Coping with diabetes through menopause
Hot Flush spoke to Claire Duncan an Animas 'One Touch Hero' about coping with her diabetes in peri menopause.
Claire’s involvement with the greater world of diabetes started through her association with the makers of the Animas Insulin Pump (part of Johnson & Johnson). She took part in the launch of their newest waterproof insulin pump by joining a team of type 1’s to swim a relay across the English Channel (a great way to prove beyond doubt that the pump was waterproof!). She then became an 'Animas Hero' (an ambassador for the company) and as such has participated in many sports and diabetes weekends, Claire says "I have a love of endurance sports from marathons to Ironman triathlons and long bicycle adventures". She's done several events at hospitals as an 'expert patient', training new pump educators in the hospital diabetes department. She also gives presentations to hospital staff and diabetes company employees and other diabetics about the use and impact of their products.
HOT FLUSH: Can you tell us about your diabetes diagnosis and how it’s impacted on your life?
CLAIRE: I was diagnosed with type 1 diabetes at the age of 23. I had the classic symptoms of extreme weight-loss, thirst and lethargy. I eventually went to the GP as I had a blocked hair follicle that refused to heal. I was sent to hospital for day surgery which involved a routine pre op blood test and the first I heard of my diabetes was getting a telling off from the nurse for not having my blood glucose levels under control! I skipped the surgery and went straight to the Diabetes department and had my first injection of insulin there and then.
My initial feelings were “well that explains why I’ve been feeling so rubbish and at least this can be treated”. After a few hours of hanging around the hospital waiting room however, I began to panic about the most common complications, blindness (diabetes is the biggest cause of blindness) and amputations. Luckily, the results of a 10-year study had just been released (DCCT study) which suggested that if you can keep fit and healthy with good blood glucose control, diabetes complications were not a forgone conclusion. Hence my love of exercise began and I educated myself on nutrition.
HOT FLUSH: Have you had any scary moments being diabetic?
CLAIRE: Yes, many scary moments! I suppose in the short term; bad hypos can be scary (hypoglycaemia / low blood sugar). If your body is short on fuel, your brain literally starts to shut down in order to preserve the main organs. Symptoms of this include slurred speech, double vision, lack of physical coordination and difficulty in thinking. This is most terrifying when it happens at night as when I am asleep I miss the early warning signs and I wake up very confused and disorientated, often thinking my dream is real life! Long term, I worry about each set of test results at my diabetes MOT, with the fear that the complications are starting.
HOT FLUSH: Are you pre, peri or post menopause and what, if any symptoms have you had to cope with?
CLAIRE: I am 48 and I suppose peri menopause is the best description of where I am currently at. My periods are a little erratic (currently about every 3 weeks) and my hormones are fluctuating, so yes, insulin also being a hormone, my requirements for insulin are fluctuating too.
HOT FLUSH: Have you experienced any of the more typical symptoms that can adversely impact on women with diabetes?
CLAIRE: I am finding that I am struggling to stay asleep these days and I miss the fact that I am no longer a heavy sleeper, it is extremely frustrating being so tired and wide awake! I am also finding I have to work harder at keeping my weight under control and I am currently a stone heavier than this time last year. The fluctuation of oestrogen and progesterone levels makes a huge difference with my insulin requirements and at times I can need double my usual dose. I can adjust my insulin myself using my insulin pump but it is not predictable each month and I can only work out the correction once it has started to shoot off the scale in the first place. This can lead to exhausting days of chasing high and low blood sugar readings which makes me feel lethargic and grumpy! I am sure everyone has days where they feel they have more or less energy but I am chasing that with extra insulin or carbohydrates to try and keep my energy levels on an even keel. The insulin dosage can be a difficult equation and it has often been joked about that a menopausal diabetic’s insulin requirements should be on the PHD mathematics syllabus!
HOT FLUSH: Do you check insulin levels more regularly than before?
CLAIRE: I have always checked my blood sugar levels (and the necessary insulin dose) several times a day. The main difference now is that I use a CGM (Continuous Glucose Monitor) at times when I am finding control difficult. This is a small implantable sensor that estimates a blood glucose reading every 5 minutes and sends the information to me via a radio frequency that I can read on my insulin pump. This allows me to set alarms to let me know when I am going out of my target range, essential for sports time or holidays when I am not sure what I am eating. I am extremely lucky that I have had a good education in how to use this newer technology through a few courses I have been lucky enough to participate in and I am very grateful for it!
HOT FLUSH: What, if any, lifestyle changes have you made in light of menopause?
CLAIRE: As ever in my life as a type 1 diabetic, sport and diet form the basis of keeping a healthy lifestyle. There are a few changes I have made with peri menopause in mind. I have massively upped my protein intake (I read an interesting book called “Roar” by Stacy Sims that talks a lot about women and nutrition, including changes through the menopause). I have also added weights to my exercise routine to try and offset decline in muscle mass and I allow myself greater recovery time as I definitely don’t bounce back like I used to!
HOT FLUSH: Have you sought any specific medical advice for managing menopause?
CLAIRE: I have spoken to my diabetes consultant about changes I have noticed. She is about the same age as me and so was an understanding ear! My consultant was also able to educate me a little more on the effect of the hormonal changes and what I might expect with regard to my insulin requirements.
HOT FLUSH: Have you got any advice for other women on coping with diabetes through menopause?
CLAIRE: Knowledge is power! Read all you can and gain from others experience. You cannot prevent the changes that are happening but you can try to understand them and arm yourself with different tactics to deal with them. There are some great forums out there, I refer to several Facebook groups to ask questions or pick up tips if I feel the need. I also monitor things more closely in terms of cause and effect, it is odd that there are many references to the effects of grief or stress on the body and the impact on your diabetes but not so much on menopause. Acknowledge that it is a real physical and psychological issue and give it the respect and time it deserves in your treatment regime.
Find out more about Claire Duncan's involvement with Animas as an endurance athlete and "one Touch Hero".