I am undergoing menopause. Can it worsen my diabetes?

Question

Hello doctor,

I am 47 and have been dealing with type 2 diabetes for five years now, but my blood sugars are completely out of control lately. My HbA1C came back at 10.8 last week, which is the highest it has ever been, and I am really scared about complications.

I started on Metformin 2000 mg daily, but it gives me terrible diarrhea and stomach cramps. The endocrinologist added Glipizide, but I keep having low blood sugar episodes where I get shaky and sweaty and have to eat candy.

My fasting glucose is usually between 180 and 220 in the mornings, no matter what I do. The worst part is, I think type 2 diabetes is affecting my eyes because things look blurry, and my optometrist saw some changes in my retina.

Also, I have tingling and numbness in my feet that keeps me awake at night. I gained 28 pounds since starting Insulin six months ago, and now my knees hurt from the extra weight. I am perimenopausal with irregular periods and hot flashes, which makes everything harder to manage.

I tried Ozempic for three months, but it made me throw up constantly, and I could not eat anything. My blood pressure is 172/94, even on two medications, and my kidneys are starting to show problems with protein in urine.

I really need help getting this under control before things get worse. Can hormones from menopause make type 2 diabetes harder to manage?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

What you are experiencing is understandably frightening, and your concerns are very valid.

An HbA1c of 10.8 % means your diabetes is currently uncontrolled, and the symptoms you describe, such as blurry vision, tingling and burning in the feet, and protein in the urine, suggest early complications that need urgent but careful management.

Menopause and perimenopause absolutely can make type 2 diabetes harder to control because fluctuating estrogen levels increase insulin resistance, worsen weight gain, disrupt sleep, and raise blood pressure, all of which push blood sugars higher.

The diarrhea from high-dose Metformin and the low sugars from Glipizide indicate that your current regimen is not well tolerated, and recurrent hypoglycemia is dangerous and should not be accepted as normal. Insulin can be necessary but often causes weight gain, which then worsens insulin resistance and joint pain, creating a vicious cycle.

Since Ozempic (Semaglutide) caused severe vomiting, other options such as lower dose GLP-1 (glucagon-like peptide-1) receptor agonists with slower titration, dual GLP/GIP (glucose-dependent insulinotropic polypeptide) agents, or SGLT2 (sodium-glucose cotransporter 2) inhibitors may be considered as they can lower sugar, help with weight, protect the kidneys, and reduce blood pressure.

Your high blood pressure and urine protein mean kidney protective medications and tight pressure control are essential. The eye changes, and nerve symptoms emphasize that glucose control needs to improve soon, but safely and gradually.

This is a situation where close follow-up with endocrinology, medication adjustment, nutrition support, and possibly diabetes education are critical. Seek urgent care immediately if you have severe low blood sugar, chest pain, sudden vision loss, or shortness of breath.

With the right combination of medications, menopause aware care, and support, it is very possible to regain control and slow or even stabilize complications.

I hope this helps.

Regards.