Reader question: What do I need to know about perimenopause and menopause with T1D?
More research needs to be done about T1D and menopause, but here is an overview of what we DO know.
What's happening during perimenopause and menopause that impacts your blood sugar?
- Reproductive hormones estrogen and progesterone are fluctuating and eventually decreasing through menopause, while the stress hormone cortisol increases with age.
- This is significant for T1Ds because lower estrogen levels and higher cortisol levels have been linked to insulin resistance.
- As body and hormones are changing, symptoms of menopause can be confused with symptoms of low blood sugar (e.g., sweating, dizziness, irritability)
- Sleep: many people experience insomnia during menopause, and poor sleep increases insulin resistance
- Body composition changes: weight gain around the midsection is a common symptom of menopause, and this change in body fat can also increase insulin resistance.
Insulin resistance and menopause
- During perimenopause, the menstrual cycle becomes irregular which can cause long stretches of increased insulin resistance and then periods of returning to your baseline sensitivity level. Tracking your cycles, despite the irregularity, can help you feel more confident adjusting insulin dosages as necessary and make you feel a little less "crazy" when your sensitivity changes abruptly.
- Many people are shocked to see how much more insulin they need in menopause - with insulin to carb ratios sometimes increasing by as much as 100%. This is where it's so important to stay curious; remove judgement on amount of insulin you may need as your body changes. Remember: for those with a functioning pancreas, their body is experiencing this as well, they just aren't involved in the calculations!
How to support hormonal changes:
- Focus on stress reducing activities like meditation, deep breathing, and stretching.
- Explore ways to support your sleep, such as a calming bedtime routine or a meditation app.
- Consider establishing sustainable changes with diet. There is no one diet that works for everyone, however, generally eating a diet rich in whole foods with lots of fruits, vegetables, and healthy fats will support insulin sensitivity over a diet heavy in processed foods.
- Incorporate more activity consistently. Walking after meals can be a great way to help your insulin do its job and avoid post-meal spikes. Lifting weights and light cardio support insulin sensitivity, but it's most important for you to find an activity you enjoy and can do consistently!