One of the most regular things I see in clinic is blood sugar dysregulation and whilst some may recognise the symptoms of having high blood sugar levels they are not obvious, and your blood sugars can creep without you even knowing it. This is a topic you will see me mention on a regular basis in my social media and I am so passionate about spreading the awareness of this topic. Much of the weight gain I see during menopause is also related to insulin dysregulation. So, let’s dive into all things insulin what it is, what does it do, what are the early signs of blood sugar dysregulation how genetics can play a role and how to support yourself.
Menopause and Insulin Resistance:
As a car needs fuel to run, your body needs glucose to perform different tasks. Insulin is a hormone crucial for taking glucose into the cells however if there is too much glucose in the blood or it is being constantly flooded eventually the insulin will stop listening to the messages to take the glucose up into the cells and leave it floating round in your blood. This can result in developing type 2 diabetes a condition which is known to also contribute to the potential development of Alzheimer’s disease. During menopause, fluctuating hormonal levels can result in insulin resistance especially the loss of oestrogen which improves your sensitivity to insulin.
Your cells respond to insulin differently depending on the levels of estrogen and progesterone in your body. Estrogen and progesterone play a role in optimizing insulin levels. That’s why insulin levels can spiral out of control as estrogen and progesterone decrease in menopause. Premenopausal women have a lower incidence of insulin resistance and type 2 diabetes than menopausal women.
Hormonal shifts during menopause bog down the estradiol production - the primary form of oestrogen. A woman’s oestrogen production falls to about 30 pg/ml after menopause, compared to 400 pg/ml. The same happens with the progesterone, i.e., from 1.5 ng/ml production during perimenopause; it drops to 0.5 ng/ml after menopause.
Insulin resistance and weight gain
During insulin resistance, your body cannot take up glucose. As a result, sugar levels keep on increasing. When there’s no option left, the signal is given to the body to store excess sugar. Once your muscles and liver are full of sugar (the main glucose storage sites), the body starts storing extra sugar as fat - pushing you towards obesity.
In menopause, your body experiences two fat distribution patterns, gynoid (round the hips) and android (waist). Premenopausal women suffer from gynoid weight gain, in which fat accumulates in the thighs and buttocks. Decreased oestrogen during menopause results in android weight gain. This type of fat accumulation in the abdominal area which can lead to diabetes, high blood pressure, and other cardiovascular problems.
The levels of a protein hormone called adiponectin starts dwindling when fat starts accumulating in the abdominal area. Decreased adiponectin levels result in insulin resistance and other metabolic syndromes. It is because this adipokine not only regulates glucose and fatty acid breakdown but also promotes insulin sensitivity. During menopause, the onset of intraabdominal weight gain coupled with low adiponectin results in the occurrence of insulin resistance after menopause.
On the other side to this I think people always assume that only overweight people develop type 2 diabetes this is not true diabetes can happen to anyone of any shape or size without you even knowing it is happening.
Insulin resistance and cardiovascular problems:
Insulin resistance causes hyperglycemia, a leading factor in causing atherosclerosis. The process of atherosclerosis is regulated when vascular tissue undergoes many changes due to hyperglycemia.
People with hyperglycemia canhave increased body weight and high cholesterol levels. Elevated blood sugar levels trigger inflammation, resulting in arterial lining impairment. This damage makes an easy way for plaque formation as small cholesterol or fatty acid deposit can quickly get stuck in the walls of blood vessels. Arteries become thick and stiff, leading to other heart problems. Menopause can also contribute here as low oestrogen levels during post menopause affect plasma lipid lipoprotein levels increasing your LDL cholesterol.
Blood sugar levels and cortisol:
Stress and sleep issues are the main features of menopause. Lack of sleep and stress messes with blood sugar levels and produces more cortisol. Cortisol, a stress hormone, is crucial for regulating blood glucose levels. More than average production of cortisol neutralises the insulin effect, resulting in insulin resistance.
During stress, cortisol supplies glucose to the body through glucogenesis. This energy helps to quell a bout of anxiety or stressor. There’s no problem with a short-term increase in cortisol levels. The problem arises when the body remains under constant stress, and cortisol keeps on increasing, resulting in high blood glucose levels.
Hyperglycemia and hypoglycemia both have an adverse effect on sleep quality. Not eating for a few hours will drop your blood sugar levels - fasting hypoglycemia. Your sleep will get interrupted as adrenals will start producing cortisol in surplus to increase blood sugar levels.
When there are high blood sugar levels, your body will try to throw away extra sugar by urination. Your sleep quality will be affected as you visit the bathroom frequently. You may also suffer from dehydration because body fluids will also excrete out along with extra sugar during urination.
Insulin resistance and Testosterone:
High testosterone levels can be associated with insulin resistance and cardiovascular problems during perimenopause and post menopause. Testosterone is a hormone to be aware of, as high testosterone levels are linked with both components of metabolic syndrome. These two metabolic components (abdominal obesity and elevated fasting glucose levels) lead to insulin resistance. Now during menopause some people suffer with low testosterone which can also cause problems such as fatigue, low sex drive, muscle weakness etc. and testosterone in the form of HRT may be prescribed however your levels of testosterone will be checked first and I would always advise having your blood sugar tested before you start testosterone and keep an eye on your levels.
