The menopause and blood glucose levels
The menopause and blood glucose levels
The menopause is the natural process that every person with a uterus goes through, when they stop having periods and are unable to conceive naturally. It occurs due to a lack of follicles left remaining in the ovaries, which would otherwise release an egg every cycle.
The menopause occurs on average at the age of 51, but this can vary widely between 40 and 60 years.
Going through the menopause while managing diabetes may feel like a challenge, but knowing and understanding what to expect can be helpful to prepare you. If you have diabetes and want to find out what effects the menopause will have — especially when it comes to blood glucose levels — then this article may help.
The effects of menopause on blood glucose levels
There have been a number of studies on the effects of the menopause on blood glucose levels, both in people with diabetes and people without.
Studies have shown that the effect may vary depending on whether the person has not yet started the menopause (premenopausal), is going through the menopause (perimenopausal), or has finished the menopause (postmenopausal).
There has been a large body of research into whether the menopause increases the risk of developing type 2 diabetes. It has been shown in some studies that reduced oestrogen levels during the early menopause can be associated with a 47% higher chance of developing type 2 diabetes.
During and after the menopause, the body makes less of the hormone oestrogen. This can cause unpredictable swings in blood glucose, which you may not be used to.
For people with type 1 diabetes, these changes can cause unexpected low blood glucose (hypoglycaemia), and you may find that you need to reduce your insulin doses.
Why does the menopause affect blood glucose levels?
As ageing happens, hormone changes before and during the menopause often cause menopausal symptoms such as hot flushes, irritability, brain fog, mood changes and sleeping difficulties. These hormonal changes can also affect your blood glucose, but why is this?
There are thought to be a few reasons behind this;
As you age, your body doesn’t use the insulin it makes as well as it did when you were younger. A small study has found that insulin resistance (a reduced effect of insulin) is present in 50% of postmenopausal people.
Some of the natural changes that occur around the time of the menopause can also have an effect on insulin resistance and therefore on blood glucose levels. One of these is changes in weight, with an increase in visceral fat (also known as 'hidden' fat which fat is stored deep inside the belly, around internal organs) and a decrease in lean mass (such as muscles), which can lead to changes in the dose of diabetes medications.
Are there any health problems associated with diabetes and the menopause?
There are some health problems and complications that can be caused by the combination of diabetes and the menopause. As we’ve mentioned above, the menopause can affect your blood glucose levels, which may increase the risk of some of these conditions.
As with all concerns regarding your diabetes, if you are worried about health risks you should discuss them with your healthcare team.
Bone health
For people without diabetes, the menopause is associated with lower bone mineral densities and an increased risk of osteoporosis, a health condition that weakens bones, making them more fragile and likely to break. This effect appears to be magnified by type 1 diabetes.
It has been found that postmenopausal people with type 1 diabetes had a risk of hip fracture more than 12 times higher than people without diabetes. A similar, although much smaller association, was shown in type 2 diabetes, with a risk of hip fracture 1.7 times higher in comparison to people without diabetes.
Infections
Frequent high blood glucose can raise the risk of urinary or vaginal infections. After the menopause, your oestrogen levels drop, making it easier for microorganisms such as bacteria or yeasts to grow in the urinary tract or vagina.
The signs of this can include burning or stinging when passing urine, or the need to pass urine frequently.
Get in touch with your GP if you suspect any infection.
Sleep problems
Some of the symptoms of the menopause, such as hot flushes and night sweats, may make it more difficult to sleep at night. In turn, tiredness and sleep deprivation can make it more challenging to manage your diabetes and keep your blood glucose levels in range.
You may find it necessary to check your blood glucose at night to ensure that you are not having episodes of low blood glucose (hypoglycaemia).
Cardiovascular (heart and blood vessel) disease
Diabetes, especially type 1, is known to increase the risk of cardiovascular disease. In fact, cardiovascular disease is the most common diabetes complication. In particular, diabetes increases the risk of heart disease by about four times in women.
Heart disease risk goes up after the menopause, so making lifestyle choices that can help manage your diabetes and keep your heart healthy, such as following a nutritious, balanced diet and staying active can be really beneficial.
How to manage your diabetes during the menopause
There are a number of simple steps that you can take to help manage the changes to your blood glucose levels that can occur during the menopause:
- Try to manage your weight
- Try to eat a nutritious and balanced diet
- Ensure you are getting exercise and staying active
- Continue to keep a close eye on your blood glucose levels
If you are having difficulty managing your diabetes, talk to your healthcare team and they will be happy to advise you,
Some changes that occur during the menopause can make managing your blood glucose levels more tricky than it was before.
However, there are several simple changes you can make that will help keep your diabetes in check.
As always, if you need further help, you should contact your healthcare team who will be able to give you the support that you need.
