26. Perimenopause, Insulin Resistance & Diabetes Explained

November is Diabetes Awareness Month, and we’re digging into why midlife women are uniquely vulnerable to blood sugar swings—and how to take back control. We cover how declining estrogen and progesterone increase insulin resistance in perimenopause/menopause, the link between type 2 diabetes and brain health (why Alzheimer’s is sometimes called “type 3 diabetes”), early warning signs to watch for, and the simple daily habits that stabilize glucose without cutting all carbs. You’ll learn the “protein + fiber + healthy fats” plate, smart swaps (oatmeal and potatoes done right), the best movement for glucose control, and how sleep, stress, and even kindness influence your numbers. We wrap with a doable weekly challenge to help you glow—without the blood sugar rollercoaster.

Chapters / Timestamps

00:00 Welcome + why Diabetes Awareness Month matters for midlife women
01:00 Perimenopause hormones → rising insulin resistance (estrogen/progesterone)
02:15 Type 1 vs. Type 2 diabetes—quick refresher
03:10 The blood sugar rollercoaster: cravings, crashes, brain fog, “hangry”
05:05 Kids as a mirror: sugar highs → meltdowns (what it teaches us)
06:25 “Type 3 diabetes”? Insulin resistance & the brain + Alzheimer’s risk
07:45 Spot the signs: skin tags, acanthosis nigricans, hair changes, waist size, BP
10:00 Reactive hypoglycemia explained (and why you feel “off” a few hours post-meal)
11:00 How to eat in midlife: protein + fiber + healthy fats (no, you don’t have to cut all carbs)
12:15 High-glycemic culprits & smarter strategies (order of eating; oatmeal/potato tips)
15:45 Movement that helps: walks after meals, strength training, plus a weekly mix
16:55 Sleep & stress: how one rough night (or chronic cortisol) spikes glucose
18:15 Can you reverse prediabetes? Lifestyle wins & hope-forward science
19:30 Your midlife glucose playbook (food, fiber goals, movement, sleep, stress)
21:50 Track what matters: journaling vs. CGM + Nicole’s CGM Blueprint
22:30 World Kindness Day: why kindness lowers stress (and supports metabolism)
23:30 Weekly challenge & wrap: one small step to stabilize blood sugar

📌 Resources:
🍫 Healthy Sugar-Free Desserts Guide → subscribepage.io/healthy-desserts-guide
📘 CGM Blueprint: A Guide to Using

Transcript

Alicia: 0:00

Hey there. Welcome back to Midlife and Glowing. Alicia.

Nicole: 0:02

and I'm Nicole. And since November is Diabetes Awareness Month, we thought this was the perfect time to have a conversation about something that impacts so many women in midlife, blood sugar, and how it can even affect your brain health.

Alicia: 0:16

Yes. Because here's the thing, midlife is when our risk for both diabetes and Alzheimer's really starts to climb. And what's fascinating is that Alzheimer's is also referred to as Type three diabetes because of its link to insulin resistance in the brain, which we touched on briefly in our Brain Health episode.

Nicole: 0:34

Right, but don't worry, this isn't about doom and gloom. This is about awareness and action. Because when you understand what's happening in your body, you can take steps to protect yourself. That's what today is all about.

Alicia: 0:46

So let's start with why this conversation really matters for women in perimenopause and menopause. Nicole, I know you talk about this a lot. What's happening with our hormones that makes us more vulnerable?

Nicole: 0:58

That's a great question. So as estrogen levels start to decline in perimenopause, our bodies naturally become more insulin resistant. Estrogen helps our cells stay sensitive to insulin, so when that hormone drops, our blood sugar tends to spike higher and crash harder.

Alicia: 1:15

Which explains why so many women suddenly feel like their metabolism just broke in midlife.

Nicole: 1:20

Yeah, exactly. This dip in estrogen and increase in insulin resistance manifests as more cravings, energy dips, and brain fog. And here's a stat that really hits home. Nearly 50% of adults over 45 either have type two diabetes or pre-diabetes according to the CDC. That's half of adults in the us.

