Hyperandrogenicity in women is closely associated with insulin resistance and a risk factor for cardiovascular disease and noninsulin-dependent diabetes mellitus. It is known that hormone replacement therapy (HRT) decreases hyperandrogenicity and improves glucose homeostasis in postmenopausal diabetic women. To investigate the role of HRT on hyperandrogenicity and glucose homeostasis in postmenopausal diabetic women. A total of 40 type 2 diabetic postmenopausal women were prospectively enrolled and followed for 12 months. The examined group consisted of 20 women who were assigned to take HRT, while the rest were left without hormone therapy. HRT consisted of 17β- estradiol (E2) 1 mg and DRSP (drospirenone) 2 mg. Fasting blood glucose ( FPG), glycosylated hemoglobin (HbA1C), insulin, sex hormone binding globuline (SHBG) and total testosterone were measured, free androgen index (FAI) was calculated by formula and insulin sensitivity was determined by the homeostatic model assessment of insulin resistance ( HOMA-IR). All metabolic measurements were taken at baseline and after 12 months.HRT treatment, compared with control group, was followed by a marked increase of SHBG (from 29.0 ± 12.3 to 56.0 ± 8.54 nmol/l) and significant decrease of free testosterone (5.17 ± 1.2 to 1.92 ± 1.3), FPG (7.8 ± 0.86 to 6.9 ± 0.6 mmol/l), HbA1C(7.6 ± 0.54 to 7.2 ± 0.43 % and HOMA-IR (4.23 ± 1.7 to 3.18 ± 1.4 µU/ml-mmol/l).HRT in postmenopausal diabetic women ameliorated hyperandrogenicity, accompanied by marked improvements in glucose homeostasis