The link between menopause and diabetes

When you think of menopause, you might think of hot flashes, mood swings and night sweats.

You might not have thought of higher blood sugar levels, which can happen to some people. Just before or after menopause, your average blood sugar levels could go up — sometimes by a lot.

Around menopause, you may even be in the prediabetes stage or nearing it. And yet, you haven’t been eating more sweets or carbohydrates, and you still exercise regularly. If you already have diabetes going into menopause, you may find it harder to control your blood glucose levels. Why?

The effect of estrogen on glucose levels

The reason for the rise in your average blood glucose levels could be the decline in estrogen that happens in menopause. Estrogen can affect your blood glucose levels.

Not everyone experiences higher blood glucose around menopause, but some people do, especially if they were already at risk of diabetes because of having a family history, previous gestational diabetes, a diet high in sugar and processed food, or because of being overweight.

A steep decline in estrogen around menopause may cause:

• Weight gain, especially above the hips
• Higher levels of cholesterol and fat in your blood
• Joint pain
• Increased frequency of urinary tract infections
• Disruptions in sleep patterns

Does menopause cause insulin resistance?

It can in some people. Gaining weight, especially around your waistline after menopause, is associated with insulin resistance. Insulin resistance happens when the cells in your body become less responsive to insulin, a hormone that helps balance your blood glucose levels. Insulin unlocks the key to allow glucose that’s broken down from food and in your bloodstream to enter cells where it can be used as energy.

If your body becomes resistant to insulin, your waistline may grow as extra calories are turned to fat and increasingly stored around your middle. And that may put you at risk of insulin resistance.

What happens when you have insulin resistance?

When cells become less sensitive to insulin, your pancreas may respond by creating more insulin to try to cause more glucose to reach the cells.

Insulin resistance certainly doesn’t happen to everyone after menopause. If you don’t have any risk factors for diabetes, you probably won’t see much of difference in blood glucose levels after menopause.

Even if you have some insulin resistance, your pancreas may be able to handle it, by producing more insulin. As a result, your blood glucose levels don’t rise or rise only slightly.

Some signs of insulin resistance

• Unexplained weight gain
• Tiredness after a meal, especially a meal high in carbs
• Acanthosis nigricans, a condition that causes areas of dark, thick skin to form in the folds and creases of your body — often in your underarms, groin and neck
• Increase in blood pressure
• Increase in triglycerides, a type of fat in your body
• Decrease in HDL cholesterol, the “good” cholesterol you want high levels of

Whether insulin resistance turns into type 2 diabetes can depend on your weight, diet, activity level and family history.

Some risk factors for type 2 diabetes

• Obesity
• A parent or sibling with the diabetes
• Being African American, Asian American, Latino or Native American
• History of heart disease
• High blood pressure (greater than 130/80)
• High cholesterol and fat levels in your blood
• Having polycystic ovary syndrome
• Being inactive

Is there a link between type 1 diabetes and menopause?

The only link is that type 1 diabetes is caused by an autoimmune disorder, and people are more likely to develop autoimmune disorders of any kind after menopause. That, too, is linked to estrogen, and a drop in estrogen can affect how some people’s immune system reacts.

If you have type 1 diabetes, your immune system goes into overdrive and kills the cells in your pancreas that produce insulin. There’s no known prevention for type 1 diabetes, although there’s treatment to slow the progression if it’s diagnosed early on.

Tips to prevent type 2 diabetes after menopause

Exercise regularly — This helps your cells respond to insulin. Physical activity might prevent you from gaining weight or gaining much weight after menopause. Regular exercise does not mean you have to run marathons. Instead try to aim for regular, moderate activity.

Lose weight, if you need to — If you’re overweight and in the prediabetes stage, losing 15% of your body weight can dramatically reduce your risk of developing type 2 diabetes.

Re-examine your diet — Are you eating healthy fats and meats? Are you eating enough vegetables? What are you putting in your coffee?

Try eating more complex carbs rather than simple carbs — Complex carbs won’t cause as high an increase in your blood glucose levels. Some examples: brown rice, beans, quinoa and whole wheat bread.

Menopause doesn’t mean your physical and mental health will decline. There’s a lot you can do to manage menopause symptoms and improve your overall health. Pay attention to what you eat and how active you are to ensure your blood glucose levels stay steady.