If Perimenopause Didn’t Already Kick Your Butt, Pre-Diabetes Might
Fighting back against a reversible diagnosis
Happy Menopause Awareness Month! Today, Tracy Collins shares her experience with tackling Pre-Diabetes caused by perimenopausal changes. Hormonal changes in the perimenopause can affect your blood sugar levels. This can cause perimenopausal women to develop pre-diabetes or make it harder for women with diabetes to manage it.
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Peri-menopause is a real ass-kick. Hair loss, brain fog, mood swings, depression, anxiety, panic attacks, weight gain, and heart palpitations are the symptoms I struggle with. There’s a list of 34 others, and they all suck.
If you’d asked me last year, I would have said my two-year battle with severe depression was enough, thank you very much. Hormone Replacement Therapy (HRT), thyroid medication, and therapy helped get my volatile mood swings under control.
Though peri-menopause is a ruthless teacher, it has empowered me to attune closely to my inner state. As my mood improved, I felt a new challenge festering.
Why am I always ravenous?
This question baffled me for 24 months. No matter what I ate, I was hungry within the hour.
Fixated on stabilizing my mood, I didn’t have time to investigate my voracious appetite. In June, I got updated blood work done, and the doctor called me for a follow-up.
Not only were my blood sugar and cholesterol elevated, but my kidney function was off. Nothing major, she said, but we need to keep an eye on this.
Her words gnawed at me.
Not only was my fasting glucose high, but my A1C, a marker for diabetes, was 5.7. In Canada, this is technically classified as ‘at risk’, but according to the CDC, it’s considered pre-diabetes.
Though I’d struggled with middle-aged weight gain, I always exercised and had a healthy diet.
You can imagine my surprise when I found out that peri-menopause and the associated metabolic changes are risk factors for insulin resistance and pre-diabetes.
Add that to the symptom shit list, ladies!
Why pre-diabetes terrifies me and should terrify you too
According to the CDC, pre-diabetes unchecked will develop into diabetes in about five years.
Diabetes is a gateway to other health conditions like heart disease, stroke, and kidney failure. But those aren’t the ones that make me shudder.
What terrifies me is the link between diabetes and Alzheimer’s disease. These days, Alzheimer’s disease is commonly referred to as Type 3 diabetes. A 2022 meta-analysis shows that Type 2 diabetes is a risk factor for Alzheimer’s disease. High blood sugar is the common denominator for both.
My grandmother had Alzheimer’s disease. She moved in with us when my parents divorced, so I am intimate with its horrors.
Her life took on a sick twist of the movie The Curious Case of Benjamin Button as her memory regressed backward. In the early days, she knew who I was. Within a few years, I was my mother as a child. After that, she was searching for her dead husband and then her deceased brother and parents.
On a few occasions, our neighbors found her wandering naked in the fields, looking ‘for home.’
Nobody deserves to go like that. No thanks.
Middle-aged women often complain about brain fog, and I am no stranger to this. Even with a detailed grocery list, I forget important items. One weekend, I planned a roast chicken dinner with vegetables, mashed potatoes, and gravy. Guess what I forgot?
The chicken.
Twice in the last year, I woke up with no idea where or who I was. It takes a moment to rouse out of that horrifying reality. That must have been what it was like for my grandmother.
Witnessing her degradation will haunt me forever, and I will do anything to avoid it.
I’m taking back control
Pre-diabetes or insulin resistance is generally reversible with lifestyle. Globally, the rates of insulin resistance are skyrocketing, ranging from 16% to 47%. In the US, about 40% of the US population is insulin resistant.
Mainstream doctors will put you on medication without telling you that changing your diet can change your lab results in 90 days.
Once I saw my lab report, I started reading voraciously and listening to podcasts. Next, I hired a dietician.
It’s been a month, and I’m seeing positive changes. I’ll have my labs re-run in a couple of months, but for now, I’m focussing on the cornerstones of lowering my glucose.
What you eat matters, but so does when you eat
Instead of focusing solely on what you eat, intermittent fasting focuses on when you eat. Fasting overnight is easy and gives your body time to use fat storage for energy. The fasting windows vary, but for me, I try not to eat between 6:30 pm and 9:30 am.
In The Diabetes Code, Dr. Fung, author, nephrologist, and diabetes expert, argues that overcoming insulin resistance through fasting is critical for the reversal of both pre-diabetes and Type 2 diabetes.
But is fasting recommended for peri-menopausal women?
Dr. Mary Clarie Haver, a menopause expert and creator of the Galveston Diet, advocates for the 16:8 model. In her model, you eat during an eight-hour window and fast for 16 hours.
Mid-life protein needs were a shock
My dietician recommends I aim for 110+ grams of protein per day.
Though it sounds like a lot (and it is), research shows that women in peri-menopause need to increase their protein to offset dips in estrogen and the corresponding muscle loss and bone density. Aiming for 1–2 g of protein per kg of body weight is the general range you’ll find online.
Breakfast is key, and I’ve learned that 40 grams of protein keeps me going until lunch. For lunch and dinner, I plan for 30+ grams per meal.
40 grams of protein equates to 3 eggs, ½ cup of egg whites, 1/4 cup of cottage cheese, veggies, and avocado — a far cry from what I used to eat. No wonder I was hungry!
A tasty hack to reduce blood sugar spikes
I started following the Glucose Goddess and listened to her audiobook. One of the hacks to stabilize your blood sugar is to drink a tablespoon of apple cider vinegar mixed in a glass of water 15 minutes before you eat carbs.
In my case, I usually limit starches to dinner, and the vinegar helps prevent glucose spikes.
Though some people don’t like the taste of it in water, I truly enjoy it. I especially enjoy it added to flavoured sparkling water which tastes a bit like a shrub, a popular vinegar-based drink. If you hate the idea of drinking vinegar, you can make a green salad and use the vinegar in your dressing.
A 10-minute activity to bring down glucose
The research is pretty clear that peri-menopausal women need to include strength training to offset muscle loss. I work out from home and aim for three days of weights per week. I also have cardio and stretching days.
To support lowered glucose, I go for a walk after dinner. Research shows that a 10-minute walk within 90 minutes of eating prevents glucose spikes.
The road ahead
It’s been one month so far, but the roller coaster of hunger and blood sugar spikes is subsiding. Since A1C is based on an average over three months, I won’t see the impact in my blood work for another 60 days.
Last week, I saw my doctor to pre-order the bloodwork. She was pleasantly surprised to hear I’d hired a dietician and made lifestyle changes to reduce my blood sugar.
Most of her patients, I learned, wait until a type 2 diabetes diagnosis and go on medication. Since I’m terrified of type 3 diabetes, or Alzheimer’s, that’s not an option for me.
On my way out the door, my doctor said that when she was my age, she’d nearly quit medicine because of her poor health and diet. She’d make radical changes that saved her life.
If you want memorable tomorrows, focus on building your health today, was her parting message.
Let’s hope it works, I thought. Let’s hope.
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