By now, most people have been to a holiday party or two. Lots of food, lots of eggnog and other carb laden alcoholic beverages, and lots of grazing all day long on all the boxes of candy friends and business acquaintances sent to us. It's easy to gain the five pounds most people gain during the holidays, and in the process, raise your blood sugar or glucose levels too high. That's your body letting you know you have prediabetes (higher than normal but still below diabetes levels) or diabetes, and unless you take action soon, your body won't like it.
Diabetes silently sneaks up on you and if untreated, slowly weakens your health. According to the North American Menopause Society, diabetes has become the number 6 killer of women ages 45 to 54 and the number 4 killer of women ages 55 to 65. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 10 US adults has diabetes now, and if current trends continue, that figure could rise to 1 in 3 by 2050. Ten million people have diabetes or prediabetes and don't know it.
Here's why diabetes is so dangerous - chronically high blood sugars silently damage blood vessels and nerves, and that can lead to:
• Heart disease
• Nerve damage (neuropathy) that leads to tingling and pain in feet and hands
• Kidney disease
• Loss of vision
• Feet infections and in some severe cases, amputation
• Bone and joint problems
• Skin infections and wounds that don't heal
• Teeth and gum infections
There are two kinds of diabetes.
Type 1 (sometimes called insulin-dependent or juvenile diabetes) occurs when the beta cells of the pancreas produce too little or no insulin. This type usually occurs in children or young adults.
Type 2 (often called adult-onset, but can occur at any age) represents over 90% of diabetes and it occurs when the body produces too little insulin or the body resists the effects of insulin so it can't control blood sugar. In general, women with diabetes lose more years of life than men do. And while the death rate for women with diabetes has risen dramatically since the 1970s, it hasn't risen for men with the disease. It's estimated that girls born in the year 2000 have mode than a 1 in 3 chance of getting diabetes in their lifetime.
Diabetes and Menopause
Menopause does not specifically cause weight gain, but menopause is associated with changes in body composition. Lower levels of estrogen cause shifts in body fat to the belly and that leads to "menopot." As a rule, the lower the estrogen level, the wider the waist circumference. I explain this in detail in my best selling book, The Estrogen Window.
Muscles require exercise to maintain their strength and to grow. Without regular exercise, muscles get smaller, and because muscles burn more calories than fat, it leads to the body burning less sugar. Combining exercise and estrogen helps maintain muscle mass after menopause and helps control glucose better.
With poor glucose control, the excess glucose that comes with diabetes eventually gets deposited in the small blood vessels of the kidneys, eyes and nerves. Controlling blood sugar levels helps prevent and sometimes reverses this damage. Poor blood sugar control leads to complications. It's why retinopathy (disease of the nerve layer of the back of your eye) is the number one cause of new cases of blindness in adults aged 20 to 74, and diabetic kidney disease is the leading cause of end-stage renal disease. High blood sugar levels on the brain causes doctors like Mark Hyman to call dementia Type 3 diabetes.
Tests for Diabetes
There are three main tests for diabetes: 1) Blood glucose level (best done after fasting). Blood glucose values tell your blood glucose level at that moment. 2) HbA1C (heem-oh-GLOW-bin A one see) does not have to be done after fasting and tells an average blood glucose level over the past 3 months. 3) Oral Glucose Tolerance Test is done after fasting. The person drinks a high concentration of sweet liquid and several blood tests are taken over the next few hours). A dipstick of your urine for glucose is a good screen to see if any of these tests are needed.
Normal, Prediabetic and Diabetic Blood Tests Levels
Normal HgbA1C is about 5, for FBS (mg/dL) is ≤ 99 and OGGT (mg/dL) is ≤139
For prediabetes, HgbA1C is 5.7 - 6.4, for FBS 100-125, for OGGT 140-149 (mg/dL)
For Diabetes, for HbA1C is ≥ 6.5, FBS is ≥ 126 and OGGT is ≥ 200 (mg/dL)
From American Diabetes Association and National Diabetes Information Clearinghouse. FBS = Fasting Blood Sugar; OGGT = Oral Glucose Tolerance Test.
Here are 7 tips to lower the risk of diabetes as you enter menopause:
1. Get tested. Women in menopause are at particular risk and every woman over 45 who is overweight should be screened and retested every 3 years. Overweight women at any age with any one of the following risk factors should also be tested: (inactive, have a first-degree relative with diabetes, delivered a baby over 9 pounds, have high blood pressure above 140/90 or take blood pressure medication, have low good cholesterol HDL ≤ 35 mg/dL or triglycerides above 250 mg/dL, a fasting glucose of 100 mg/dL to 125 mg/dL). Be sure to measure your blood sugar regularly.
2. Exercise. Regular exercise can lower your risk for diabetes and help control your weight. It also lowers the risk of breast cancer, heart disease and depression.
3. Eat healthy. Eat whole foods and limit sugary drinks, processed foods, fast foods and sweet desserts. Eat more vegetables, and speak with a dietitian. In other words, help Santa by leaving carrot sticks and humus instead of sugar cookies or sugar plums.
4. Control weight. The good news is, you don't have to lose a lot of weight to make a huge impact. A 7% loss of weight can greatly lower the risk of diabetes and heart disease. For a woman who weighs 150 pounds, a 7% weight loss is approximately 10 pounds.
5. Consider estrogen for menopausal symptoms. The latest information on hormone therapy (HT) reveals that taking HT lowers the risk of developing type-2 diabetes, especially if it's begun within 6 years of menopause. It's one of the many benefits I explain in The Estrogen Window.
6. Check for Osteoporosis. Women with diabetes are at increased risk for thinning of the bones or osteoporosis. So are women in menopause. Be sure to get a bone density exam when you enter menopause. Some doctors recommend waiting until you're 65. I think that is much too late.
7. Regular check-ups for your eyes, blood pressure and heart. People with diabetes are at increased risk of vision loss and heart disease. The best way to stay well is to have regular check-ups and measure your blood sugar frequently.
If you are not sure if you are in menopause, or want to know how your symptoms compare to those of other women, visit MenopauseQuiz.com and take the no cost 2-minute quiz.