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Oral HRT Linked to Higher Clot and Heart Disease Risk Than Patches in Women With Type 2 Diabetes

The observational EHR study presented at the EASD meeting remains unreviewed.

Overview

  • Researchers analyzed records for more than 36,000 women with type 2 diabetes in the TriNetX database, average age about 59, with follow-up of up to five years across the United States and Europe.
  • Oral hormone therapy was associated with roughly double the risk of pulmonary embolism and a 21% higher risk of heart disease compared with transdermal patches.
  • Transdermal therapy was linked to a 25% lower incidence of heart disease versus diabetic women not using hormone therapy, with no excess risk of pulmonary embolism, deep vein thrombosis, stroke, or cancer in that comparison.
  • The study reported no meaningful differences between oral and transdermal formulations for deep vein thrombosis, stroke, or breast, ovarian, or endometrial cancers.
  • The lead author proposed avoiding oral estrogen for this population, while independent clinicians urged patient counseling and called for larger prospective studies to confirm these findings.