Diabetes, Estrogen & Insulin Resistance: Your Action Plan

infomenopausehub
Oct 29
4 min read

A Practical Quick-Reference Guide for Women in Perimenopause, Menopause & Post-Menopause

THE KEY CONNECTION

Declining estrogen during menopause significantly increases your risk of insulin resistance—the first step toward type 2 diabetes.

Good news: Insulin resistance is reversible at this stage.

Why estrogen matters: Estrogen helps muscles use glucose for fuel and regulates liver glucose production. Without it, we become vulnerable to high blood sugar and insulin resistance—independent of age.

STEP 1: ASSESS YOUR RISK

Check these risk factors: ✓ Age 45+ or early menopause✓ Family history of type 2 diabetes✓ Waist measurement >80cm✓ Physically inactive (less than 3 hours exercise/week)✓ High blood pressure or high cholesterol✓ PCOS, sleep apnoea, or fatty liver disease

Action: Measure your waist at belly button level. Write it down: _______ cm

STEP 2: GET THE RIGHT TESTS

Book a GP appointment and request:

Fasting glucose (fast for 8-12 hours before test)
HbA1c (3-month blood sugar average)
Fasting insulin (KEY test - you must ask specifically for this)
HOMA-IR score (calculated from fasting insulin + glucose)
Lipid panel (cholesterol, triglycerides)

Don't accept "your bloods are fine" without seeing actual numbers.

What the numbers mean:

Fasting glucose: <5.6 mmol/L is normal; 5.6-6.9 is prediabetes; ≥7.0 is diabetes
HbA1c: <5.7% is normal; 5.7-6.4% is prediabetes; ≥6.5% is diabetes
HOMA-IR: <1.0 is excellent; 1.0-1.9 is good; 2.0-2.9 is early insulin resistance; >3.0 indicates significant insulin resistance
STEP 3: TRANSFORM YOUR BREAKFAST
START eating:
✅ 2-3 eggs (scrambled, poached, omelette with vegetables)
✅ Greek yoghurt (full-fat or 2%) + 1/4 cup berries + 2 tbsp nuts or seeds
✅ Scrambled tofu with spinach and mushrooms
✅ Avocado (1/2) + 2 eggs or smoked salmon
✅ Protein smoothie (protein powder + berries + spinach + chia seeds + unsweetened almond milk)
Why this works: Protein + fat keeps blood sugar stable for 3-4 hours and prevents mid-morning cravings.
STEP 4: BUILD BETTER MEALS ALL DAY
LUNCH & DINNER FORMULA:
1/2 plate: Non-starchy vegetables (leafy greens, broccoli, cauliflower, capsicum, zucchini) 1/4 plate: Lean protein (palm-sized portion - fish, chicken, tofu, legumes) 1/4 plate: Complex carbs (brown rice, quinoa, sweet potato, wholegrains) Add: 1-2 tbsp healthy fats (olive oil, avocado, nuts, seeds)
SMART SNACKS (if needed):
- Apple slices + 2 tbsp almond butter
- Veggie sticks + hummus
- Small handful nuts (10-15 almonds or walnuts)
- Hard-boiled egg + cherry tomatoes
- Greek yoghurt + cinnamon
DRINKS:
✅ Water (aim for 2 litres daily)
✅ Herbal tea (unsweetened)
✅ Black coffee or with dash of milk
❌ Soft drinks, fruit juice, cordial
❌ Alcohol (or limit to 1-2 drinks per week)

STEP 5: MOVE YOUR BODY STRATEGICALLY

RESISTANCE TRAINING: 2-3 TIMES PER WEEK (Non-Negotiable!)

Beginner Routine (15-20 minutes):

Squats: 2 sets of 10 reps (bodyweight or holding dumbbells)
Push-ups: 2 sets of 8-10 reps (on knees if needed)
Lunges: 2 sets of 8 reps each leg
Plank: 2 sets of 20-30 seconds
Dumbbell rows: 2 sets of 10 reps each arm

Progress gradually: Add 1-2 reps per week OR increase weight by 0.5-1kg when current weight feels easy.

Where to start:

YouTube: Search "beginner strength training for women over 50"
Local gym: Book 2-3 sessions with a personal trainer
Equipment: Start with 2-5kg dumbbells and resistance bands

DAILY WALKING: 30 MINUTES

After breakfast, lunch, or dinner (post-meal walks lower blood sugar by 10-15%)
Break into 3 x 10-minute walks if needed
Aim for brisk pace (should be able to talk but not sing)

OPTIONAL: HIIT 1-2 times per week

20-30 seconds high intensity + 1-2 minutes rest, repeated 6-8 times
Examples: Fast walking intervals, cycling, swimming, dancing

STEP 6: OPTIMIZE SLEEP & STRESS

SLEEP (7-9 hours):

Evening routine:

Finish eating 3 hours before bed
Dim lights 1 hour before bed
Keep bedroom cool (18-20°C)
Avoid screens 1 hour before bed
Try magnesium supplement (250-360mg) 1 hour before bed

STEP 7: DISCUSS HORMONE THERAPY

Questions to ask your GP or menopause specialist:

"Based on my symptoms and metabolic risk, am I a candidate for MHT?"
"What's the difference between oral and transdermal estrogen for insulin resistance?"
"How might MHT affect my blood sugar and diabetes risk?"
"What are the risks and benefits for someone with my health profile?"
"Can we trial MHT for 3-6 months and reassess?"

Research shows: Women on MHT have 20% lower incidence of type 2 diabetes. Transdermal estrogen (patches/gels) may have metabolic advantages over oral forms.

THE BOTTOM LINE

Every 10% increase in muscle = 11% reduction in insulin resistance risk

You have the power to change your metabolic trajectory. Start with ONE change today - whether that's changing your breakfast, booking that GP appointment, or doing your first resistance training session.

Insulin resistance is reversible. Take action now.

REFERENCES

Haver MC. The New Menopause: Navigating Your Path Through Hormonal Change. Harmony/Rodale, 2024.
Harper S, Bardwell E. The Perimenopause Solution: Take Control of Your Hormones. Ebury Publishing, 2021.
Bhatia T. The Hormone Shift: Balance Your Body and Thrive Through Midlife. Harmony/Rodale, 2023.
Gates N. The Feel Good Guide to Menopause. ABC Books, 2019.
Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin N Am 2019;46:501-514.
The NAMS 2017 Hormone Therapy Position Statement. Menopause 2017;24:728-53.

Disclaimer: This guide is for educational purposes only and should not replace personalised medical advice. Always consult your healthcare provider before making significant changes to your diet, exercise routine, or starting new supplements or treatments.