Do you have insulin sensitivity? If you are perimenopausal you are at a higher risk.

During perimenopause, estrogen and progesterone levels begin to decline. These hormonal changes can impact insulin sensitivity in the following ways:

1. Insulin resistance: Some women may experience a decrease in insulin sensitivity, leading to a condition called insulin resistance. Insulin resistance means that the body's cells become less responsive to insulin, resulting in higher levels of insulin in the bloodstream. This can lead to elevated blood sugar levels and an increased risk of developing type 2 diabetes.

2. Weight gain: Many women tend to gain weight or experience changes in body composition during perimenopause. This weight gain, particularly around the abdominal area, can further contribute to insulin resistance and impaired insulin sensitivity.

3. Metabolic changes: Hormonal fluctuations during perimenopause can also affect metabolism, including how the body processes carbohydrates and fats. This can lead to higher post-meal blood sugar levels and difficulties in maintaining stable glucose levels.

It is important to note that not all women will experience changes in insulin sensitivity during perimenopause. Individual variations in genetics, lifestyle factors, and overall health can influence how a woman's body responds to hormonal changes.

Personally I have gained weight over the past couple years even though my diet and activity levels have remained pretty consistent. Most of this weight gain has been in my midsection, like many women my age range. Learning about how perimenopause can impact my insulin sensitivity lead me to having blood work done and using a continuous glucose monitor to track my blood glucose levels. I am also working with a dietician to help with my food choices and timing of certain foods around the time of day and workouts.

A continuous glucose monitor (CGM) provides some valuable insights into your insulin sensitivity. By wearing a CGM, you can observe how your blood glucose levels fluctuate in response to various factors such as meals, physical activity, stress, and medication. This information can help you and your healthcare provider assess your insulin sensitivity and make informed decisions about your diabetes management or overall metabolic health.

Here's how a CGM can be helpful in evaluating insulin sensitivity:

1. Glycemic patterns: CGMs provide a detailed view of your blood glucose patterns over time, including post-meal spikes, fasting levels, and overnight trends. Consistently high blood glucose levels may indicate reduced insulin sensitivity, while rapid fluctuations could suggest problems with glucose regulation.

2. Glucose response to meals: By monitoring your glucose levels before and after meals, you can observe how your body responds to different types and amounts of carbohydrates. If your blood sugar remains elevated for an extended period after meals, it may indicate decreased insulin sensitivity.

3. Exercise and insulin sensitivity: CGMs can help assess how your blood glucose responds to physical activity. Improved insulin sensitivity often results in better glucose control during and after exercise, while decreased sensitivity may lead to greater fluctuations or difficulty maintaining stable levels.

While CGMs provide valuable data, it's important to remember that they measure interstitial fluid glucose levels rather than direct blood glucose levels. As a result, there may be slight discrepancies between CGM readings and traditional fingerstick blood glucose measurements. If you're considering using a CGM or have questions about interpreting the data, it's recommended to consult with a healthcare professional experienced in diabetes management or endocrinology. There are also a variety of companies that specialize in using CGMs with their platform for advice and guidance. Here are a few I recommend checking out: Supersapiens | Glucose Monitor For Metabolic Efficiency, Nutrisense - Smart insights into your unique body with CGMs & Personal Dietitians, and soon to be launched- Neutrally. They can guide you on using a CGM effectively to evaluate your insulin sensitivity and optimize your overall health.

Here are some other common methods used to determine insulin sensitivity:

1. Fasting blood glucose and insulin levels: A fasting blood test measures your blood glucose (sugar) and insulin levels after an overnight fast. Higher fasting blood glucose levels or elevated insulin levels may indicate reduced insulin sensitivity.

2. Oral glucose tolerance test (OGTT): This test involves drinking a glucose solution, followed by several blood sugar measurements taken over a period of a few hours. By assessing how your body handles a sudden influx of glucose, the test can help determine insulin sensitivity and the presence of conditions like impaired glucose tolerance or diabetes.

3. Hemoglobin A1c (HbA1c) test: This test measures the average blood sugar levels over the past 2-3 months. Elevated HbA1c levels indicate poorer blood sugar control and may suggest reduced insulin sensitivity.

4. Insulin resistance index: Calculated using specific formulas, the insulin resistance index provides an estimation of insulin sensitivity based on fasting glucose and insulin levels.

5. Hyperinsulinemic-euglycemic clamp: Considered the gold standard for measuring insulin sensitivity, this test involves a continuous intravenous infusion of insulin while maintaining blood sugar levels within a normal range. It measures how much glucose needs to be infused to maintain normal blood sugar levels and provides a direct assessment of insulin sensitivity.

To manage insulin sensitivity and mitigate potential risks, it is recommended to adopt a healthy lifestyle that includes regular physical activity, a balanced diet, and weight management. If you have concerns about your insulin sensitivity or are experiencing symptoms related to blood sugar regulation, it is advisable to consult with a healthcare professional for personalized advice and guidance.