Evidence check: HbA1c in the context of menopause

HbA1c reflects average blood glucose over 2–3 months. During menopause, declining estrogen can reduce insulin sensitivity, potentially raising fasting glucose and HbA1c. Evidence is moderate (human-moderate): observational studies show a modest increase, but effects vary by lifestyle and genetics. An elevated HbA1c in menopause is not automatically pathological but warrants monitoring in context of risk factors like obesity or family history of diabetes. Normal HbA1c is below 5.7%; 5.7–6.4% indicates prediabetes. Menopausal women should focus on diet, exercise, and regular check-ups. Caveat: HbA1c can be affected by iron deficiency or kidney function. Evidence: human-moderate. Sources: none from provided context.