Preventing Diabetes During Menopause
Diabetes has rapidly risen around the world to become a global pandemic. According to the International Diabetes Federation, an estimated 537 million adults were living with diabetes in 2021, compared to 108 million in 1980. Diabetes has significant lifespan, financial, and societal impacts. In the U.S., diabetes is the seventh leading cause of death. Fortunately, the primary form of diabetes, what’s called, Type 2 diabetes, is preventable.
Type 2 diabetes results when the pancreas does not produce enough of the hormone insulin. Insulin is critical for moving sugar from the blood into your cells, so low insulin levels cause an unhealthy rise in blood sugar. Sustained periods of high blood sugar are dangerous for the cardiovascular, nervous, and immune systems.
Type 1 diabetes is a genetic condition usually diagnosed in childhood. Unlike type 2 diabetes, it is not preventable or reversible.
Type 2 diabetes frequently develops around the same time women are in the menopause life stage. Your risk of type 2 diabetes depends on a wide range of factors, including your diet, lifestyle, and genetics. Diet and exercise are powerful tools in reducing your risk of developing type 2 diabetes and can even be effective in reversing it.
Type 2 diabetes increases your risk for serious health conditions, including heart disease, stroke, hypertension, blindness, kidney disease, and dementia. Knowing if you’re at risk of being prediabetic and potentially diabetic is the first step toward diabetes prevention and healthy aging.
Your risk of type 2 diabetes increases with age, especially during perimenopause and the transition to menopause. Women who experience early menopause (before age 45) are at a higher risk for developing diabetes.
Your risk of type 2 diabetes increases if a parent or sibling has type 2 diabetes.
Visceral fat refers to body fat stored deep in the abdomen around the organs. Higher levels of visceral fat have been linked to an increased risk of type 2 diabetes, even when someone is of normal or low body weight.
Visceral fat is stored around the abdomen, so waist measurements are frequently used as an assessment of risk. The risk of type 2 diabetes is higher in women with a waist circumference over 35 inches (88.9 centimeters).
Physical Activity Levels
People who are less physically active are more at risk for developing type 2 diabetes. Both aerobic (cardiovascular) exercise and strength training can improve metabolic health and the body’s ability to use and store energy. Making exercise a regular part of your routine will help you maintain a healthy weight as well as a healthy metabolic system.
Race and Ethnicity
People who identify as Black, Hispanic, Native American, Asian, or Pacific Islander are more likely to develop type 2 diabetes than white people. The role of race and ethnicity on health outcomes is complex and only somewhat understood. Still, research supports that individuals in these higher-risk groups should pay close attention to diabetes prevention.
Blood Lipid Levels
Low levels of high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — and high levels of triglycerides increase the risk of type 2 diabetes. The Study of Women’s Health Across the Nation (SWAN) study found that women are more likely to develop low HDL and high triglycerides during perimenopause.
Women with gestational diabetes during pregnancy are more at risk of type 2 diabetes later in life.
Polycystic Ovary Syndrome (PCOS)
PCOS is a condition that includes metabolic and hormonal changes. More than half of women with PCOS develop type 2 diabetes by age 40.
Menopause and Diabetes Risk
The decline in estrogen during the menopause transition is increasingly linked to chronic disease risk. Is there a connection between menopause and diabetes?
Menopause and Aging
Longitudinal research over decades does not show that menopause contributes to developing diabetes in midlife. Instead, researchers believe that age-related factors in cardiovascular and metabolic health are the real contributors to risk.
Depression is more common in women with diabetes, and depression also increases in postmenopausal women. Stress, anxiety, and depression are all factors that can be managed with the right tools and resources.
Both menopause and diabetes are risk factors for heart disease. Developing diabetes after forty can compound that risk, considering adults with diabetes are twice as likely to have heart disease than adults who do not have diabetes.
Decreasing estrogen levels affect your bone health as you age. Women with type 2 diabetes can have bone quality issues, which puts them at an increased risk of fracture.
Hormonal changes and sleep disturbances can lead to “brain fog” during perimenopause. Cognition is an important part of healthy aging, and diabetes has been linked with a significant decline in cognitive function. Preventing diabetes through a healthy lifestyle can also help decrease the brain fog you may experience with menopause, keeping you mentally sharp.
When to Talk to a Provider
Type 2 Diabetes Symptoms
Type 2 diabetes can be hard to spot because symptoms may develop slowly over years. Hallmark symptoms of type 2 diabetes include:
- Frequent urination
- Chronic thirst
- Slow healing time of wounds
- Very dry skin
- Blurry vision
- Unexplained weight loss
- Numbness or tingling in hands or feet
The American Diabetes Association recommends routine screening in all adults age 35 or older and the following groups:
- People younger than 35 who are overweight or obese and have one or more risk factors associated with diabetes.
- Women who have had gestational diabetes.
- People who have been diagnosed with prediabetes.
Preventing and Reversing Diabetes
Experts agree that a healthy diet and regular exercise can make a large impact on type 2 diabetes risk. The NIH Diabetes Prevention Program found that losing 5-7 percent of body weight and exercising about 30 minutes a day can reduce the risk of developing diabetes by a whopping 58 percent!
Focusing on the foundations of nutrition and exercise not only reduces diabetes risk but improves cardiovascular health and lessens the impact of many menopausal symptoms.
While type 2 diabetes cannot be fully cured, you may be able to manage your blood sugar well enough to not need medication. The strategy for managing diabetes is the same as prevention. Focus on eating well and moving as much as possible, and maintaining a healthy weight.
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