I’m 54, in perimenopause and healthy—ideal weight, don’t drink or smoke, exercise every day—but my insulin levels are nearly at prediabetes levels. Can approaching menopause be causing my insulin levels to go up?


Yes, menopause and an increased risk for type 2 diabetes are connected. One reason is that estrogen, which of course drops as a woman approaches menopause, helps to move excess blood sugar out of your bloodstream, where it can do damage, and into your muscles, where it can be used more quickly. With less estrogen, more sugar stays in the blood. Estrogen also helps more evenly distribute fat around your body so that it doesn’t accumulate in your belly—your “love handle” area. With less estrogen, fat may gather in the abdomen—and excess abdominal fat is associated with an elevated risk for diabetes and heart disease. How much estrogen is in your bloodstream is also partly regulated by the bacteria in your gut—which are affected by what you eat and how active you are. Taking antibiotics can alter your gut bacteria as well—and not in a good way. Since it sounds like you’re already taking some smart steps to stay healthy, you may just need to finetune your diet and lifestyle a bit more. Even though you aren’t overweight, make sure you're limiting (or eliminating) soda, cutting back on packaged foods that contain lots of added sugars and eating plenty of vegetables, fruits and legumes. A dietitian can evaluate your diet and advise you on other changes that can help. Meanwhile, keep these recommendations in mind… • Avoid taking antibiotics unless your doctor says that it’s absolutely necessary. • Add fermented foods such as pickles, kimchi, sauerkraut and kefir to your diet. These can improve gut bacteria, which can help reduce belly fat. For more tips on preventing diabetes, see Bottom Line's article, "Got Prediabetes? Millions Do…But You Can Reverse It!"

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