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Written by Dr Serena Jones, GP
Dr Serena graduated from Manchester University in 2008 (MBChB).
She also holds the MRCGP, DRCOG and DFSRH.
Diabetes affects millions of women worldwide, and its impact can vary significantly based on life stages, from puberty, to reproductive years, pregnancy, menopause and beyond.
The effect of hormone fluctuations on blood sugar levels are becoming increasingly recognised, increasing health risks and altering traditional diabetes symptoms.
A recent study highlighted the risk of type 2 diabetes being higher in women who had their menopause before the age of 45 or after the age of 55 years old [1].
Diabetes and puberty
For girls, puberty is a critical time where hormonal changes, including fluctuations in oestrogen and progesterone, can lead to changes in insulin sensitivity and therefore into blood sugar instability.
Many young women with type 1 diabetes find that blood sugar levels become more challenging to control, especially around menstruation. [2]
During these years, it’s also essential to build good self-care habits. Teenagers can feel self-conscious about monitoring and injecting insulin in social settings, which may lead to skipped doses. It’s essential both parents and healthcare providers play a crucial role by encouraging open communication and providing emotional support to help teenage girls feel confident in managing their diabetes.
Diabetes during reproductive years and pregnancy
Polycystic Ovary Syndrome (PCOS), is a hormonal disorder, that is strongly linked to insulin resistance and an increased risk of type 2 diabetes. Women with PCOS should monitor their glucose levels regularly and may benefit from lifestyle changes, medications, and regular screenings.
Gestational diabetes, occurs when the body cannot produce enough insulin to regulate blood glucose levels during pregnancy, it usually arises in the second trimester. Often, gestational diabetes doesn’t cause any symptoms, but signs may include increased thirst, frequent urination, fatigue, and frequent infections, such as urinary tract infections (UTIs).
- Risk factors: Obesity, being over 35, a family history of diabetes, and prior history of gestational diabetes all increase the risk.
- Health risks: Uncontrolled blood sugar can lead to complications such as premature babies, large birth weight babies (macrosomia), preeclampsia (raised blood pressure), and a higher likelihood of needing a C-section. There’s also an increased risk of developing type 2 diabetes later in life for both the mother and child.
Pre-existing diabetes in pregnancy, women with type 1 or type 2 diabetes face a higher risk of complications during pregnancy. Careful blood glucose management is vital, as elevated sugar levels in the early stages of pregnancy can lead to birth defects or miscarriage.
Maintaining optimal blood sugar levels through regular monitoring, a balanced diet, and appropriate use of insulin or oral medication is essential.
Our range of blood glucose monitors are safe to use during pregnancy, find out more here.
Diabetes and menopause
As women approach menopause there are significant fluctuations in hormone levels, the decline in oestrogen often leading to increased insulin resistance.
Key symptoms in menopausal women with diabetes
- Increased blood sugar levels: Hormonal changes can make blood sugar control more difficult. Women may experience more frequent episodes of high blood sugar (hyperglycaemia) as insulin sensitivity decreases.
- Weight gain: Metabolism often slows down during menopause, leading to weight gain, which can worsen insulin resistance and complicate blood glucose control.
- Increased infections: such as urinary tract infections and thrush.
- Hot flashes and night sweats: These common menopausal symptoms may overlap with symptoms of blood sugar fluctuations, such as sweating, dizziness, or palpitations, making it harder to differentiate between the two conditions.
- Sleep disturbances: Hormonal changes during menopause can lead to poor sleep or insomnia, which is linked to increased stress hormones and higher blood sugar levels.
- Increased risk of cardiovascular disease: Both diabetes and menopause independently raise the risk of heart disease, and this risk becomes more pronounced when the two conditions coexist [3]
Managing diabetes during menopause
Managing blood sugar becomes more complex during menopause. Checking blood sugar levels more frequently is essential to adjusting insulin or medication doses as needed.
A healthy diet rich in fibre, lean proteins, and whole grains, low in alcohol, combined with regular physical activity, can help manage both weight and blood sugar levels.
Some women find relief from menopausal symptoms with HRT, which can help stabilise Oestrogen levels.
Post-menopause and beyond:
For older women, diabetes can bring new risks and complications, including a higher chance of heart disease, kidney problems, and vision loss. At this stage, preventive care becomes particularly important. Regular screenings for heart health, kidney function, and eye exams can help detect complications early. Additionally, keeping up with physical activity and managing a balanced diet can improve insulin sensitivity and help prevent complications.
Ageing can also bring changes in appetite and digestion, which may impact blood sugar.
Conclusion
Understanding how diabetes control can change during different stages of a woman’s life empowers them to take control of their health.
For women with diabetes, managing their condition effectively requires regular monitoring of blood sugar levels and lifestyle adjustments.
With the right support, monitoring, and treatment strategies, women can successfully navigate these life stages while maintaining good control of their diabetes.
References:
- Erin S LeBlanc, Kristopher Kapphahn, Haley Hedlin, Manisha Desai, et al. (2018). Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: Findings from the Women’s Health Initiative. Jan 1. 24(1):64–72.. Menopause.
- NHS – Diabetes and Pregnancy: NHS Pregnancy and Diabetes
- Diabetes UK: Diabetes and Menopause
