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In this article, I will focus on a very important issue for women during and after menopause: blood sugar. Blood sugar or blood sugar level is the concentration of glucose in the blood. Glucose is a carbohydrate found in bread, cereals, fruits, dairy products and some vegetables. Although glucose is an important fuel for the body, if the level of glucose in the body is too high, it can be very problematic and lead to complications such as diabetes.
Blood sugar can reach problematic levels during and after menopause. Age and other risk factors can contribute to this problem, but there is evidence that the hormonal changes of menopause may play a role. In our clinic, we see blood sugar problems occurring or worsening during and after menopause.
So what are these hormonal changes? If you remember from my first article on menopause, many of the problems with menopause are caused by a decrease in estrogen. Before menopause, the ovaries produce most of the estrogen in the body. After menopause, the ovaries stop producing estrogen. Instead, estrogen comes mainly from body fat. The main form of estrogen found in women before menopause is estradiol. Before menopause, normal estradiol levels are 30-400 picograms per milliliter (pg/ml). After menopause, it drops to 30 pg/ml (1).
Progesterone levels also decrease after menopause. Before menopause, these levels can be around 1.5 nanograms per milliliter (ng/ml). Before ovulation, these levels rise. If pregnancy occurs, its level rises to 150 ng/ml during a healthy pregnancy. After menopause, these levels drop to 0.5 ng/ml (2).
Estrogen and progesterone affect the action of insulin in the body. Insulin is a hormone produced in the pancreas that helps your body use glucose for energy and store the rest.
Estrogen helps improve insulin. Typically, premenopausal women have increased insulin sensitivity (meaning their bodies use insulin more efficiently) than men of the same age. Premenopausal women also have a lower prevalence of type 2 diabetes compared to men of the same age. But after menopause, this benefit is lost due to a decrease in estrogen in the body (3) A decrease in estrogen levels can lead to insulin resistance, where your body does not respond well to insulin and blood sugar rises.
Although the relationship between progesterone and insulin is a little more complex than that of estrogen, there is evidence that it can also affect insulin sensitivity and that a decline in progesterone after menopause affects blood sugar (4).
Hormonal changes during menopause also play a major role in women’s weight gain. Premenstrual women often gain weight around the thighs and buttocks in the form of subcutaneous fat. But during and after menopause, women tend to gain weight in the abdominal area. This fat is called visceral fat. This type of fat releases a protein called retinol-binding protein 4, which is associated with insulin resistance. High levels of visceral fat can lead to type 2 diabetes (5).
Also, if you already have diabetes, you may notice that your blood sugar goes up and down significantly more than before menopause. This can lead to complications caused by diabetes. If you have or are diabetic, it is important to control your blood sugar levels during and after menopause (6).
As I mentioned in my last post, sleep disturbances are also common during menopause due to hot flashes/night sweats. Unfortunately, sleep deprivation can also cause problems with blood sugar processing. In connection with sleep problems, the body often produces more cortisol, which is a stress hormone. Cortisol supplies the body with glucose by using protein stores through gluconeogenesis in the liver. This is good in the short term when you have to work in a stressful situation. But if the body increases cortisol levels for a long time, it continuously produces glucose and increases blood sugar levels (7). This high cortisol can also cause weight gain in the abdominal area.
And on top of that, high blood sugar can cause sleep disturbances. When someone has hyperglycemia (high blood sugar), their kidneys try to get rid of the sugar through urination, which can mean frequent trips to the bathroom during the night. In this process of excreting sugar through the urine, the body can also pull fluid from its tissues, making you feel dehydrated. Therefore, waking up to a glass of water can also disturb sleep.
Sleep disturbances can also be caused by fasting hypoglycemia (low blood sugar). Fasting hypoglycemia occurs when blood sugar drops because it has not eaten for several hours. A person wakes up suddenly due to an increase in cortisol, which is produced by the adrenal glands to increase blood glucose levels.
A person can also fluctuate between hyperglycemia and hypoglycemia, both of which affect sleep. It is very important to monitor your blood sugar with an experienced professional to stop the cycle of bad behavior.
It is also important to note that eating should not affect your energy levels. If you have energy after a meal or feel tired after a meal, this is a sign of a blood sugar problem. Those with insulin resistance feel tired after eating. This is a sign that some lifestyle changes are needed.
Alzheimer’s disease is called type 3 diabetes because we understand that blood sugar affects the nerve damage in Alzheimer’s disease. In one particular study comparing Alzheimer’s patients to non-Alzheimer’s patients, researchers found that type 2 diabetes was more common in the Alzheimer’s group. In fact, 81% of 100 Alzheimer’s patients had either type 2 diabetes or impaired fasting glucose (IFG) (8). People with IFG have blood sugar levels lower than the diagnostic level of diabetes, but higher than normal. They are at serious risk of developing diabetes if lifestyle changes are not made.
Insulin resistance plays an important role in the development of Alzheimer’s disease. As you know, insulin resistance is a big part of the development of diabetes and pre-diabetes. Insulin also plays a very important role in the brain. Insulin regulates cognition and memory, aids neuronal growth, promotes synaptic plasticity, prevents apoptosis or cell death, and aids general neuronal migration. When the body cannot use insulin effectively, the brain suffers (9). Although Alzheimer’s disease is a multifactorial disease, insulin resistance is a very large risk factor.
Menopause poses challenges in managing blood sugar levels due to the hormonal changes associated with the transition. If not managed properly, these changes can increase the risk of blood sugar problems, which can increase the risk of developing Alzheimer’s disease (10).
Now that you’ve learned about menopause and high blood sugar issues, what can you do about it?
One important thing to pay attention to is diet. Menopausal and postmenopausal women often do well on a low-carb diet because they can’t get glucose into their bodies. In addition, low-carbohydrate diets usually help menopausal and postmenopausal women lose weight, which becomes more difficult with age. Losing weight also helps regulate blood sugar. In one particular study, postmenopausal women who followed a paleo diet lost more belly fat and total weight after two years compared to women who followed a low-fat diet (11).
It should be noted that diet should be the primary focus of health goals. There is no substitute for a high-quality, nutritious diet.
In one particular study, postmenopausal women following a paleo diet had a greater reduction in abdominal fat and total weight than women following a low-fat diet two years later.
It is also important to be active. Something as simple as walking 30 minutes a day can help you lose weight and control your blood sugar. When you exercise, your muscles burn the sugar in your body, which helps lower your glucose levels.
Drinking water can also help control blood sugar and reduce the risk of diabetes (13). Drinking water increases your kidneys’ ability to get rid of excess blood sugar through urine. As an added bonus, it also restores blood. It is important to note that drinking sugary drinks does the opposite! If you want to know how much water you should drink per day, take your weight and divide it by two; this is equal to the amount of water you should drink in ounces per day. For example, a 150-pound person should drink 75 ounces of water per day to stay properly hydrated.
Managing stress levels is very important for many health problems, and blood sugar is no exception. When you are stressed, your body releases hormones such as cortisol, epinephrine, and glucagon.
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