Alicia: 1:40

Oh, that should actually really be a wake up call. Now, I know there's different types of diabetes. Can you explain the difference between type one and type two?

Nicole: 1:48

Yes. Type one diabetes is actually an autoimmune disorder that typically is discovered in children, although it can present later in life too. And type two diabetes is typically brought on by lifestyle choices, specifically over consumption of refined carbohydrates like sugar. I know I just mentioned estrogen, but progesterone can play a role in blood sugar regulation as well. Progesterone is also involved in our metabolic health. So there's a couple different factors for women in midlife that we're kind of coming up against, but let's do a quick refresher on blood sugar because I think it's important to really understand this. So insulin is the hormone that helps move glucose or sugar from your bloodstream into your cells to be used for energy.

Alicia: 2:33

But when your body becomes insulin resistant, your cells stop responding well to insulin, right?

Nicole: 2:38

Yes, and that results in glucose building up in your blood instead of being used properly. Over time that leads to pre-diabetes and then type two diabetes. And even before you get to that point, you feel it through mood swings, cravings, fatigue, brain fog, and stubborn weight gain. By the time pre-diabetes shows up, insulin resistance has likely been present for several years, if not a decade or more.

Alicia: 3:02

And for midlife women, it's like the double whammy. Your hormones are shifting and your blood sugar is bouncing all over the place.

Nicole: 3:09

Yeah, and I've mentioned before that where your blood sugar goes, your energy and mood follow, so you feel it. You bounce around from that anxious high blood sugar, energy and mood to the hangry type of low blood sugar, energy and mood. So it feels like quite a rollercoaster.

Alicia: 3:26

I've definitely experienced that. You know, I didn't used to be a big breakfast person, so I was running on. You know, basically caffeine,

Nicole: 3:35

Yeah.

Alicia: 3:36

and strong will. Uh, but you know, it was kind of like the joke, you know, we got to spend a lot of time I've talked about with our hockey families and you know, the ladies always knew that, okay, Alicia's getting a little hangry. We better get her something to eat. And I did it to myself. You

Nicole: 3:52

Yeah.

Alicia: 3:53

I was doing it to myself. So I definitely can relate. And it's a terrible feeling, you

Nicole: 3:59

Oh yeah.

Alicia: 3:59

like shaky and like you're gonna faint or like your head is floating in the clouds. It's, it's not a pleasant feeling. And it is easily fixable with a little preparation. So,

Nicole: 4:13

Yeah,

Alicia: 4:13

you know, and one of my children definitely takes after me this way, but he doesn't so much do it to himself, but we can always tell when he's hungry. Like he is a different person when he's hungry. So, you know, that Snickers commercial, like I can totally relate.

Nicole: 4:28

yeah, totally Chris and I'll do that to each other too. Oh man. You're cranky. You better eat. Get in there and eat something. Uh, but yeah, I mean, really when you think about kids are the absolute perfect depiction of what blood sugar swings look like. We all know what a kid hopped up on sugar, looks like, right? Like they're on that sugar high. They are like maniacs, they're running all over the place, right? That anxious type of energy it's kind of crazy, you know, like, and then when their blood sugar crashes, because when you have a spike like that, it comes crashing down and it goes too far, so then you end up with low blood sugar and that's what that hangry feeling is about. It's your body saying, need sugar now'cause it's too low. Need to get that up. And when kids' blood sugar crashes, that's when you get the meltdowns so, you know, if you wanna know what it looks like, just look at what happens to kids when they get sugar. That's exactly, and we can feel that in ourselves too when we do that. So,

Alicia: 5:31

And the crazy thing is a lot of the sugary treats.

Nicole: 5:37

Yeah.

Alicia: 5:38

and snacks and things, they're like marketed towards children. Like, here feed your child this like, sugar filled granola bar or whatever. And it's like we're, it's not great.

