Women with endometriosis face 46% higher risk of type 2 diabetes

A major study led by researchers at George Mason University’s College of Public Health shows that women with endometriosis have a 46% higher risk of developing type 2 diabetes compared to women without the condition

Published in Diabetologia, the ARCHES (Advancing Research on Cardiovascular Health and Endometriosis) retrospective cohort study evaluated 25 years of medical records (1996–2021) from nearly 3 million women in the Utah Population Database, including roughly 100,000 diagnosed with endometriosis.

While previous studies evaluated endometriosis as a single uniform condition and observed minimal association with metabolic disorders, this study examined specific subtypes, suggesting that chronic systemic inflammation linked to endometriosis may impact long-term metabolic health.

Maggie Fuzak Nunziato, a George Mason doctoral student in epidemiology, led the research with Anna Pollack, professor of Global and Community Health.

“Previous studies largely evaluated endometriosis as a single condition and generally reported little or no overall association with type 2 diabetes,” said Fuzak Nunziato, the study’s lead author. “Our findings add to a growing understanding that endometriosis may affect more than reproductive health alone.”

Subtype variations and demographic findings

The study revealed key nuances across disease forms and patient demographics:

• Location matters:

  • The correlation with type 2 diabetes was strongest among women diagnosed with extra-pelvic endometriosis, where disease lesions are present outside the pelvic cavity.

• Unexpected risk groups:

  • The association was most pronounced among premenopausal women and non-obese women, demographics not typically classified as high risk for type 2 diabetes.

Clinical implications and future research

Endometriosis affects approximately 1 in 10 women of reproductive age. Although the study demonstrates a strong association rather than direct causation, the findings indicate that endometriosis may have health consequences extending far beyond reproductive organs.

If confirmed by further mechanistic research, these findings could lead clinicians to implement earlier cardiometabolic screening and preventive care for women diagnosed with endometriosis.