Health Topics

4 Tips to Keep Fit Through Menopause

Decrease Your Risk of Diabetes and Pre-Diabetes in Midlife

Struggling to Keep Fit Through Menopause

Keeping off those extra pounds is an ongoing battle for many women. And it only gets more challenging as we enter menopause.

It’s just the way we’re made. Female hormones tend to promote fat formation. That means our bodies store fat more easily than men’s bodies. As we get older, our metabolism slows, enabling even more weight gain. And as we lose muscle mass (beginning at age 40), body fat often takes its place. As we age, we need to do more to combat these changes.

Why not let nature take its course? Because being overweight — at any age — generally means you have higher cholesterol and higher blood pressure. These increase your risk for a variety of diseases, including this biggie: diabetes.

What is diabetes?

Diabetes is a disease in which you have high levels of glucose (sugars and starches from the food you eat) in your blood. In type 1 diabetes, your body doesn’t produce enough insulin. In type 2 diabetes, your body actually produces too much insulin but your cells don’t react to it as well. Both types can occur at any age, but type 2 commonly occurs in people who are overweight or who have a family history of the disease.

Insulin is an important chemical that takes glucose out of your blood and feeds it to your cells, energizing your body. If insulin isn’t available or isn’t working, sticky glucose builds up in your blood.

That’s not good. Over time, impaired circulation of blood to your organs and tissues can result in the following:

  • heart attack
  • stroke
  • kidney failure
  • blindness
  • amputation

But you don’t need to have full-blown diabetes to experience these complications. There’s something called prediabetes that also threatens your health.

Prediabetes: A Wake-Up Call

Prediabetes is when your blood glucose levels are higher than normal — but not yet high enough to be diabetes. Still, your risk of heart attack is 1.5 times higher than normal. (It’s two to four times higher with diabetes.) And long-term cardiovascular damage may already be happening.

According to the American Diabetes Association, people who develop type 2 diabetes almost always have prediabetes first. Without preventive measures, prediabetes can become full-blown type 2 diabetes in three to 10 years. This doesn’t always have to happen. Not when prediabetes is viewed as a wake-up call for adopting a healthier lifestyle.

Steps to Lower Your Diabetes Risk

Many people can prevent diabetes — even if they have a family history of the disease. Maintaining a normal body weight is key.

Here are some things you can do to protect yourself from developing type 2 diabetes or prediabetes:

Get a blood test

Blood sugar tests are as important for mid-life women as regular mammograms and bone density screenings. Have one every three years, starting at age 45, so you can track your scores and offset any warning signs of diabetes right away. Start earlier if you:

  • Have a family history of diabetes
  • Have high blood pressure or high cholesterol
  • Had gestational diabetes
  • Gave birth to a baby weighing more than 9 pounds

These factors below increase your risk of developing type 2 diabetes:

Diabetes is diagnosed when:

  • Hemoglobin A1c levels are 6.5 percent or more
  • Fasting blood sugar is 126 or more, or a glucose (sugar) level two hours after eating is 200 or more

Prediabetes is diagnosed when:

  • Hemoglobin A1c levels are 5.7 to 6.4 percent
  • Fasting blood sugar is 100 to 125
  • Two-hour glucose is 140 to 199 after a glucose challenge

Lose a few pounds

Dramatic weight loss isn’t always the goal. Losing just 10 to 15 pounds will help. You can cut your risk of diabetes in half if you begin the following steps:

  1. Eat a low-carbohydrate, low-fat diet. Special “dietetic” or “diabetic” foods aren’t necessary. Eat mostly fresh fruits and vegetables, whole-grain breads and cereals, skim milk and yogurt, and lean meats. Limit soda, sweets, snack foods, fruit juices and alcohol. Avoid pitfalls like juicing and protein supplements.
  2. Walk briskly or do moderate-to-intense exercise 35 minutes a day, five days a week. Not a walker? Then swim, dance, lift weights or do other activities that keep you moving. Lifting light weights and doing activities that develop your muscles can boost your metabolic rate and help your body burn extra calories even when you’re at rest.
  3. Do yourself a favor by not hopping on the scale every day. Don’t obsess. Of course you may be slightly heavier after an indulgent weekend or big dinner. Just weigh yourself once a week and track your progress on a calendar or chart. Choose the same day and time every week (e.g., Wednesday mornings).
  4. Set small, easily attainable goals (e.g., “I will walk for 10 minutes once a week” rather than “I will lose 20 pounds”) and celebrate when you achieve them. Set timelines for yourself and build on your successes by adding to your goals week by week.

Lifestyle Changes Lower Diabetes Risk Best

While there are drugs that can lower your blood sugar, lifestyle changes actually work best — lowering your risk of developing full-blown diabetes by more than 50 percent. Metformin, a first-line antidiabetic drug, also works well and lowers the rate of developing diabetes by 30 percent.

If you do have diabetes, it is best to use medication to control it and to help prevent complications. However, diet and exercise are still important pieces.

Lifestyle changes can do a lot more than help to prevent diabetes. They can help to improve your heart and blood pressure, reduce your cholesterol and lower your risk of some cancers, not to mention help you look and feel better at midlife and beyond.

Andrea Sikon, MD, Chair of Cleveland Clinic’s Department of Internal Medicine, offers women’s health consultations in Cleveland Clinic’s Center for Specialized Women’s Health. To schedule an appointment with her or another women’s health specialist, call 216.444.4HER or visit