Nicole: 5:51

no.

Alicia: 5:51

not great. You know, I think that we need to focus less on sugar

Nicole: 5:57

yeah,

Alicia: 5:57

for snacks for our children, you know, and,

Nicole: 5:58

a hundred percent.

Alicia: 5:59

again, that preparation,

Nicole: 6:01

Mm-hmm.

Alicia: 6:02

might take a little bit more preparation to

Nicole: 6:04

Right.

Alicia: 6:05

unfortunately get your hands on something that's healthier for them because

Nicole: 6:09

Mm-hmm.

Alicia: 6:10

not a lot of the easily accessible items that you can get in a store are stuff you should really be

Nicole: 6:16

Right? Yeah. Yeah. It's true. Now let's talk about why Alzheimer's is sometimes referred to as type three diabetes. And we did talk about this before, but it's because insulin resistance doesn't just happen in your muscles or your liver. It can also happen in the brain too.

Alicia: 6:32

And that means that your brain isn't able to use the glucose for energy as efficiently.

Nicole: 6:36

Exactly. And the brain is hungry. It uses about 20% of your body's energy when it can't get the fuel it needs, you see memory issues, cognitive decline, even higher risk for Alzheimer's disease. In fact, studies show that people with type two diabetes have about a 60% higher risk of developing Alzheimer's.

Alicia: 6:55

I mean, that's sobering,

Nicole: 6:56

Yeah,

Alicia: 6:57

but it also shows how connected everything is. You know, taking care of your blood sugar isn't just about your waistline or your energy. It's literally about protecting your brain.

Nicole: 7:06

yeah. It is, absolutely. So before we get into some practical tools we can implement to support better blood sugar control and reduce our risk, let's answer some common questions on this topic.

Alicia: 7:17

Okay, what are the early warning signs of insulin resistance that I should be looking for?

Nicole: 7:22

Well, let's first talk about physical signs, things that you can actually see happening with your body that are associated with insulin resistance. First up. Skin tags. These are soft fibromas or little outgrowths on the skin, and they're a benign skin condition, but they're associated with insulin resistance. Another telltale sign of insulin resistance is areas of velvety darkened skin that most often occur around the neck, the groin, and the armpits. The technical medical term for this is acanthosis nigricans. Hair abnormalities can be an indicator of insulin resistance too. Specifically something called androgenetic alopecia and hirsutism. In women, the way that androgenetic alopecia shows up is diffuse hair loss, but most of the thinning is concentrated on the crown of the scalp, and then hirsutism is excess body hair in a male pattern in women, which includes increased hair growth on the chin, the upper lip, the abdomen down the midline of the abdomen and the area around the nipples. abdominal obesity is also associated with insulin resistance. Obesity concentrated in the abdominal region is due to an increase in fat storage around the organs. So this type of fat comes with an increased risk of many chronic diseases including diabetes, cardiovascular disease, and cancer. Waist circumference is often used as an indirect measure of abdominal obesity, so for women, a waist circumference greater than 35 inches is a sign of abdominal obesity, which again is associated with insulin resistance. Hypertension, which is high blood pressure, and even pre-hypertension, which is borderline high blood pressure, is another potential sign of insulin resistance. Normal blood pressure is less than a 120 over 80 millimeters of mercury. So essentially everything over that would fall into the category of either pre-hypertension or hypertension and would be a potential indication of insulin resistance. Now let's talk about a few symptoms of insulin resistance. The severity of symptoms can vary depending on how long the insulin resistance has been there. If it's just starting, you might not notice major symptoms, but as it progresses, there are two symptoms in particular that you should be aware of. The first is intense cravings, especially for sweets. And the second is reactive hypoglycemia. So what is reactive hypoglycemia? Hypoglycemia means low blood sugar. So it's basically a blood sugar crash that often happens a few hours after eating. So it essentially happens shortly after a blood sugar spike, and it comes with a collection of symptoms which include fatigue, headaches, hunger, irritability, and that combination of hunger and irritability that we talk about hangry, feeling hangry. That is a symptom of reactive hypoglycemia. As is anxiety, tachycardia, which is rapid heart rate, confusion, brain fog, weakness, feeling lightheaded or dizzy, nausea, and even more severe symptoms like impaired vision, decreased coordination and seizures are associated with low blood sugar. But essentially, if you routinely feel crummy a few hours after eating, or you feel like you need to eat every few hours to avoid feeling crummy. That could be an indication of insulin resistance. Your body is not regulating your glucose effectively.'cause that is one of the jobs of insulin.

