Managing Diabetes and Menopause

Here’s what to expect and how to stay in control.

Dorothy Foltz-Gray
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In 2010, business owner Deena Pierott, 53, of Vancouver, WA, began to notice her menopausal symptoms—mood swings, hot flashes and fatigue—were intensifying. “I was in the early stages of type 2 diabetes,” says Pierott. “[The combination] was the perfect storm.”

“Together, diabetes and menopause are even more challenging,” confirms endocrinologist Asha Thomas, MD, a director with the Division of Endocrinology and Metabolism at Sinai Hospital of Baltimore. Fluctuating levels of estrogen and progesterone can cause blood sugar levels to seesaw. The hormonal changes can also increase the risk of vaginal and urinary-tract infections, already higher in women with diabetes. And night sweats and hot flashes wreak havoc with slumber—a problem because “not sleeping can also disrupt hormones like cortisol, resulting in more uneven blood sugars,” says Dr. Thomas.

Bone thinning can also escalate after menopause, a particular concern for women with diabetes as they are more prone to bone and joint problems. Finally, menopause also brings metabolic changes that can cause pounds to pile on, exacerbating a woman with diabetes’ already high risk of heart disease.

But anticipating menopausal changes can help you keep your diabetes under control. Follow these tips:

  • Know the landscape. “Have a conversation with your endocrinologist and your gynecologist before menopause about possible changes,” says Dr. Thomas. “And begin to check your blood sugar more frequently to [monitor] changes.” How frequently you check depends on your symptoms and how well your glucose has been controlled. Ask your endocrinologist to review other health factors that menopause can affect, such as blood pressure and blood lipids (fats), important for controlling heart disease risk.
  • Overhaul diet and exercise. Pierott has shed 25 pounds of a 50-pound gain by dropping her junk-food habit, eating white meat instead of red and loading up on more green vegetables. She also started walking 30 minutes a day and lifting light weights three times a week. “I now have more energy and am better able to handle stress,” she says. Exercise also reduces insulin needs by helping the body use insulin more efficiently.
  • Spy on sleep. If you’re unsure whether hot flashes or low blood sugar are stealing sleep, check your glucose at 3 AM, says Thomas. If your blood sugar is low or high, that’s what’s waking you, not the hot flashes. It’s also important to practice good sleep habits, establishing a regular bedtime and nixing caffeine and exercise right before bed.
  • Protect your bones. “The most significant bone loss occurs within the first two years of menopause,” says Dr. Thomas. “The risk of bone thinning is great in women with diabetes, and menopause magnifies that.” The by-products of high blood sugar affect all organs, including the bones. Ask your doctor about taking calcium and vitamin D supplements and getting a DEXA scan, which measures bone density.
April 2013