Why menopause can increase your blood sugar by 50%

The worse your symptoms, the higher your risk

Estrogen replacement therapy, which is commonly prescribed during menopause, can sometimes unmask or worsen underlying diabetes.

Menopausal women, who frequently experience extreme symptoms like hot flashes and night sweats, face a 50 per cent higher risk of developing Type 2 diabetes, according to a recent study published in JAMA Network Open.

“Although researchers have not been able to establish a direct cause and effect link but just an association, hormonal changes during menopause do affect how your body produces and uses insulin (sugar-regulating hormone), which can lead to fluctuating blood sugar levels, weight gain and higher blood pressure,” says Dr Anil Bhoraskar, senior diabetologist at S.L. Raheja Hospital, Mumbai.

What’s the link between hot flashes and night sweats and the increased risk of Type 2 diabetes?

One possible cause is the decline in the levels of the female hormone, estrogen. This can trigger a barrage of changes, including elevated adrenal hormones like cortisol and counterregulatory hormones (a group of hormones that work together to prevent hypoglycemia and maintain fuel supplies in the body). These changes can lead to lower insulin secretion and an excessive release of catecholamines (stress hormones like dopamine and adrenaline for example). This leads to insulin resistance.

Interestingly, estrogen replacement therapy, which is commonly prescribed during menopause, can sometimes unmask or worsen underlying diabetes. In cases where women receive hormonal supplementation, especially in the perimenopausal phase, it may negatively affect insulin production and increase insulin resistance. However, hormone therapy can increase the risk of Type 2 diabetes only in some cases.

What’s the impact of inflammation, poor sleep quality and increased weight in driving up disease risk in menopausal women?

The impact of hormonal changes on inflammation can negatively affect sleep quality. For women, who are overweight with more abdominal fat, there is a heightened risk of blood clotting in the heart, Obstructive Sleep Apnea (OSA) and diabetes. Sleep apnea itself is a risk factor for heart rhythm disturbances. If not properly managed, these conditions can worsen over time.

Do lifestyle, pre-existing conditions or family history amplify the risk of Type 2 diabetes in these women?

The study clearly showed that lifestyle factors and family history play a significant role in women’s health, particularly during perimenopause. It’s essential to address these risks so that a woman doesn’t feel challenged at age 45. Unfortunately, we are seeing an increasing number of Type 2 diabetes cases in women as young as 25.

What should menopausal women do to prevent or manage diabetes?

Manage weight. Reduce fat intake, exercise for at least 45 minutes a day to raise your heart rate, with the pulse increasing from a resting rate of around 70 to 120, provided there are no underlying heart conditions. For women suffering from sleep apnea, clinicians should recommend a CPAP (Continuous Positive Airway Pressure) therapy early on.