Women with endometriosis face a 46% higher risk of developing type 2 diabetes than women without the condition, according to the largest study yet to examine the relationship between the two diseases.
The research, led by doctoral student Maggie Fuzak Nunziato and professor Anna Pollack at George Mason University's College of Public Health, drew on 25 years of medical records, from 1996 to 2021, held in the Utah Population Database. The team followed nearly 3 million women, including roughly 100,000 diagnosed with endometriosis, making it far larger than earlier studies on the topic. The findings were published August 10 in the journal Diabetologia as part of the ARCHES cohort study.
The 46% increase in diabetes risk was not uniform across the endometriosis cases studied. It was strongest among women with extra-pelvic endometriosis, cases in which tissue resembling the uterine lining grows outside the pelvic region, and among premenopausal women. The association was also more pronounced among women without obesity, a group not typically flagged as high-risk for type 2 diabetes, suggesting endometriosis itself, rather than weight, was driving the elevated risk in that group.
A possible inflammation link
Endometriosis, which affects roughly 1 in 10 women of reproductive age, is already known to cause chronic pelvic pain and infertility, and is marked by persistent, low-grade inflammation throughout the body. Researchers believe that ongoing inflammation may be the mechanism connecting the disease to disrupted blood sugar regulation over time, though they emphasize the study shows an association rather than a proven cause-and-effect relationship.
"Our findings add to a growing understanding that endometriosis may affect more than reproductive health alone," Fuzak Nunziato said, according to the George Mason findings reported by U.S. News. The researchers say the results argue for clinicians to consider metabolic screening for women with endometriosis, particularly those with extra-pelvic disease, rather than treating the condition purely as a reproductive issue.
The study's size and long follow-up period make it a notable addition to a small but growing body of research linking endometriosis to broader metabolic and cardiovascular health. The researchers say further work is needed to clarify the biological pathway and to determine whether treating endometriosis-related inflammation earlier could reduce a woman's long-term diabetes risk.
