Menopause and Diabetes: What's the Connection?

As if menopause didn't already change a lot of things in your body, here are a few more things to know. This time, it's about a disease that is the number six killer of women ages 45 to 54 and the number four killer of women ages 55 to 64. Diabetes affects one in nine adult women.

If you already have diabetes, menopause can change things. And if you don't have it, menopause may make it more likely to occur.

Let's start with the basics. A diabetes primer, please?

We're talking here about the most common type of diabetes, type 2, once known as adult-onset diabetes. People with type 2 diabetes have a hard time producing enough insulin or using it properly, and you need insulin to maintain normal glucose levels in your body. It is no longer known as adult-onset diabetes because it's occurring more and more in children, due to the alarming rates of childhood obesity.

Type 1 diabetes, which was once known as juvenile diabetes, is an autoimmune disease where your pancreas produces little to no insulin because your immune system attacks it and destroys the cells responsible for producing insulin.

So, how are menopause and diabetes linked? Are hormones to blame?

Researchers say it's tough to separate the effects of menopause from the effects of weight and age (both increase the risk of diabetes), but hormones could have something to do with the development of diabetes around menopause.

Estrogen and progesterone can affect the way your cells respond to insulin. As hormone levels change around menopause, your blood sugar levels fluctuate and might be more unpredictable and fickle than before menopause. It's important to keep your blood sugar levels under control, because your risk of complications from diabetes becomes higher as these levels become higher.

But—this is important—despite the hormonal connection, hormone therapy is not recommended solely to reduce your risk of developing diabetes. Read more about hormone therapy recommendations.

And then, there's weight gain to consider. As you probably know, many women gain weight during the menopausal years.

What other reasons can make diabetes more likely around menopause?

Blame weight. If you're going through or already have gone through menopause, then it's likely you've gained some weight.

Weight gain is a risk factor for developing diabetes. The sad truth is that more than 90 percent of people with type 2 diabetes are overweight or obese.

If you're already predisposed to diabetes, excess weight makes your cells less sensitive to insulin released from your pancreas. If you already have diabetes, weight gain increases your need for insulin or other diabetes medications.

There's solid evidence to show the advantages of losing weight when it comes to diabetes (and many other health conditions). By losing just 5 to 7 percent of your weight, it's possible to prevent or delay diabetes. That means if you weigh 200 pounds, just 10 to 14 pounds can make a huge difference.

So, let's talk about exercise. Good idea?

Good, in so many ways. There's evidence that fat cells are more resistant to insulin than are muscle cells. That's a good reason for exercise and building your muscles, which can help use up the extra sugar circulating in your blood. Learn more about fighting menopausal weight gain with exercise.

How do I know if diabetes is lurking?

First and foremost, keep your weight within healthy limits and make sure you get plenty of exercise.

But since some people, despite that, can still develop diabetes—especially if there's a family history—here are some clues:

• Increased thirst
• Fatigue
• Blurry vision
• Frequent urination
• Unintended weight loss
• Frequent infections
• Areas of darkened skin, especially in the armpits and neck
• Tingling or numbness in hands or feet

Should I get tested?

Yes, absolutely. Diabetes develops slowly and can affect you for years without you even knowing it. In fact, more than a quarter of people with diabetes haven't even been diagnosed, according to estimates from the Centers for Disease Control and Prevention.

Can you remind me how?

There are a number of blood tests available; some don't require fasting, while others do. Some require drinking a sugary liquid.

The American Diabetes Association recommends you get tested every three years, beginning around age 45, especially if you're overweight.

The U.S. Preventive Task Force says that if your blood pressure is above 135/80, you should be screened every three years. And if you have additional risks—like a family history of diabetes—you might want to get tested more frequently.

So, if I already do have diabetes, how do I manage it? Or if I don't have it, how do I avoid it?

Lifestyle modifications go a long way. Eat healthy meals. Make sure to limit sugar and fat and increase sources of omega-3 fatty acids like mackerel, salmon and sardines and include plant-based sources like soy, canola oil, walnuts and flax seeds. Learn more about managing menopausal weight gain with diet.

Limit calories if you're overweight and keep physically active. Also, keep tabs on your blood pressure, blood glucose and cholesterol. And if you smoke (please don't say you do!), quit.

Why is it so important that I avoid diabetes?

Diabetes can lead to other problems like heart attack and stroke, nerve damage, kidney disease, eye disease, foot problems, gum disease and other dental problems, sexual and bladder problems and more.

Before we go, I definitely need a game plan.

Here you go.