Perimenopausal Glucose Diaries: Part I

What I learned about my body when I started using a CGM

I’ve been low-key venting about my perimenopausal weight gain for the past year, and alternately embracing my desire to get my health under control (It’s perfectly fine if I want to lose a few pounds, dammit!) and then apologizing for that fact (Please don’t report me to the Body Positivity Police!). The rollercoaster of it all is a fairly spot-on encapsulation of perimenopause. Hot and cold. High and low. I’m a living Katy Perry song.

I mentioned a month or so ago that I started monitoring my glucose with biosensors—aka, a CGM, or continuous glucose monitor. I decided to do this after my bloodwork had indicated increased glucose and a higher A1C twice in the past year. As so many midlife women do, I became my own detective/doctor (which sucks, and I am not bragging about this and actively wish women were not left to be our own health advocates) and put the pieces together. The clues:

1. I was 46 years old.

2. I had gained nearly 20 pounds in the past three years

3. The majority of the weight gain happened during the most stressful year of my life, after my divorce.

4. I have a history of diabetes in my family.

5. I was finally exploring HRT because of night sweats and more.

Conclusion: I had perimenopause-related insulin resistance

My doctors agreed. I was right on the borderline of having a prediabetes- level A1C—which measures your glucose levels over a period of three months—and with my family history and confounding weight gain, my doctor started me on Metformin. I was also on a low-dose estrogen patch as well as oral progesterone. My weight was not budging.

I am a fairly healthy eater—living in close proximity to Boulder, CO and being gluten-free are sort of prerequisites for being low-key crunchy, and I have tried to be especially tuned into how certain foods affect my system, not just whether they are “good” or “bad.” I have weird food allergies, an autoimmune swallowing disorder, and I deal with a lot of inflammation. So as a result, I am reasonably healthy and fairly nutrition-savvy.

To be fair, my exercise efforts had not been amazing since the divorce. Trying to get to yoga or go to the gym when you are the sole parent guiding your kids through an intense crisis while also suddenly trying to work full-time is laughable. I did my best. But since June, I have been consistently exercising again, with only “meh” results. I’ve lost a little weight, but I am feeling less stressed and sleeping better. Ramping up my exercise was not the panacea it was in my thirties. Neither was upping my intake of salmon and chia seed pudding (not together, ew). I think therein lies the dilemma with perimenopausal weight gain: Things that used to work suddenly do not.

I wanted the primary culprit of my midlife weight gain to be stress, a scapegoat I could shrug off along with a dozen pounds as my life stabilized. And my doctor corroborated that—she essentially said (as I wept) that the majority of my health issues over the past few years was likely due to stress. I thought once I could tame the cortisol, the pounds would disappear.

Like so many things about midlife, it was a bit more complicated.

Right now, I find it nearly impossible to disentangle the following factors as they pertain to my general health and wellbeing:

• ADHD

• Perimenopause

• Insulin resistance

• Single parenthood stress

And, fun fact, there is a direct link between estrogen and glucose levels: When your estrogen is fluctuating wildly, as it does during perimenopause, your glucose levels are going to do the same thing. And that sucks.

24/7 glucose monitoring: Say hello to my little friend!

So back to my CGM. Since June, I’ve been wearing glucose sensors—to be specific,
Stelo by Dexcom, used within the Nutrisense program. I did a lot of research before I chose a brand, and full disclosure, there are affiliate links in this post. I want to be transparent about that for a few reasons: 1. I love that I can keep this column paywall free, and working with brands is a helpful way for me to do that while also not going broke, and 2. I absolutely only promote products that I feel strongly about, and I’m going to be very honest about my experience.

That said, I am mildly obsessed with the Nutrisense program app. I think it is honestly the most productive tool I’ve found to help me understand what’s happening inside my body. There is 24/7 glucose monitoring via the app, and after tracking my data for the past two + months, I am finally figuring out some patterns that I never could have discovered without the continuous tracking.

