You may be surprised to find out that you have prediabetes. Many people think of type 2 diabetes as afflicting people who are older and overweight. In reality, more than 10 percent of people with type 2 diabetes are a healthy weight, and more young people are developing the disease. Most people are diagnosed with prediabetes and diabetes during midlife, so it’s not surprising that a prediabetes diagnosis may accompany your symptoms of menopause.
Once you accept that you have prediabetes, you should consider yourself lucky. About 38 percent of adults have prediabetes, but more than 80 percent don’t know it. “You have the opportunity to reverse this and avoid developing type 2 diabetes,” says Gennev health coach Monika Jacobson, a registered dietitian nutritionist. Diabetes affects your metabolic health, increasing your risk for heart disease, stroke, and cancer. Use this opportunity to allow this prediabetes diagnosis to kick yourself into some lifestyle habits that can support your overall health and help lower your blood sugar.
While menopause is a risk factor for some conditions like high cholesterol, the connection with diabetes isn’t so clear. “As we age, we are more likely to experience weight gain or become less physically active, which are both known independent risk factors for developing insulin resistance [a precursor to diabetes],” says gynecologist Ghazaleh Moayedi, D.O. “Many women describe an increase in abdominal fat during menopause, and increased abdominal fat can also lead to insulin resistance and increased blood glucose levels.” Other symptoms of menopause, like poor sleep and increased stress, can also contribute, making it difficult to figure out menopause’s specific role in the development of diabetes. Regardless, diabetes and menopause often intersect during this stage of life.
Prediabetes, defined as having a fasting blood glucose level of 100 to 125 mg/dL, develops when your body becomes less effective at regulating glucose. Your pancreas produces insulin which enables cells to absorb glucose and use it for energy. As you age, your body becomes less sensitive to insulin, a condition known as insulin resistance and a precursor to prediabetes. Instead of being stored in cells and used for fuel, glucose builds up in your blood, resulting in prediabetes and diabetes (a fasting blood glucose level above 125 mg/dL). In addition to age, weight gain, inactivity, abdominal fat, and other issues mentioned above can also affect your body’s ability to regulate blood sugar.
The good news is that lifestyle changes like exercising and improving your diet, along with weight loss, can reverse the typical pattern of prediabetes leading to type 2 diabetes and its many complications like heart disease, nerve damage, kidney disease, and eye problems. In the National Institutes of Health-sponsored Diabetes Prevention Program trial, people with prediabetes who followed the prescribed lifestyle program reduced their risk of developing Type 2 diabetes more than those who took medications—58 percent compared to 31 percent.
Watch your weight. You probably are already aware that losing weight can be particularly hard during menopause. Some days it may seem like simply looking at a slice of cheesecake adds pounds. But when it comes to prediabetes, losing even small amounts of weight can improve your health. Losing as little as 5 to 7 percent of your weight—about 8 to 12 pounds if you weigh 170—can prevent prediabetes from progressing to full-blown diabetes.
If you’re not overweight, check your waistline. Abdominal fat is more dangerous than fat in other areas of your body and can contribute to diabetes, heart disease, and cancer, even if your weight is healthy. It can be common for body fat to be centered around the belly during menopause, and nutrition and exercise habits can help support a healthy body shape and size.
Look for hidden sugars. Obviously, the sugar you eat is going to affect your blood sugar levels. You know the biggest culprits like, cake, candy, and soda that you should eliminate entirely or eat only occasionally. But you may not be aware of all of the places that added sugars may be lurking—yogurt, pasta sauce, ketchup, energy bars, and salad dressings. The American Heart Association recommends that women consume no more than six teaspoons or 25 grams of added sugars a day. Check your food labels and tally up how much you’re getting a day, and then start to cut back. Most people get significantly more than the recommended amount so even if you can’t get all the way down to 25 grams, any cuts you make will likely be beneficial.
