Diet & Lifestyle Tips for Women in Perimenopause & Menopause with T1D

Hormonal fluctuations during this period significantly impact blood sugar levels in ways that contradict everything you spent the past 30 years of menstruation trying to learn and manage!

You had your insulin doses all figured out for your menstrual cycle, right? And then suddenly, it all changes. Those changes make every part of health management harder — including managing your weight and diet, too. 

Melissa Slemp, a certified nutritional and hormone health coach at Abundant Health with Melissa, personal trainer, and host of the "Type 1 in Midlife" podcast, knows the challenges of perimenopause and menopause are quite real. 

With over 40 years of experience managing type 1 diabetes, Melissa shares her insights and practical nutrition tips to help women thrive during this transitional phase.

Understanding the Hormone-Blood Sugar Connection

Yes, those hormonal changes absolutely affect your diabetes and your insulin needs. 

“As women approach menopause, declining estrogen levels can lead to increased insulin resistance, making blood sugar management more challenging,” explained Melissa.

Melissa added that fluctuating hormones can wreak havoc on blood glucose levels, as insulin sensitivity decreases when estrogen and progesterone levels drop.

This hormonal rollercoaster necessitates a thoughtful, holistic approach to both diet and lifestyle. Without extra attention, this shift in estrogen production can lead to dramatic weight gain, constant fatigue, and even depression.

But you can take charge through your lifestyle habits and minimize the impact menopause has on your health and quality of life.

Tip 1: Get More Quality Protein

As estrogen levels drop during menopause, keeping your muscles strong becomes even more important — and that’s where protein and weight-bearing exercise come in!

"Make sure you're getting enough protein every day to support muscle maintenance and growth,” said Melissa. “You’re losing muscle every year after your mid-30s unless you work to maintain muscle through diet and exercise.”

And your bones! Preventing osteoporosis is a concern for any woman over 40 years old — but diabetes definitely increases your risk.

The exercise part is simple: show up to the gym three days a week for even just 15 minutes and work those dumbbells or circuit machines! It doesn’t have to be complicated. Imagine: that’s 45 minutes of strength training every week. That adds up!

The good news on the nutrition part? There are plenty of delicious ways to get more protein. 

Try adding lean protein sources like seafood, beans, legumes, dairy, meat, or poultry to your meals. Not only will this help keep your muscles strong, but it can also curb cravings, boost metabolism, and give you steady energy throughout the day. 

Plus, spreading your protein intake across meals can make a big difference in slowing down the digestion of your meal — making it a tiny bit easier to manage those post-meal blood sugar spikes.

Tip 2: Focus on Phytoestrogen-Rich Vegetables – like Broccoli!

Did you know some plant-based foods can actually help with menopause symptoms like hot flashes? They contain phytoestrogens — natural compounds that act a little like estrogen in your body.

There are three types of phytoestrogens: isoflavones, lignans, and coumestans. 

Melissa suggests adding foods like tempeh, broccoli, carrots, and sesame seeds to your meals, saying, "Phytoestrogen-rich foods may help reduce hot flashes, providing relief."

Soy products, like soy milk, are also great sources of isoflavones and phytoestrogens and have been linked to lower inflammation and better heart health. 

Tip 3: Focus on Low Glycemic Index (GI) Foods

Well, we all need dessert and yummy carbs sometimes, right? But it’s essential to keep those more indulgent carbs balanced, aiming to get more high-quality carbohydrates instead.

Insulin resistance is definitely part of your menopause journey — which means it’ll be harder to manage weight gain, too. This is where those low-GI foods come in. 

“It doesn’t have to be all or nothing,” Melissa stressed. “But take a look at your diet. How much sugar are you eating or drinking every day? Where can you start to cut back and swap in healthier carbohydrates for that highly processed stuff?”

Think whole grains, legumes, nuts, seeds, and most fruits and veggies.

• Swap your favorite breakfast of oatmeal: Chia seed pudding or add chia seeds into your oatmeal to get in more protein and fat while lowering the glycemic index.

• Pasta lovers can enjoy spaghetti squash instead and still enjoy a homemade marinara sauce.
• Swap white rice for cauliflower rice: It’s easy to add to a vegetable stir fry along with a protein source.
• Reduce coffee’s impact on blood sugar by adding collagen protein and a teaspoon of coconut oil. This helps curb cortisol and caffeine spikes as you start your day!

Pasta Swaps – all gluten-free

• Bean pasta (i.e., black bean, edamame, legume, chickpea, mung bean, lentil)
• Spaghetti squash
• Shirataki Miracle Noodles
• Zucchini noodles (how to make without a spiralizer)

Rice Swaps

• Black Rice (gluten-free)
• Cauliflower Rice (gluten-free)
• Farro
• Buckwheat (gluten-free)
• Quinoa (gluten-free)

It can be hard to convince your taste buds at first, but once you get going, you may start to crave more whole foods and need less of the sweet, highly processed stuff. 

Remember, the goal isn’t to wipe out all the treats. It’s about balance.

The Role of Healthy Fats

Healthy fats deserve a shoutout when it comes to feeling your best during menopause! They play a big role in hormone balance, support your heart health, and may even help reduce the risk of breast cancer.

(Hey, did you know menopausal women are just as likely to have a heart attack as men? Heart attacks are commonly thought of as a man’s condition, but you are at risk, too!)

Try adding more omega-3 and omega-6-rich foods like avocados, olive oil, trout, and chia seeds to your meals. These fats can also help ease some menopause symptoms — so they’re definitely worth including in your diet!

Just remember, a little goes a long way since fats are calorie-dense. The key is balance—pairing fats with protein and fiber to keep your meals both yummy and satisfying.

Create a Diet that Works for YOU

Every woman’s journey through menopause and diabetes is different, so it’s all about finding what works best for you!

Melissa encourages women to listen to their bodies and choose foods that support their health while still being delicious. 

• How do you feel after eating that breakfast sandwich from Starbucks? Energized or sluggish? 
• How do you feel after three cups of coffee? Jittery or focused?
• When is your most common overeating time of day? What’s fueling that event? Are you eating too little for lunch and then binge eating at dinner?
• How can you make room thoughtfully for treats in your week?

A little self-reflection can go a long way! The goal is to feel good and enjoy what you eat!

It’s Not About Perfection

Managing diabetes while going through menopause can feel like a lot. (Seriously, it also just seems cruel after so many years of studying your insulin doses during your menstrual cycle!)

If you’re feeling overwhelmed, take a step back and remember you do not have to adopt a strict, obsessive diet — ever. Instead, you’re recreating your own relationship with food by exploring new things, being honest about your current diet, and challenging yourself to improve your habits.

If you're looking for extra support, Melissa Slemp is here to help! With her personal experience and expertise as a diabetes and hormone health coach, she can guide you through this transition with practical advice and real-life strategies. 

Reach out to her for one-on-one Coaching with Melissa and feel empowered to thrive in this next chapter!

You can also try her free guide: 5 Key Ingredients for Hormone & Blood Sugar Balance.