2528-P: More Than Hot Flashes: Menopause Stages and Diabetes Management Burden

Introduction and Objective: Menopause is a major hormonal transition associated with metabolic and symptomatic changes that may affect glycemic control and diabetes self-management, yet remains underexamined in diabetes research and clinical care despite the growing number of women aging with diabetes. Methods: In August 2025, women with diabetes in the US aged ≥40 (n=3,389) completed an online survey reporting menopause stage (premenopause, perimenopause, menopause, postmenopause) and diabetes type (type 1 adults [T1A], type 2 insulin-treated [T2I], or type 2 non-insulin-treated [T2NI]). Key outcomes included self-reported A1c and perceived control of diabetes management assessed (four-point scale) among other clinical markers. Results: Among T2I and T2NI women, better glycemic control (A1c≤7) was more common in menopausal and postmenopausal stages, while an A1c>7 was more common during premenopause and perimenopause. Obesity (BMI ≥30) among T1A participants was more prevalent in perimenopausal and menopausal women. Perceived diabetes burden followed similar patterns: perimenopausal participants across diabetes types were most likely to report feeling overwhelmed by diabetes management. Menopausal and postmenopausal women with T1A more often reported that diabetes management required substantial effort, whereas premenopausal and perimenopausal participants across diabetes types more frequently reported that diabetes management greatly interfered with daily life. Conclusion: Menopause stages are associated with differences in glycemic control and diabetes management burden among women with diabetes, with perimenopause representing a particularly vulnerable period and persistent management burden observed among postmenopausal women with type 1 diabetes. These findings underscore menopause as an underrecognized factor in diabetes management and highlight the need for stage-specific menopause-informed diabetes care. Disclosure A. Krishnan: Consultant; Current; Abbott, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, LifeScan Diabetes Institute. A.J. Beltran: Research Support; Current; Abbott, Dexcom, Inc., Eli Lilly and Company, diaTribe, Insulet Corporation, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Ypsomed AG, LifeScan. T. Bell: Research Support; Current; Abbott, Tandem Diabetes Care, Inc., Xeris Pharmaceuticals, Inc., Dexcom, Inc., vTv Therapeutics, Insulet Corporation, Lilly Diabetes, A. Menarini Diagnostics, ConvaTec Inc., Medtronic. P. De Piante: Consultant; Current; A. Menarini Diagnostics, ADOCIA, Ypsomed AG, Medtronic, Menarini Group, Insulet Corporation, Roche Diabetes Care, Roche Diagnostics.