Menopause and Diabetes: Is there a connection?

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All you want to know about menopause and diabetes

Fluctuating hormones during menopause can have a strong impact on existing diabetes and may play a significant part in the increase of diagnosis of type 2 diabetes in menopausal women. Studies have suggested that progesterone is connected with the development of diabetes but research scientists are still striving to find the answer because it’s difficult to separate the association and effects of menopause from the effects of ageing and weight gain.

Almost 3.7 million people have been diagnosed with diabetes in the UK. More people than ever are at risk of type 2 diabetes. According to Diabetes UK, if nothing changes, more than five million people will have diabetes in the UK by 2015.

Five percent of diabetics have type 1 diabetes where the body can’t produce insulin. It’s usually diagnosed in those under 40

Type 2 diabetes is more common with the risk of developing it, increasing with age, particularly post-45. Type 2 diabetes means the body is insulin resistant, i.e. it doesn’t use insulin efficiently. Over time, the body can’t produce enough insulin to maintain consistent blood glucose levels. 

 
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How are women’s hormones linked with blood glucose levels?

Oestrogen and progesterone have an influence on how well women’s bodies respond to insulin. Insulin is the hormone that controls blood glucose levels. As oestrogen levels deplete, our bodies become less responsive to the effects of the insulin produced (or injected).

Oestrogen is responsible for lowering blood glucose levels, while progesterone increases blood glucose levels. As these hormones change through the menstrual cycle, the reactions produce spikes and drops of the blood glucose levels. These fluctuations make it difficult to control blood glucose levels, sometimes swinging from high to low levels for no apparent reason.

As these hormones interact with the insulin they can impact on its effectiveness. Women may experience an increase in their blood glucose level 3 to 5 days before and after their period. Whilst fluctuations may be regular from month to month for some, it may vary for others, making it really difficult to monitor blood glucose levels when close to a period.

Even more annoyingly, progesterone fluctuation can activate food cravings that make even the most well-behaved diabetic reach for those comforting unhealthy snacks to satisfy these hankerings, making management of diabetes and weight control a huge struggle.

If oestrogen and progesterone can affect the blood glucose level, can diabetes affect women’s menstrual cycle?

Generally, women with type 1 diabetes start their periods later than women who don’t have diabetes. They may also experience menstrual complications before age 30 too. Type 1 diabetes women tend to have a longer menstrual cycle than women who do not have type 1 diabetes. This means they may have a tendency to undergo an earlier menopause than those without diabetes.

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Diabetes after menopause

After menopause, changes in hormone levels may trigger fluctuations in blood glucose levels. Blood glucose levels may also become more variable or less predictable than before.

A drop in oestrogen levels may make some women more resistant to insulin, therefore diabetes medication may have to be reviewed or increased. However, a drop in progesterone levels may improve their sensitivity to insulin, and so one factor can partly cancel out the other.

Because changes are unpredictable, it’s important to monitor the effects that the menopause has on blood glucose control during menopause, either through home blood glucose testing, if you do this, or by regular HbA1c checks.

Tips for Managing Diabetes for perimenopausal Women

Women with type 1 and type 2 diabetes are also known to have an earlier perimenopause. Perimenopause usually can lasts for a few months, several years or up to10 years. In the last 1 or 2 years of perimenopause, a significant drop in oestrogen occurs. This is the period when women experience the “menopause symptoms”.

If you think your menstrual cycle and your blood glucose level are becoming too unpredictable, here are some tips that may helP.

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Know your menstrual cycle

Remember to note when symptoms like breast tenderness, bloating, stomach cramps, food cravings, and general grouchiness kick in before your period begins. Once you have established a general pattern, you can consult your doctor about your insulin at different stages in your menstrual cycle to keep your blood glucose level stable and accommodate your food cravings.

Regularly get tested for diabetes

Women going through perimenopause and menopause, should regularly get tested for diabetes. Regardless of age, all women who are overweight should be tested for diabetes. Women who are over 45 years old and overweight, should get retested at least every 2 years.

