Combined continuous hormone replacement therapy (HRT) is associated with improvements in serum lipoprotein levels in nondiabetic women; however, the effect in women with diabetes has not been determined. This study by Manning et al evaluates the effect of combined continuous HRT on lipoprotein and coagulation factor concentrations, and on glycemic control in postmenopausal women with type 2 diabetes. In this randomized controlled crossover study, 61 postmenopausal women with type 2 diabetes received 6 months of treatment with combined continuous HRT or placebo. The concentrations of total and low-density lipoprotein cholesterol decreased significantly during treatment with HRT. There were no changes in high-density lipoprotein (HDL) concentrations, its subfractions, or triglycerides. Lipoprotein, fibrinogen, and fructosamine concentrations were reduced with HRT. In postmenopausal women with type 2 diabetes, combined continuous HRT has beneficial effects on lipoprotein concentrations and improves some markers of coagulation and glycemic control.