Alicia: 10:54

Okay, so what's the best way to eat for stable blood sugar in midlife? Do I have to cut out all the carbs?

Nicole: 11:01

No, you absolutely do not need to cut out all carbs. While large amounts of refined and processed carbohydrates are associated with insulin resistance and type two diabetes, there are a lot of complex carbohydrates that are really good for you. Complex carbohydrates are gonna be your major sources of fiber in your diet too. So, to answer this question, if we make things really super simple, the best way to eat for stable blood sugar in midlife is to focus on protein, fiber, so those complex carbohydrates, and healthy fats. At every meal make sure you have your source of protein, your source of fiber, and some healthy fats. We often try to make. nutrition complicated, but it can be super simple. Pair a healthy protein source like grass fed beef, salmon, chicken, Turkey, eggs. Pair that with veggies and then use grass fed butter, tallow or avocado oil for cooking or drizzle olive oil over your veggies afterwards. If you have half an avocado with your meal, maybe. Something along those lines, but that's simple, easy, delicious, and healthy, and it keeps your blood sugar stable. But a big part of eating in a way that stabilizes blood sugar is avoiding the things that spike blood sugar. Things like sugar, sugary drinks, juice, white bread, pasta, rice, instant oatmeal, baked goods. Packaged snacks, cereals, chips, crackers, even high glycemic fruits and vegetables like dried fruit, bananas, mangoes, pineapple, watermelon, dates, potatoes, corn. Those are all examples of high glycemic fruits and vegetables that can spike your blood sugar. Now, I will say also there's a couple things. Number one, something to know about potatoes that can be helpful if you cook them and cool them and eat them cooled. Think like potato salad or we've got a spiced sweet potato pudding recipe on our website. Some of the carbohydrate turns into something called resistant starch, which functions more like fiber, and that is going to actually support better blood sugar regulation. So the way you eat potatoes can impact whether or not it spikes your blood sugar. But I will also say that when it comes to fruits and vegetables that I just mentioned. If you eat them alone, they can spike your blood sugar, but you can also keep your blood sugar more stable if you pair those higher carbohydrate items with a protein, fat, and fiber. And you can also improve blood sugar regulation by when you eat those high glycemic fruits and vegetables or high glycemic foods. So if you start your meal with protein healthy fats. Or fiber, the more high fiber complex carbohydrates, things like broccoli and leafy greens and things like that, you can actually minimize the spike that would come from those high glycemic foods. Okay, so let's just say, let's use oatmeal as an example, because I think people think of oatmeal as, you know, this really healthy item, and I'm not saying it's not healthy, but it actually can spike your blood sugar if you eat just oatmeal at a meal. You know, there's not a whole lot of protein in there. And yes, it does have some fiber, but it's actually not a huge amount. so if you were to just have a meal of oatmeal and you take a look at your blood sugar, you would see your blood sugar is gonna spike. if you take eggs and you eat your eggs before your oatmeal and then you have your oatmeal, that can minimize or decrease how high your blood sugar is gonna spike from that, and also how low it would crash afterwards too, because that protein is gonna keep that blood sugar much more stable for longer than a carbohydrate. So, those are just a couple tips and things that you can think about when thinking about how to eat in a way that keeps your blood sugar nice and stable, because that's gonna impact your energy, your mood, your metabolism, and so many other things.

