INS and diabetes mellitus: Extensive evidence from human and animal studies suggests that sex hormones are involved in modifying cardiometabolic risk, in particular diabetes development.1 These differences in risk may be explained by changes in body composition, alterations in glucose metabolism, and insulin sensitivity due to declining sex hormone concentrations associated with aging and menopause.1 However, whether glycemic traits specifically mediate the relationship between female sex hormones and glycemic deterioration remains controversial.2 3