DIABETES AND MENOPAUSE

It is necessary to differentiate the perimenopause and the menopause.
Perimenopause (pre-menopause) is a period that will be marked by hormonal changes and more particularly by progesterone and estrogen.


Pr. Salim Djelouat
Pr. In Medical Analysis and Bioclinician
Certified medical expert in medicine, health and well-being – Paris –
Salimdjelouat@gmail.com


Summary
I – EPIDEMIOLOGICAL RECALL
II – PRESENTATION OF THE FACTS
III – How does menopause affect diabetes?
IV – “Substitute” hormonal treatment of menopause and diabetes –
V- Is it then necessary to prescribe a “substitutive” hormonal treatment for diabetic women?


I – EPIDEMIOLOGICAL RECALL
Before age 55, those are the men most vulnerable to diabetes;
This trend is reversed from age 55 or those are the most affected women.
In total, an estimated 143 million women worldwide have diabetes, a figure that could rise to 222 million in 2030.

II – PRESENTATION OF THE FACTS
We know that the specificities of diabetes are identical to both sexes, but it is proven that women have more special conditions for diabetes disease and especially for its control.
The reasons for this difference are found in the hormonal physiology of women.
We also know that the menstrual cycle, pregnancy for example, vary the physiological norms – either increase or decrease – and therefore, be partly responsible for this tendency to not be able to control his diabetes.
Another fact is that women are more likely to suffer from cardiovascular complications that are closely related to diabetes.
The mastery of all complications related to diabetes can only be done with good control of his disease.
In our writing, we reviewed the main specificity, which can accentuate diabetes – and of course its complications – in women.

III – HOW DOES MENOPAUSE AFFECT DIABETES?
It is necessary to differentiate the perimenopause and the menopause.
Perimenopause (pre-menopause) is a period that will be marked by hormonal changes and more particularly by progesterone and estrogen.
As a reminder – and see above – these hormones play a role in the cells’ response to insulin.
In perimenopause
Hormonal changes will be much more marked by decreases in the level of these hormones, which will cause variations in blood sugar – blood sugar level -.
Unfortunately these glycemic variations are difficult to predict and vary from one woman to another.
At this time, these changes – with periods very irregular – will cause much more hyperglycemia, than hypoglycemia.

Recommendation –
At this time, it would be necessary to adjust his treatment according to fluctuations in blood glucose.
menopause period –
Menopause is marked by the absence of menstruation, which means that there is more fluctuation of ovarian hormones, diabetes will be stabilized or balanced.
Particularity of perimenopause and menopause in women with type 1 diabetes –
In women with type 1 diabetes, there is early onset of perimenopause and menopause, compared with non-diabetic women.

Good to know
This period of perimenopause and menopause will lead to weight gain, problems of libido, vaginal dryness, depression and increased cardiovascular risk, and these disorders can have a “boomerang” effect on the glycemic balance.
The “boomerang” effect is an accumulation of stress, which will have a bad impact on the management of diabetes.
This period of menopause will also be marked in diabetic women by the risk of:
Cardiovascular illnesses –
Diabetes coupled with menopause, will be responsible for an increase in cholesterol and triglyceride levels.
During this period, the risk of developing cardiovascular disease also increases, with diabetes causing greater effects on triglyceride and cholesterol levels in women than in men. It is therefore essential that during this stage, you are particularly careful.
You must control the disease more than ever.
This increase in these parameters may be the cause of cardiovascular disease.
Weight gain –
Lack of physical activity and non-compliance with dietary rules will, in some women, be responsible for physical changes and more particularly for weight gain with changes in fat distribution.
There is an increase in fat around the abdomen – waist -.
This increase will cause a very bad action of insulin on blood glucose, thus leading to insulin resistance.
This insulin resistance, will be responsible for a rise in blood sugar.
Hot flashes and hypoglycemia –
It is known that hot flushes are quite common during périménopause and affect more than 60% of women.
They can last up to 5 years, to disappear.
“Nocturnal” hot flushes or those that appear during sleep can be confusing with the symptomatology of hypoglycaemia, which will cause a woman to consume carbohydrates.
This inappropriate carbohydrate consumption may be the cause of uncontrolled hyperglycaemia

Recommendation –
Before going to resuscrate, it would be advisable to control its blood sugar level.

IV – “SUBSTITUTE” HORMONAL TREATMENT OF MENOPAUSE AND DIABETES –
Hormonal “replacement therapy”, the so-called treatment of menopause, consists of giving the woman during périménopause hormones, especially estrogen and possibly progestins, to reproduce the hormonal cycle, which will be “little ready” identical to that of before périménopause.
Hormonal replacement therapy is not without risks of complications in women, whether diabetic or not, but these risks are more prevalent in women with diabetes.
The main risks reported are –
Breast cancer
Thrombophlebitis – blood clot –
stroke
Coronary disease

V – SHOULD YES OR NO, PRESCRIBE A HORMONE TREATMENT “SUBSTITUTIVE” IN DIABETIC WOMEN?
The question is asked.
Before making the decision to prescribe treatment, the benefit-risk effect must be assessed, which can affect the woman’s quality of life.
Based on this assessment, the decision will or will not be made.
“Hormonal” replacement therapy in diabetic women may be responsible (in addition to the risks common to all women) of –
Risk of obesity – overweight –
More marked in women with type 2 diabetes.
This weight gain, will promote the occurrence of phlebitis and accelerate the complications of hormone replacement therapy.
Hypertension –
It is known that high blood pressure is associated with diabetes, so consider the risks of uncontrolled hypertension.
Cholesterol and Triglycerides –
Decrease in good cholesterol and increase in triglyceride levels.
These variations of cholesterol and triglycerides will be responsible for some vascular problems, such as an appearance of atheroma …

Advice
In case of hormonal treatment; these two biological parameters are to be monitored.
Medical background –
No prescription of the hormone treatment “substitutive”, in case of –
– Atheroma
Infarction
Stroke


Pr. Salim Djelouat
Pr. In Medical Analysis and Bioclinician
Certified medical expert in medicine, health and well-being – Paris –
psychotherapist
Scientific author
Webmaster and blogger


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About the Author

Salim Djelouat
Medical Analyst and Bioclinicist Certified Medical Specialist in Health, Fitness, and Physical Therapy - Paris - Psychotherapist Scientific author Webmaster and blogger

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