01 Jul Diabetes and How BHRT Can Help
Most diabetic patients in the US have type 2 diabetes, or diabetes mellitus. This blog will focus on that population exclusively. Diabetes is a disease in which the body is unable to regulate blood sugar levels appropriately. In diabetic patients, the body’s production of insulin can decrease, and the cells response to insulin can become dulled. We call this decreased effectiveness “insulin resistance”. That is, the cells have become resistant to the effects of insulin… not a good thing! Insulin serves a very important purpose in our body. It pushes the sugar circulating around in our bloodstream into the cell, where it can be used to produce energy. With inadequate insulin activity, that sugar stays in the bloodstream where it can cause problems with the cardiovascular system, kidneys, and small blood vessels in the eyes, fingers, and toes. These problems can lead to heart attacks, strokes, kidney disease, blindness, and even amputation.
According to the American Diabetes Association:
- Approximately 9.4% of the population has diabetes
- 1.5 million Americans are newly diagnosed with diabetes each year.
- Among patients 65 years old and older, 25.2% of seniors are diabetic
- Diabetes is the 7th leading cause of death in the US
- Minority populations are disproportionately affected
- Medical expenses for diabetic patients are 2.3X higher for diabetic patients
With such a high diabetes prevalence in our society, it is imperative that you address this problem if you have had irregular blood sugar readings at your doctor’s office. If you haven’t been to the doctor recently, it is important to note that the progression of diabetes can be slowed or even reversed if caught early. The most important thing you can do to stop or prevent diabetes is to lose weight, exercise and eat right. This involves monitoring your intake of sugars and other carbohydrates, and maintaining a healthy exercise regimen.
As a component to lifestyle modifications, bioidentical hormone replacement can affect your response to insulin. Specifically, testosterone has been shown to decrease insulin resistance (meaning, make our cells more sensitive to insulin’s effects) in both male and female patients. Men with low testosterone levels are more likely to have metabolic syndrome (defined as 3 or more of the following: high waist circumference, high triglycerides in the blood, low HDL, high blood pressure, or high blood sugar) In post-menopausal women, insulin resistance also decreases when given estradiol and progesterone. We have also seen optimization of hormones in both male and female patients contribute to reduction of waist circumference and central body fat, both of which are risk factors for diabetes. Balancing the hormones may give you more energy, and increase endurance in the gym. This circles back to the central theme of BHRT in our practice at Pharmacy Solutions: that as a component of lifestyle change, hormone replacement therapy can have profound effects on quality and length of life in out patients.
Bitoska I, Krstevska B, Milenkovic T, et al. Effects of Hormone Replacement Therapy on Insulin Resistance in Postmenopausal Diabetic Women. Open Access Maced J Med Sci. 2016;4(1):83-8.
Chrysohoou C, Panagiotakos D, Pitsavos C, et al. Low total testosterone levels are associated with the metabolic syndrome in elderly men: the role of body weight, lipids, insulin resistance, and inflammation; the Ikaria study. Rev Diabet Stud. 2013;10(1):27-38.
Li C, Ford ES, Li B, Giles WH, Liu S. Association of testosterone and sex hormone-binding globulin with metabolic syndrome and insulin resistance in men. Diabetes Care. 2010;33(7):1618-24.
Tchernof A, Calles-escandon J, Sites CK, Poehlman ET. Menopause, central body fatness, and insulin resistance: effects of hormone-replacement therapy. Coron Artery Dis. 1998;9(8):503-11.