perimenopause 1. INTRODUCTION Type 2 diabetes (T2D) is one of the five main causes of death in Taiwan and many other countries,1,2 burdening affected individuals, their families, and society.3,4 Therefore, prevention and early detection of the disease is a public health priority. The correlation between an increased incidence of T2D and postmenopausal women has long been studied. The findings of most cross-sectional or longitudinal studies on the correlation between natural menopause and the risk of diabetes are controversial.5–9 However, the results differed in women with surgically induced * Address correspondence. Dr. Li-Ying Huang, Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, 69, Guizi Road, Taishan District, New Taipei City 243, Taiwan, ROC. E-mail address: [liyinghuang@yahoo.com](liyinghuang@yahoo.com) (L.-Y. Huang). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2023) 86: 897-901. Received October 25, 2022; accepted April 11, 2023. doi: 10. 1097/JCMA.0000000000000976. Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) menopause. The aforementioned studies unanimously indicateda significantly higher risk of developing diabetes in surgically induced menopausal women.10–13 The potential mechanisms linking m

FAQs

What was the main purpose of this study?

To observe how insulin resistance, glucose effectiveness, and insulin secretion phases change during the perimenopausal period in women aged 45–60 years and clarify mechanisms related to diabetes risk.

How were IR, FPIS, SPIS, and GE determined?

They were calculated from demographic and biochemical data using previously published equations, after randomly enrolling 4,194 nondiabetic women.

Which factors changed with age, and which did not?

With older age (≥52 years), body mass index, blood pressure, fasting plasma glucose, LDL cholesterol, triglycerides, and SPIS were higher and GE was lower. GE and SPIS changed significantly, while IR and FPIS showed no change.

Sep 29, 2026

Uploaded by Levi