There's plenty to be scared of with diabetes, unfortunately. But airing and sharing your fears can help you feel a heck of a lot more empowered to face them. Today at our diabetes advice column Ask D'Mine, veteran type 1, diabetes author and community educator Wil Dubois is taking on menopause (no, really!) and a teenage type 1 who is living in fear of lows.

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Nina from Nevada, type 2, asks: How does the onslaught of menopause affect your diabetes? Does menopause actually affect the diabetes or the other way around? I am curious because my whole body seems to be falling apart with this new phase of my life.



Wil@Ask D'Mine answers: You know about circadian rhythms, right? The body's under-the-hood system for controlling sleep cycles? I personally suspect we also have a "falling apart" cycle that hits every ten years at 30, 40, 50, 60... I propose we call it the Everything-just-went-to-shit-cycle, or the EJWS Cycle for short.

But seriously, to answer your question: it seems that menopause effects the diabetes. It does so primarily by making your blood sugar control a complete train wreck, and there're three major mechanisms involved.

First, in ladies, the girl-hormones estrogen and progesterone help control insulin absorption by the body's tissues. In and after menopause, the changes in hormone levels can wreak havoc on your BGs, making them both more erratic and highly variable.


Second, some ladies put on weight during menopause. This matters a lot to you, Nina, 'cause you're a type 2. More weight = more insulin resistance. More insulin resistance = more meds needed to keep the blood sugar in check.

And, third, as if the first two weren't enough: hot flashes and night sweats screw up your genuine circadian rhythms, and sleep disturbances have been shown to mess up your blood sugar, too.

There's a great article on this issue over at Mayo Clinic, which calls diabetes and menopause A Twin Challenge. It covers all of this in much more detail, along with a few other things I didn't want to depress you with, like the fact you'll be even more likely to have yeast infections and bladder infections now than ever before. But be sure to see page two of this article, as they've got some tips to help you navigate this storm.

We also covered this issue in some detail here at the 'Mine back in June. Check it out: "Diabetes & Menopause: Not So Musical."

And you know, after digging into this for you, I'm really beginning to appreciate my Y chromosome...


Marina from California, type 1, writes: Hi, I'm 16 years old, and I found this website a couple of days ago. I have read many stories from many different people and it's helped me realize that I'm not the only one struggling with diabetes... eww... Anyways, I was diagnosed at age 11 and was doing great controlling my sugar up until a few years after that when I was alone and my sugar went down to 60 because I forgot to eat (dummy) and I got TERRIFIED! After that I have been having such a hard time having it normal. I just get scared because of the horrible shaky feeling when it's low... and I know that in a way having my sugar at 60 is better than 300, but I really need some support and advice from someone that understands what I'm going through and to tell me that "it's going to be OK, just drink some juice and you'll be fine." Sorry for writing a whole novel, but you seem like my last and only hope... please respond! Thanks.



Wil@Ask D'Mine answers: Sorry, kiddo, I'm not going to tell you, "just drink some juice and you'll be fine."  I'll bet a lot of people have already told you that. Like your parents. Your doc. Maybe your CDE.

I don't think one more voice will make a difference.

But I will say this —   I. Totally. Get. It.

I understand where you're coming from. Lows are terrifying, particularly if you're alone. So. It's OK to be terrified. But you can't let that terror rule you. Or ruin your life.

What you need to do is manage your terror. Find a way to live in peace with it. Hey, lows are the cost of doing businesses on insulin. They will happen. No avoiding it. But remember that horrible shaky feeling of being low that you hate? That feeling is a blessing. A gift from the diabetes gods. It's nature's way of saving your bacon — by warning you that you're going dangerously low (some of us don't feel the warning signs!). Don't freak out and fear that feeling. Instead, rejoice when you feel it. It's the ultimate life insurance policy.

But, let's review some of our weapons against the terror you are feeling. First, you're wearing a medic alert, right? If you're gonna worry about passing out all alone, having a friendly note to the paramedics on your wrist is a good idea.

More importantly, how often are you checking your blood sugar? Lows are more likely at certain times of the day, generally in that three-to-four hour period after eating, or the time slot two hours after correcting a high BG. The best anti-low insurance is a proactive fingerstick. If you get into the habit of checking three hours after eating and two hours after correcting, you can head off a lot of trouble at the pass. Keep your active insulin in mind. Fast-acting insulin lasts 4 hours in most folks. So if you are at, say, 102, three hours after a meal, you've still got an hour of active insulin in your body. An hour of insulin that will send you low. You can grab that juice box now, instead of waiting for trouble to hit. And, yeah. I'll say it after all: Just drink some juice and you'll be fine. But I'm telling you to drink the juice before the low hits, so you don't get low at all.

What else can you do? Well, more prevention. You can sharpen your carb-counting skills. You can make sure your insulin-to-carb ratios and your insulin sensitivity are right for you. You can also make sure that you always carry some fast-acting carbs with you, like glucose tablets or raisins or a juice box, so you're always prepared.

You've grown quite a bit since you joined the family, and you're at an age where things change quickly. When was the last time your therapy was adjusted?

Bottom line here, it's OK to be scared. Lows scare all of us. But you can't let that fear rule and ruin your life.

After all, keeping your blood sugar high to avoid lows only opens the door to new terrors.




This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.



Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.