Navigating your diabetes and the menopause

How to balance this complicated condition and your menopausal symptoms

If you have diabetes, changing oestrogen levels during the menopause can make your body less responsive to insulin
You may also become more prone to other symptoms
Some lifestyle adjustments can help

Around five million people in the UK are believed to have diabetes – around one in 15 of the population, according to Diabetes UK [1]. That means many of you will be managing your diabetes during your menopausal journey. Managing diabetes is essential for your future health as it can help reduce the risk of complications, which includes problems with your heart, feet, eyes and kidneys.

For those who don’t have diabetes, while menopause won’t cause diabetes, changes to your hormones during this time can increase your risk of developing type 2 diabetes.

Changes to where your body stores fat during and after the menopause – often leading to more weight around your middle – can affect how effectively your body uses insulin. This is known as insulin resistance and can increase the likelihood of type 2 diabetes.

Type 2 diabetes is the most common type of diabetes and accounts for about 90% of diabetes cases in the UK. It occurs when your body does not make enough insulin or it does not utilise the insulin effectively. This means too much glucose remains in your blood, resulting in high blood glucose levels.

For those who already have a diagnosis of type 2 diabetes this can also lead to unexpected changes in your blood glucose levels, so look out for unexplained highs and lows in blood sugar levels, especially if you’re taking insulin or tablets such as gliclazide or glipizide.

In addition to changes in your hormones around the time of the menopause, other factors can increase your risk of developing type 2 diabetes including being overweight, physically inactive and family history. Hormonal changes can also lead to higher blood pressure, which is another risk factor for type 2 diabetes.

For those already diagnosed with type 1 diabetes and type 2 diabetes, managing your condition during the perimenopause and menopause can get more complicated as your hormones fluctuate and decline.

REALTED: diabetes and menopause factsheet

Both diabetes and the menopause can also leave you at higher risk of urinary and vaginal infections such as cystitis and thrush, and pain during sex.

How can I manage my diabetes during the menopause?

Check your blood sugar levels more often

Falling levels of oestrogen can increase your insulin resistance, which means your blood sugar levels can be higher and more erratic. Keep a closer eye on your levels, with more frequent testing. A flash glucose or continuous glucose monitor can allow this to happen more easily than frequent finger prick tests, for those able to access the technology.

Testing will help pick up if symptoms like hot flushes and heart palpitations are being caused by a hypo (low blood sugar levels) or your menopause.

Treatment adjustments

You may need to adjust your treatment due to increasing insulin resistance as you go through your menopause, so speak to your healthcare team about this.

Follow a healthy diet

Both diabetes and the menopause increase your risk of heart disease and the risk of breaking your bones so consider how to improve your diet to protect your future health. Eating well can also help prevent insulin resistance and help you manage your blood sugar levels.

Improvements can include cutting down on refined and processed foods and increasing fruit, vegetables, and wholegrains. Follow Diabetes UK’s advice on a healthy balanced diet.

Keep active

Being active can help manage blood sugar levels during the perimenopause and boost bone strength, which can be affected by your declining oestrogen levels. Exercise can also reduce the risk of heart disease and stroke. See the NHS guidelines for physical activity for adults aged 19 to 64.

Talk about HRT with your GP

HRT helps many women struggling with the symptoms of the menopause. Having diabetes doesn’t mean that you can’t take hormone replacement therapy (HRT). In fact, it can be particularly beneficial as it reduces your risk of cardiovascular disease, as well as improving your wellbeing and energy, which can improve glycaemic control, so discuss it with your healthcare team.

Remember your health checks

Everyone with diabetes should get certain important health checks every year, including those that check your average blood sugar levels, blood pressure, cholesterol and screening to check the health of your eyes and feet, according to Diabetes UK.

Make sure you get these as they are important for picking up any complications early and managing your long-term health. Before seeing your doctor, write down symptoms from your diabetes and menopause so you can discuss the impact they are having.

Resources

Diabetes UK: menopause and diabetes

References

1. Diabetes UK