Favor fiber over refined carbs. Not all carbohydrates are created equal. Refined carbs like white bread, white rice, and white pasta act exactly like sugar when they get into the body. Instead of eating those types of carb, load up on whole grains, vegetables, and fruit. (Yes, you can still eat it, but avoid fruit juices and fruit in sugary syrups.) Whole fruit is loaded with fiber which will keep you feeling full longer and level out spikes and dips in blood sugar levels. Erratic blood sugar levels increase your chances of developing full-blown diabetes. Aim for at least 25 grams of fiber a day.
Replace sugary beverages. It’s one of the easiest ways to bring down your intake of added sugars. A grande vanilla latte has more than eight teaspoons of sugar. A can of soda has nearly 10. Smoothies can have even more. Replacing sugar-sweetened beverages with no sugar drinks such as water, tea, seltzer, and sparkling or infused water can be highly effective in reducing the glucose load and work on the pancreas, says Jacobson.
Stroll after meals. Blood sugar and insulin spike after eating. A 15-minute walk improves your body’s ability to regulate those spikes by using some sugar. In a study of people with prediabetes, those who did three 15-minute, post-meal walks had better blood sugar levels than those who did a single 45-minute walk. Don’t have 15 minutes? Walk anyway. Even shorter walks of two to five minutes offer some benefits.
Lift weights. Muscle plays a key role in regulating blood sugar levels and using glucose for fuel. After you eat a meal, your muscles should take up about 80 percent of the glucose in your blood. But as you get older, you start to lose muscle mass which can impair blood sugar regulation. The decline can begin in your 30s and accelerates as you age, especially if you’re not doing any resistance exercise like lifting weights to maintain your muscle mass. The good news: even if you haven’t been strength training, starting now will prevent future muscle loss and may build new muscle to improve your body’s ability to regulate blood sugar. Physical activity guidelines recommend that you do two or three strength workouts a week.
Break up long bouts of sitting. Too much sitting hinders your body’s ability to regulate glucose and increases diabetes risk. Based on the latest research, a five-minute movement break every 30 minutes is most helpful. If that’s not practical, do what you can. When your muscles are working, they use up more glucose and improve your body’s ability to use insulin, lowering glucose levels in your blood. In general, aim for at least 150 minutes of moderate-intensity aerobic activity like walking, jogging, cycling, or swimming a week.
Prioritize sleep. Getting enough deep sleep is essential to regulate blood glucose levels. When sleep is chronically low or disrupted, there is a lower production of insulin and an increased risk for diabetes. While sleep problems are common during menopause, you can improve your sleep by avoiding habits like erratic sleep schedules and too much screen time before bed.
Keep up good dental hygiene. Your teeth are probably the last thing you’d associate with diabetes, but the two are related. Periodontal disease, a chronic oral infection known as gum disease, has been linked to a higher risk of developing type 2 diabetes. To avoid this risk factor, make sure you’re brushing and flossing daily and see your dentist regularly.
Reduce stress. You’re probably thinking, “Yeh, right.” We get it. Stress is unavoidable, but even small efforts to ease stress can break the cycle of its detrimental effects. Repeatedly being in “fight or flight” mode from chronic stress is believed to increase levels of inflammation, which then impairs glucose metabolism and leads to insulin resistance, says Jacobson. There are many ways to relax, so find one that works for you and make it a regular habit.
As you implement these strategies, talk to your doctor or healthcare provider about retesting your blood glucose levels to check your progress. You’ll need to wait at least three months to see any changes. Your doctor will likely recommend a hemoglobin A1c blood test, which determines your average blood sugar over the last three months, a more accurate measurement than fasting glucose, which measures current levels only.
Learning you have prediabetes can be daunting, but don’t let it stop you. It’s a time to jump into action to protect your long-term health. Following a healthy diet and getting daily exercise can help you reduce your risk for type 2 diabetes. And Gennev’s integrated care team can guide you with a personalized wellness plan and the support you need to help you stay on track. Schedule a one-on-one virtual visit to get started today.
The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.