Alicia: 15:03

Okay, next question. Can exercise really improve my blood sugar? And if so, what type is best?

Nicole: 15:09

Yes, absolutely. It definitely can. And I would say the type that's best is the type that you'll do consistently, right? Moving your body, using your muscles is the key, because your muscles are what utilize glucose. It's gonna pull the glucose out of your bloodstream and into your cells to be used. So it's gonna help reduce that blood sugar spike. So moving your body is the key. It doesn't have to be intense. Just 10 minutes of light intensity walking after meals significantly improves blood sugar regulation and lowers insulin. But strength training is fantastic because it not only burns excess glucose in the moment, it also reduces insulin and increases muscle mass, which supports long-term blood sugar regulation. So any type of exercise is great, but we've touched on this many times. The ideal exercise regimen for midlife women should include strength training for the reasons that I just mentioned. It increases the muscle mass and that is huge for midlife women. And it also supports, you know, things like better bone density. So strength training, three to four days per week, high intensity interval training, one to two days per week. And doing that high intensity interval training. In short bursts like that, your fat burning capacity is increased for like, I think 48 hours afterwards. So one to two days per week of that, and then moving throughout the day. So maybe you're aiming for seven to 10,000 steps a day, something like that. And if you don't wanna keep a specific count, just stay active. If you find yourself sitting, you know, try to get up once every hour and just walk around for a few minutes.

Alicia: 16:43

So how do stress and sleep fit into blood sugar control? You know, I never realized they were connected.

Nicole: 16:50

Yes, absolutely both stress and sleep can have a huge impact on blood sugar control. Lack of sleep can lead to insulin resistance, making it harder for your body to regulate your sugar levels. Studies show that even partial sleep deprivation over one night can increase insulin resistance. So it, it definitely has an impact. Lack of sleep also messes with your hunger, hormones, and gut health, which leads to increased cravings, and then stress can lead to spikes in blood sugar too. When we are stressed, our body releases cortisol and adrenaline, which can cause blood sugar levels to rise. Stress also often leads to emotional eating. And what do we often turn to? Comfort foods, which are often high in sugar, stress can lead to inactivity as well. When we're stressed, we're less likely to exercise, which is crucial for managing those blood sugar levels. And chronic stress can also weaken the immune system, making you more susceptible to infections, which can affect blood sugar levels as well.

Alicia: 17:47

So is it too late to make changes if I've already been told I have pre-diabetes, can I actually reverse it?

Nicole: 17:54

It's never too late. It's never too late. It really isn't. I mean, if you've been told you have pre-diabetes, I mean when would've been the best time to address it? Yeah. I mean, probably five to 10 years ago when the insulin resistance started, but here we are. You have pre-diabetes, it hasn't crept to the point of diabetes yet you absolutely can reverse it and you can even reverse diabetes. The American Diabetes Association, I wanna say in 2018, came out with a new position paper and acknowledged that type two diabetes is reversible with lifestyle. So you absolutely can. And the dietary changes that I mentioned are the best place to start. Dietary changes, exercise, we always talk about like health is a function of the things that we do daily and it's, you know, we talk about those simple little things, you know, health can often be very boring. You know, like it is just those, those basic things, like getting a good night of sleep makes a big difference in a lot of areas. Your brain health, but also blood sugar regulation and that impacts, you know, so many things that we're talking about here. So yes, if you've been diagnosed or you've been told you have pre-diabetes, you can absolutely reverse it. It's not a life sentence.

Alicia: 19:11

All right, so let's talk solutions. What can women actually do?

Nicole: 19:15

The good news is there's a lot we can do. First up nutrition, make protein the centerpiece of every meal. Pair it with fiber, rich foods and healthy fats to slow the release of glucose into your bloodstream. Think salmon with roasted veggies or eggs with avocado and greens.