Blood sugars and your genetics
There are certain genes that can have an impact the first one is TCFL2 a variance in this gene can lower your response in insulin up to x5. If you have this genotype you may have a lower glycemic threshold and are more a risk of becoming fat on the inside rather than gaining weight externally making it more difficult to spot. The gene PGC1A plays a role in regulating your insulin however the good news is your genes are not your destiny you can have a huge impact on how these genes are expressed through changes to your nutrition and lifestyle.
Signs and Symptoms, you may be having blood sugar dysregulation
· Increased thirst and hunger
· Frequent urination
· Dizzy if you do not eat
· Need to eat every 2-3 hours
· Craving sugar or caffeine
· Energy peaks and troughs through the day
· Abnormal weigh gain round the middle
· More prone to infections (vaginal and skin)
· Feeling of numbness in hands or feet
· Fatigue and exhaustion
· Delayed wound healing
· Velvety and dark patches on the groin, armpits, and neck - a condition called acanthosis nigricans or skin tags around the neck area
· Disrupted menstrual cycle ( irregular, missed, or heavy periods)
Tips for managing blood sugar levels:
Ø Fixing your blood sugar levels can help you relieve many unwelcome symptoms of menopause. A diet including three meals a day all containing approx. 30g of protein is key and up to 40g if you are working out on a regular basis. This will keep you feeling fuller for longer and reduce the cravings.
- Include fibre with every meal as this can slow down how quickly the sugar is absorbed by your body. Lots of vegetables as your carbohydrates focus on those that grow above the ground.
- Choose the foods having fruits that have a low glycemic impact mainly apples, pears, plums, kiwi and all the berries 2 portions a day and stay away from tropical fruits.
- Don’t eat sweet treats on their own e.g., if you want to have that slice of cake add some protein such as yoghurt and nuts which will lower the blood sugar spike. Better still eat this at the end of a meal rather than on its own in the day.
- Avoid snacking unless you have low blood sugar issues or GUT related problems that require you to eat little and often as you are constantly spiking your blood sugars, aim for 12 hours fast overnight e.g., stop eating at 7pm and start after 7am in the morning.
- Make a habit of doing exercise regularly studies have shown that even a 10 min walk after a meal and can lower that blood sugar spike from your meal. Include strength training muscle itself has a big impact on insulin sensitivity.
- Keep yourself hydrated. Your kidneys flush out extra sugar when you drink water, which helps you control your blood sugar levels.
- Manage your stress levels to stop cortisol increasing your blood sugars. Most people know what relieves their stress and calm their minds. No matter what relaxation technique you choose whether meditation, yoga, stretching, massage, deep breathing, or anything else, do it.
- Besides reducing blood sugar levels, cinnamon boosts insulin sensitivity and slows down carbohydrate breakdown. You should not consume more than 2 grams a day.
- Make sure that your diet is providing you with enough micronutrients. Micronutrient deficiency, e.g., chromium and magnesium, can increase blood sugar levels. Chromium plays a role in fixing blood sugar levels as it is involved in carbohydrate and fat metabolism. You can get chromium from nuts, fruits, meat, and vegetables.
- Consume magnesium-rich foods, e.g., green leafy vegetables, tuna, pumpkin seeds, banana, squash, avocado, and dark chocolate. Magnesium improves insulin sensitivity and reduces diabetes risk.
- Keep a check on your blood sugar levels because, during menopause, sugar levels keep on fluctuating. Try using a continuous blood sugar monitor as this will tell you what foods spike your blood sugars, and this is very individual.
- Make sure that you are getting enough sleep. Poor sleep quality results in elevated cortisol levels. It also boosts appetite and increases insulin resistance. All these factors contribute to hyperglycemia and weight gain.
- Exclude refined carbohydrates from your diet, i.e., white sugar, white flour, white rice, and pasta. Caffeine and alcohol affect blood sugar levels, so limit their consumption
Should I get my insulin levels tested? YES
If you have any symptoms mentioned above, then I would encourage you to have your blood sugar and/or insulin levels tested. Testing your blood sugar levels will help your health care professional determine if you have prediabetes or are at risk of developing diabetes. The earlier you diagnose prediabetes, the easier it is to make lifestyle changes to avoid further complications. That’s why I encourage all my clients to get their insulin levels tested. The first test the doctor will do is the HbA1c this test measures last three-month blood sugar levels. Measurement of the blood sugar levels attached to hemoglobin. From there they can do further tests if they need to. An additional test I like to do is a fasting insulin test as this can detect blood sugar issues in advance of it actually showing up in your blood sugars.
If you are struggling with any of the symptoms, I have outlined above please reach help and get help today prediabetes in a reversible condition, but I am so passionate about people not getting to this stage. HRT or not menopause is the time to know your body how it works and what you need to do to support it.
BOOK YOUR COMPLIMENTARY 30 MINUTE MENOPAUSE REVIEW WITH ME TODAY 'BOOK NOW'
Comments