Navigating Perimenopause and Pre-Diabetes: A Personal Journey
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Chapter 1: The Struggles of Perimenopause
Perimenopause can be incredibly challenging. Symptoms such as hair thinning, mental fog, emotional fluctuations, anxiety, and unexpected weight gain are just a few of the hurdles I face. There’s a comprehensive list of 34 additional symptoms, each more frustrating than the last.
A year ago, I would have insisted that my two-year struggle with severe depression was more than enough to handle. Thankfully, Hormone Replacement Therapy (HRT), thyroid medications, and therapy helped stabilize my emotional ups and downs.
Despite the harsh lessons that perimenopause teaches, it has also encouraged me to be more aware of my emotional health. As my mood improved, I became increasingly puzzled by my insatiable hunger.
For two years, I grappled with the question: why am I constantly craving food? I was so focused on managing my mood that I neglected to explore my unrelenting appetite. In June, I had a blood test, and my doctor reached out for a follow-up.
To my surprise, my blood sugar and cholesterol levels were elevated, and there were slight concerns regarding my kidney function. While she reassured me it wasn’t anything urgent, her words lingered in my mind.
Not only was my fasting glucose level high, but my A1C, which indicates diabetes risk, was at 5.7. In Canada, this categorizes me as 'at risk,' while the CDC identifies this as pre-diabetes. Despite my middle-aged weight gain, I had always maintained an active lifestyle and a balanced diet.
It was shocking to learn that the metabolic changes associated with perimenopause could increase the risk of insulin resistance and pre-diabetes. Add this to the ever-growing list of symptoms, ladies!
Section 1.1: The Alarming Reality of Pre-Diabetes
The CDC warns that pre-diabetes can progress to diabetes within five years if left unchecked. This condition can lead to various health issues, including heart disease, strokes, and kidney failure. However, the aspect that truly frightens me is the connection between diabetes and Alzheimer's disease.
Alzheimer's is increasingly referred to as Type 3 diabetes, and a 2022 meta-analysis revealed that Type 2 diabetes heightens the risk of developing Alzheimer's. High blood sugar is a common factor in both conditions.
My grandmother suffered from Alzheimer's. After my parents divorced, she came to live with us, and I witnessed the devastation firsthand. Her memory deteriorated gradually, resembling a horrifying plot twist from "The Curious Case of Benjamin Button." Initially, she recognized me, but eventually, I became my mother as a child in her eyes.
After some time, she was searching for her deceased husband, brother, and parents. There were instances when neighbors found her wandering aimlessly, lost and confused.
No one deserves such an end. I certainly don’t.
As a middle-aged woman, I often experience brain fog, and I am no stranger to its effects. Despite having a well-organized grocery list, I frequently forget crucial items. One weekend, I meticulously planned a roast chicken dinner complete with vegetables and mashed potatoes. Can you guess what I overlooked?
That's right—the chicken.
Twice this year, I woke up with no recollection of who or where I was. It’s a disorienting and frightening experience, reminiscent of what my grandmother must have gone through. Witnessing her decline is a haunting memory, and I will do everything in my power to avoid a similar fate.
Subsection 1.1.1: Regaining Control
Fortunately, pre-diabetes and insulin resistance can often be reversed through lifestyle changes. Globally, the incidence of insulin resistance is alarming, with rates ranging from 16% to 47%. In the U.S., approximately 40% of the population is affected.
Unfortunately, many mainstream doctors tend to prescribe medications without informing patients that dietary changes can lead to significant improvements in lab results within as little as 90 days.
Upon reviewing my lab results, I began researching extensively and listening to health podcasts. I even hired a dietitian. After a month of following her guidance, I’m already noticing positive changes. My next lab tests are scheduled for a couple of months from now, but for now, I’m concentrating on the fundamentals of reducing my blood sugar levels.
Section 1.2: The Impact of Timing on Eating
While what you consume is crucial, the timing of your meals is equally important. Intermittent fasting emphasizes not just what you eat but when you eat. Fasting overnight is straightforward and allows your body to utilize fat storage for energy. My personal fasting window runs from 6:30 PM to 9:30 AM.
In "The Diabetes Code," Dr. Jason Fung, a nephrologist and diabetes specialist, emphasizes the importance of fasting in overcoming insulin resistance and reversing pre-diabetes as well as Type 2 diabetes.
But is intermittent fasting suitable for women experiencing perimenopause? Dr. Mary Clarie Haver, a menopause expert and the creator of the Galveston Diet, recommends the 16:8 model, where you eat within an eight-hour window and fast for the remaining 16 hours.
Chapter 2: Nutritional Needs in Midlife
My dietitian has advised that I aim for over 110 grams of protein daily. While that sounds daunting (and it is), research indicates that women in perimenopause need to boost their protein intake to counteract decreases in estrogen, which leads to muscle and bone density loss.
The typical guideline suggests aiming for 1–2 grams of protein per kilogram of body weight. Breakfast has become particularly important, and I’ve learned that consuming 40 grams of protein helps sustain me until lunch. For both lunch and dinner, I target over 30 grams of protein per meal.
To put this into perspective, 40 grams of protein equates to three eggs, half a cup of egg whites, a quarter cup of cottage cheese, along with vegetables and avocado—a far cry from my previous diet. It’s no wonder I was always hungry!
Section 2.1: Stabilizing Blood Sugar Levels
After listening to the "Glucose Goddess" audiobook, I discovered a simple trick to stabilize blood sugar: consume a tablespoon of apple cider vinegar mixed with water 15 minutes before eating carbohydrates.
I typically limit starchy foods to dinner, and the vinegar has proven effective in preventing glucose spikes. While some may find the taste unappealing, I enjoy it, especially when mixed with flavored sparkling water, reminiscent of a shrub—a popular vinegar-based beverage. If drinking vinegar isn’t your preference, simply incorporate it into a salad dressing.
Subsection 2.1.1: The Benefits of Physical Activity
Research clearly indicates that women in perimenopause should incorporate strength training to combat muscle loss. I work out at home, aiming for three days of weight training each week, along with cardio and stretching.
To further lower my glucose levels, I take a 10-minute walk after dinner. Studies suggest that a short walk within 90 minutes of eating can effectively mitigate glucose spikes.
Chapter 3: Looking Ahead
It has been a month since I started this journey, and the roller coaster of hunger and blood sugar fluctuations is starting to stabilize. Since A1C levels reflect an average over three months, I won’t see the effects of my changes in my lab results for another 60 days.
Last week, I consulted my doctor to pre-order my blood tests. She was pleasantly surprised to learn that I had hired a dietitian and made proactive lifestyle modifications to control my blood sugar.
Most of her patients, I found out, tend to wait until receiving a Type 2 diabetes diagnosis before resorting to medication. Given my fear of developing Type 3 diabetes, or Alzheimer's, that option is off the table for me.
As I was leaving, my doctor shared that she had nearly quit medicine at my age due to poor health and diet, but she made significant changes that ultimately saved her life.
Her parting words resonated deeply: If you want memorable tomorrows, focus on building your health today.
Let’s hope these changes work, and let’s hope for a healthier future.