As you navigate menopause, you may also be dealing with other health issues, like diabetes. This combination of managing menopause symptoms and challenges related to diabetes can bring with it a range of physical and emotional issues. In this article, we’ll learn more about diabetes and explore its relationship with menopause, so you can empower yourself with the knowledge you need to live with confidence and grace.
What is diabetes?
Diabetes is a chronic (long-lasting) condition that affects how the body turns food into energy. People with diabetes have higher levels of sugar in their blood than are healthy. Insulin is a hormone that’s produced by the pancreas that helps glucose, or sugar, get from the blood into the cells for energy or storage. When you have diabetes, there’s either not enough insulin or it’s not functioning correctly, so sugar builds up in the blood instead.
Over time, having too much sugar in the blood can cause quite a few health complications, such as heart disease, vision loss, and kidney disease. That’s why it’s important for people with diabetes to take care of themselves and work with their healthcare providers to make sure their blood sugar levels stay in a healthy range.
How is blood sugar regulated in a healthy adult?
In healthy people, the hormone insulin helps control blood sugar levels. After you eat, your blood sugar levels rise. In response, the pancreas releases insulin to help the glucose (sugar) from the foods you eat, move from the blood into cells in the liver, muscles, and fat tissue. Glucose is stored in these cells as either energy or storage. The process of releasing insulin and moving glucose to the cells helps lower blood sugar levels since the glucose is being moved from the blood to the cells. When blood sugar levels go down, the pancreas stops releasing insulin.
What are the risk factors for developing diabetes during menopause?
Several factors can make it more likely that you may develop diabetes, including:
- Age. The risk of diabetes increases with age.
- Family history of diabetes. If a close family member has diabetes, you’re more likely to develop it too. Genetics play an important role in whether you may develop diabetes.
- High blood pressure. Having high blood pressure is associated with an increased risk of diabetes.
- High cholesterol. Higher cholesterol levels can increase the risk of diabetes.
- Being overweight or obese. Excess weight, especially around your middle (belly), is associated with insulin resistance. Insulin resistance is when the body's cells don’t respond effectively to insulin and can lead to higher blood sugar levels and an increased risk of diabetes.
- Not being active. A lack of regular exercise can reduce how sensitive you are to insulin. People with lower insulin sensitivity are not able to use glucose effectively, which can lead to diabetes.
- Gestational diabetes. If you had gestational diabetes, a type of diabetes that happens during pregnancy, you’re at greater risk of developing diabetes later in life.
Can menopause affect blood sugar levels in people with diabetes?
As estrogen levels decline during menopause, your risk of getting diabetes increases, especially for those that experience early menopause (menopause before age 45). This is because estrogen plays an important role in regulating blood sugar levels. It does so by:
- Helping the body make more insulin.
- Improving the ability of the cells to respond to insulin and take in glucose from the bloodstream (insulin sensitivity).
- Helping the body use glucose for energy more effectively.
More specifically, estrogen works directly in the pancreas, muscles, liver, and fat tissue, all of which impact your blood sugar. Here's how estrogen helps keep your blood sugar levels in check:
- In the liver, estrogen lowers the amount of glucose made by decreasing an enzyme called glucokinase.
- Estrogen helps the liver store more glucose by increasing an enzyme called glycogen synthase.
- In fat tissue, estrogen helps break down fat by increasing an enzyme called lipoprotein lipase. This reduces the amount of fat stored.
Can the change in body shape during menopause contribute to the development of diabetes?
During menopause, some people may experience “menopause belly”, an increase in fat around their middle/belly. This type of fat is called visceral fat, which is deeper inside your body and wraps around your organs. It’s different than the fat you can feel and pinch under your skin, which is called subcutaneous fat.
An increase in visceral fat around the midsection can contribute to developing diabetes. Visceral fat releases hormones and other substances that can make your body more resistant to insulin and more prone to inflammation, both of which are linked to diabetes. Insulin resistance is when the cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily remove glucose from your blood.
I have diabetes and am considering starting menopause hormone therapy (MHT). How might MHT affect my blood sugar control?
Menopause hormone therapy (MHT) can have varying effects on how well those with diabetes can control their blood sugar levels. Some studies suggest that MHT can help improve how insulin functions in the body and can help lower blood sugar levels in women with type 2 diabetes. But this can be different for each person, and it also depends on the type of MHT used.
If you have diabetes and are thinking about starting MHT, it’s important to talk to your healthcare provider first. They can help you understand how MHT might affect your blood sugar control and can make sure it’s a good choice for you.
Are there lifestyle changes that can help manage blood sugar levels during menopause?
Yes, the good news is that there are quite a few changes you can make to your eating habits and exercise routine that can help you better manage your blood sugar levels. Consider these tips:
- Eat a balanced diet. This means lots of fruits, veggies, whole grains. These foods contain essential nutrients and fiber, which can help control blood sugar levels.
- Limit certain things in our diet. The less saturated and trans fats, cholesterol, and added sugars you can eat, the better. They can make it harder for our bodies to use insulin, which can raise blood sugar levels.
- Choose lean protein sources. Lean protein is your friend! It helps keep muscles strong and supports healthy blood sugar control. Some lean protein choices could include chicken, fish, or beans.
- Regularly move your body. Regular exercise can help your body use insulin better and help keep blood sugar levels low. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. This can include brisk walking, cycling, swimming, or any activity that raises your heart rate and makes you sweat.
- Maintain a healthy weight. Extra weight, especially around the belly, can make it harder for your body to use insulin. Aim for a healthy weight by consistently eating well and exercising regularly.
- Practice stress management techniques. When you’re stressed, your body releases hormones that can raise blood sugar levels. Consider relaxation techniques, such as deep breathing, yoga, and meditation, to help reduce stress and improve blood sugar control.
- Consider fasting overnight. Try not to eat after dinner and go at least 12 hours overnight prior to eating again.
Remember, these are just some general tips. It’s always a good idea to talk to a healthcare provider or dietitian who specializes in diabetes to get personal advice based on your specific needs, including any changes to your diet or exercise routine.
