Menopause is when the body gradually produces less of the hormones oestrogen and progesterone.
During this time women with diabetes may find that their blood glucose levels become less consistent or predictable. These hormonal changes along with hyperglycaemia contribute to mood changes, fatigue, short-term memory loss and hot flushes.
This leads to eating unnecessary calories which can cause a rise in blood glucose levels and clients may need an increase and/or change of diabetes medications. You may also find there may be more episodes of low blood glucose levels which mainly occur during the night and can further compromise sleep which is already disrupted by sweats and hot flushes associated with menopause.
Hyperglycaemia (high blood glucose levels) is often associated with increased urinary tract and vaginal infections, which can also occur after menopause due to a drop in oestrogen which makes it easier for bacteria to thrive.
There are post menopausal diabetes complicationsthat you need to be aware of. There is a higher risk of developing osteoporosis with people diagnosed with type 1 being more at risk than those with type 2 diabetes. For those with diabetes and not so active, it also increases the risk of bone fractures. Your GP may do a fracture risk assessment and a dietitian can assist you with your diet to help lower the risks of fractures.
Weight gain and a higher risk of atherosclerosis (hardening and thickening of the artery walls) can lead to heart attack or strokes.
What can women do to manage diabetes and menopause?
Preventing weight gain can be a challenge for many women on reaching menopause but can be managed with a more concerted effort to avoid the excess kilos creeping on.
A healthy well balanced diet will assist in weight management, reduce high cholesterol levels, high blood pressure and heart disease, decrease hot flushes, balancing mood, and preventing osteoporosis;
Eat plenty of fresh vegetables and 2-3 serves of fruit/day;
Drink 6-8 glasses water/day;
Reduce alcohol intake to 1-2 standard drinks per day or less as this will help reduce hot flushes;
Decreased caffeine intake (coffee, cola, tea,chocolate) helps reduce hot flushes;
Include Plant Sterols and Stanols 2-3 g daily to help reduce cholesterol level, for example, soy beans, tofu, legumes and whole grains;
Try and increase soluble fibre by adding Linseeds,nuts, and prunes to daily intake;
Include lean meats and more oily fish, sardines, salmon;
Include daily serves of high calcium, low fat dairy foods to reduce risk of osteoporosis.
An appointment to see the Dietitian can be of great benefit to gain extra support at this time.
Complementary and Natural Therapies – Many women may take these to help with symptoms of menopause (in particular the hot flushes) but it is important to talk with your GP or Diabetes Specialist so there is no conflict with conventional medications. Hormone Replacement Therapy (HRT) may also be prescribed for a short time to help with symptoms of menopause.
Be Active - Regular exercise/strength training/ aqua aerobics - at least 30 minutes a day of moderate intensity to control weight, reduce cholesterol level and keep bones healthy. It’s never too late to get started, choose something which you will enjoy and maintain. Remember to check blood glucose levels more frequently if on diabetes medications in order to prevent hypoglycaemia (hypo) and always carry hypo food.
Quit Smoking – For overall health, it’s never too late to give up.
Menopause and sex – Painful intercourse due to vaginal dryness can be overcome by using a lubricant, many can be bought over the counter at the pharmacy.
Emotional health – Looking after this is very important as depression and mood changes are
common. Talk to a counsellor, psychologist or GP about any difficulties.