Here are my key takeaways:

The foods that give me glucose spikes surprised me

One evening after dinner I went out for ice cream with my daughter, bracing myself for a spike. Nothing. Ice cream doesn’t seem to impact me as much as other foods, but also, having a full stomach after a protein and fiber rich dinner and walking around downtown with our ice cream may have helped. What shocked me? A “healthy” bowl of oatmeal sent my glucose skyrocketing. I was pissed. Same with rice or rice noodles. But I learned a few tricks about that as well:

Adding protein and fiber to every meal prevented spikes—so did eating frequently throughout the day

I had 24/7 data showing me the result of all my nutritional choices, and it was a really eye-opening way to keep me accountable. Having fried rice with shrimp and minimal veggies at PF Chang’s was a bad move. But a Chipotle chicken, black bean, and rice bowl with lettuce and salsa gave me enough protein and veggies to prevent a spike. Win! I also learned that if I mixed my steel-cut oats with protein powder, hemp/chia/flax seeds, dates, and apples, the fiber + protein kept my glucose stable.

Stress impacts my glucose. Big shocker.

I anticipated this would be the case, and it was true. Last week I drove to my new doctor’s office in downtown Denver for the first time, and when I arrived, my glucose was spiking, as was my blood pressure. The stress of driving in rush hour, parking someplace unfamiliar, and meeting a new doctor was something I couldn’t shield my body from. The body, as I enjoy cheekily commenting, does indeed keep the score.

I learned that I am actually experiencing hypoglycemia some of the time.

This blew my mind. I’m supposed to have an issue with my glucose being too HIGH, not too low! When I first began to notice readings that dropped below 70—labeled “LOW” on the app—I was so confused. Even after I started eating breakfast again and making sure to have frequent snacks, I would occasionally experience a significant drop. But as I’ve learned that glucose and estrogen wreak havoc together during perimenopause, it makes more sense. I’m working with my doctor on how to manage this. I spent the better part of the weekend with prolonged hypoglycemic episodes followed by periodic spikes. Some of this is still a mystery, but having information about my body that I can trust to be legit—the data doesn’t lie—helps a lot.

I can actually tell when my glucose is too high or too low.

Like, in my own body. Being able to check in the app to confirm what I’m feeling has been so validating—if I feel overly activated or flustered, it’s often a sign that I’m having a glucose spike, and when the data confirms it, it helps me realize I am in tune with my body’s signals. Alternately, when my glucose drops, I often feel tired, dizzy, clammy, and lose focus. It’s wild.

So those are the primary things I’ve learned, and I have to say, it has absolutely been worth it. I thought I might stop after a few months, but as my hormones and glucose continue to fluctuate in a baffling dance routine, I don’t think I’m quite done keeping tabs on it. I’m observing over time the impact of a few key lifestyle changes:

1. Eat breakfast. Even when I don’t want to.

2. Pay attention to the foods that affect my glucose levels, whether or not they are considered good/bad. Every body truly is different, and you can’t know how your meals are impacting your glucose unless you are monitoring your data 24/7.

3. Eat frequently throughout the day: I now eat smaller, regular meals rather than realizing it’s 1:30 pm and I haven’t gotten hungry yet all day (ADHD meds + hyperfocus mode makes this a real problem for me).

4. Add protein and fiber as much as possible in every meal.

As for the Nutrisense program itself? I love it, you guys. I really do. The Stelo by Dexcom sensors are super easy to use and the Nutrisense app integrates with them. It integrates with my Apple Watch too, so my sleep data and workouts are in there, and I can manually add my meals to see where they line up with spikes and dips. They also have nutritionists you can work with (they accept many major insurance companies, which is AMAZING), so you can actually have a professional work with you and tailor nutrition to you based on your data. It’s a pretty freaking cool program.

Whether you are diabetic or prediabetic or have insulin resistance or are perimenopausal and frustrated with weight gain, I think glucose monitoring is a truly useful tool. You know I’m incapable of lying, so believe me when I say, I really can’t recommend Nutrisense enough. If you use this link, you can save money and I’ll get a commission, too—winning! You can use the code MOTHERPLUS30 to save 30%, which is a lot.

If you have any questions for me, I would LOVE to answer them. So hit me in the comments, and if you are struggling with glucose/perimenopause/weight gain? I think this is a really great option to understand your body a little bit more.

In case you missed it and you’re curious whether using a CGM is tricky or painful or confusing, watch this delightful video of my oldest child helping me figure it out.

XO,
Steph

P.S. We *just* started The Artist’s Way for the Midlife Woman 12-week workshop, and our first lesson and meeting is Wednesday at noon EST, so there’s still time to join us here!

P.P.S. And my September shows are all listed here!