In a recent study, researchers have said that compounded HT and estrogen alone for managing menopause symptoms increases type 2 diabetes risk. However, Combined estrogen plus progestin from the manufacturer has no association with the risk of diabetes.
It is already known that MHT or Menopausal hormone therapy reduce the incidence of type 2 diabetes mellitus (T2DM). There are changes in the types and dosages of female hormones used for MHT after the Women's Health Initiative study.

In the present research, researchers determined whether MHT is associated with an increased risk of T2DM in a retrospective cohort study that included the MHT group as postmenopausal women older than 40.
This study was based on national health insurance data and cancer screening data. MHT group had five categories; tibolone, combined estrogen plus progestin by the manufacturer (CEPM), oral estrogen, combined estrogen plus progestin by the physician (CEPP), and transdermal estrogen.
Non-MHT group had postmenopausal women who never used MHT ( 2002 to 2019).
The study results are:
The MHT and control groups had 330,771 women and 798,550 women, respectively.
The percentage of T2DM diagnosed in the non-MHT group, tibolone group, CEPM group, oral estrogen group, CEPP group, and transdermal estrogen group was 15.2 %, 16.6 %, 12.1%,16.6 %, 15.4 % and 17 % respectively.
Tibolone, oral estrogen, CEPP, and transdermal estrogen increased the incidence of T2DM.
The CEPM group had no change in the T2DM risk.

Concluding further, MHT, including tibolone, the most prescribed agent, increased the risk of T2DM in this study.
Based on the study's findings, CEPM did not increase the risk of T2DM.
They said, "Only tibolone increased the risk of T2DM in participants among those who are older than 70 years."
Further reading:
Yuk, Jin-Sung MD, PhD1; Kim, Jung Min MD, PhD2. Menopausal hormone therapy and the risk of type 2 diabetes mellitus: Health Insurance Database in South Korea–based retrospective cohort study. Menopause 30(5):p 497-505, May 2023. | DOI: 10.1097/GME.0000000000002170