Women with these risk factors are most prone to develop diabetes and should be tested regularly to prevent the development of diabetes:

  • Live an inactive lifestyle

  • Have family history of type 2 diabetes

  • Have a family history of polycystic ovaries or currently suffer from polycystic ovaries

  • Delivered a baby over 9 pounds

  • Have high blood pressure above 140/90 or are required to take blood pressure medication

  • Have high cholesterol

Aside from regular tests for diabetes, women who are going through menopause should also have regular check-ups for their eyes, blood pressure, bones and heart.

Exercise

Even though you may have no urge to exercise, it can help to stabilise blood glucose levels. Basically, exercising releases endorphins (the brain’s natural mood elevator and painkiller) to reduce cortisol and stress level. Without the excess cortisol in your bloodstream, your oestrogen, progesterone, and insulin fluctuation should be easier to manage.

Women in their 40s can include weight bearing exercises to help improve insulin sensitivity. If you are exercise averse then check out our 3 vlogs with Baz Moffat for easy weight bearing exercises for beginners.

Exercise, eat healthy and weight control are the 3 golden rules to help prevent women developing diabetes. Exercise helps control weight, lowers the risk of breast cancer, heart disease, and osteoporosis. Statistics show that a 7% loss of weight can greatly lower the risk of diabetes and heart disease.

Eat nutritious snacks

Food cravings are hard to resist! But if you eat nutritious snacks that are full of healthy fibre and complex carbohydrates, like nuts, seeds, fresh and dried fruit, you will be less inclined to reach for the less healthy snacks.

Adjusting insulin dosage

Everyone goes for a snack every now and then. Talk to your doctor about adjusting your insulin dosage to take account of any extra snacking you may be doing.

As well as regular diabetes check ups, women going through menopause should also have regular check-ups for their eyes, blood pressure, bones and heart.

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Is it menopause or diabetes causing symptoms?

Managing diabetes whilst going through menopause can feel like a twin challenge for most women due to the combined effects that each condition can have on the body.

The best way to remain in control is by knowing what to expect so that you can prepare yourself for the unique challenges that may lie ahead.

It’s often easy to mistake menopausal hot flushes, and mood swings for low blood glucose symptoms. Consequently these symptoms could initially be related to menopause, interrupting your sleeping pattern and cause daytime fatigue. The tiredness may make you think that you are experiencing low blood glucose level. If you try to eat extra calories or sugar to fix the non-existing low blood glucose issue, you could end up with high blood glucose level.

At the same time, the extra calories may contribute to your weight gain. If this problem turns into a regular issue, you might find it increasingly hard to control both your blood glucose level and your weight.

Talk with your doctor

Do not feel embarrassed about discussing your body changes with your doctor. Nothing is more important than receiving the help you need. If you are struggling with vaginal dryness, loss of libido, hot flushes or other symptoms, there are many treatments available.

Hormone Replacement Therapy (HRT) and Diabetes

If menopausal symptoms are affecting your quality of life, your doctor may recommend hormone replacement therapy (HRT). Having diabetes does not necessarily mean you cannot use HRT. Benefits can include reduced risk of hip fractures as well as improvement in menopausal symptoms. Talk to your GP about HRT options that may improve insulin sensitivity, helping with blood glucose control.

Urinary and vaginal infections may be more common in menopausal women but those with high blood glucose levels are more likely to suffer these. Getting help to control your diabetes reduces the frequency of these infections. Vaginal symptoms are improved with local oestrogen which is available as vaginal tablets, pessaries, cream or a vaginal ring. Lubricants can make sexual intercourse more comfortable but does not treat the underlying problem.

Check out our post with Claire who has had type 1 diabetes since the age of 23 and how she manages ‘Coping with diabetes through menopause’.

If your looking for a friendly place to find likeminded menopausal women why not join our private Facebook Group the ‘Hot Flush Chill Zone’.

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