Alicia: 19:31

Don't forget fiber. Most of us are getting nowhere near the recommended 25 to 35 grams of fiber. Fiber not only stabilizes blood sugar, but it also feeds your gut microbiome, which plays a role in metabolism and inflammation. So load up on beans, lentils, berries, leafy greens, cruciferous veggies.

Nicole: 19:51

And for most people, sweets are what get us in trouble. So we created a healthy sugar-free desserts guide that walks you through healthier sweeteners and other ingredient swaps and shares seven mouthwatering dessert recipes. We're talking angel food cake, peanut butter cookies, fudgy brownies to name a few. It is possible to enjoy treats that won't send you on a blood sugar Rollercoaster ride. And movement is next. It doesn't have to be extreme. A walk after meals can help lower blood sugar by pulling glucose into your muscles. Literally just short 10 minute walks post meal are a great way to support better blood sugar control and strength training is especially powerful because more muscle mass means better glucose control overall. So don't skip out on the strength training. It's great for bone density and muscle mass, and it's associated with better long-term health.

Alicia: 20:41

And as we said, poor sleep makes your body more insulin resistant the very next day, and in midlife when sleep is already tricky. This is an area worth protecting.

Nicole: 20:50

Yes. Not only does poor sleep make you more insulin resistant, it also increases cravings for those unhealthy foods like we talked about. So sleep has to be a priority in this stage of life. The benefits are endless. And finally stress. Cortisol, that stress hormone literally raises your blood sugar, which means if you're running on stress 24 7, your body can spike glucose even without food. Stress management isn't optional. It's part of blood sugar balance and, like sleep, important for so many aspects of overall health in midlife.

Alicia: 21:21

I feel like we should add one more, tracking. Whether it's a continuous glucose monitor or just journaling how your energy feels after certain meals. Tracking helps you connect the dots.

Nicole: 21:32

Yes, because what spikes one woman might not spike another. Knowledge is power here. Doing a food journal for a few days or weeks to get an idea of what your patterns are can be really powerful. If you do want to explore glucose tracking with a continuous glucose monitor that can provide so much insight into how your lifestyle is impacting your glucose levels. If you don't know where to start, I wrote an ebook called the CGM Blueprint, A Guide to Using Glucose Data to Supercharge Your Metabolism and Boost Energy. So we'll make sure that that's linked in the show notes.

Alicia: 22:02

And now since World Kindness Day falls in November, can we talk about kindness for a second?

Nicole: 22:08

This might seem unrelated, but hear us out. Acts of kindness have been shown to lower blood pressure, reduce stress hormones, and even improve heart health. And since stress and cortisol are so tied to blood sugar, kindness actually plays a role in metabolic health too.

Alicia: 22:22

I love that, and I think kindness to yourself matters just as much because let's be real, sometimes we're so hard on ourselves about what we eat or how we exercise. Self-kindness actually makes it easier to stay consistent.

Nicole: 22:34

Yes, for sure. You can't shame yourself into better health, but you can support yourself with compassion, and that's the energy that keeps habits sustainable.

Alicia: 22:43

So to wrap this up, midlife is the season where blood sugar balance matters more than ever. It impacts your energy, your hormones, your weight, and yes, your brain health.

Nicole: 22:53

And the tools we talked about today, protein, fiber, movement, sleep, stress management, even a little kindness are powerful ways to support both your metabolism and your memory.

Alicia: 23:05

So here's your challenge this week. Choose one area to focus on. Maybe it's adding protein to breakfast. Maybe it's a 10 minute walk after dinner. Maybe it's lights out by 10.

Nicole: 23:15

And if you need more ideas, don't forget to download our Daily Glow Rituals Guide. We'll link it in the show notes. It's full of quick hormone supportive practices. You can start right away.

Alicia: 23:25

Thanks for joining us today. We'll be back next week with more ways to glow through midlife.

Nicole: 23:29

Until then, take care of yourself and keep glowing.