FollowOne thing I’ve learned recently is that a rising HbA1c isn’t always caused by eating too many sweets.
As women enter perimenopause, hormonal changes can make our bodies more insulin resistant. Add in poor sleep, stress, gradual loss of muscle mass, and the natural aging process, and blood sugar levels can start creeping up—even without cakes, desserts, or sugary drinks.
Estrogen plays an important role in how the body responds to insulin. It helps regulate insulin sensitivity, which allows glucose to move from the bloodstream into the cells. As estrogen levels fluctuate and gradually decline, insulin sensitivity can decrease, increasing the risk of higher blood sugar and insulin resistance over time.
That’s been my experience too. My HbA1c has been hovering around 6.0 despite not really indulging in sweet foods.
That realization is one of the reasons I started strength training with my mum, and why I intend to continue for as long as I can. At this stage of life, building and maintaining muscle feels increasingly important. Muscle tissue plays a key role in glucose uptake and can significantly improve insulin sensitivity and insulin resistance.
I’ve also been paying closer attention to my HbA1c and making small, consistent changes to my diet and lifestyle. I’ve spoken to several doctors—some advised focusing on lifestyle adjustments before medication, while my gynae did suggest Metformin given my PCOS, which is closely linked to insulin resistance.
What I’m learning is that health isn’t determined by sugar alone. Sleep, hormones, stress levels, physical activity, muscle mass, and overall diet all play important roles.
For those of us navigating perimenopause, I think it helps to be a little kinder to ourselves. Not every change in our body is due to “bad habits.” Sometimes our bodies are simply evolving, and we need to adapt with them rather than fight against them.
By “adapt,” I mean making more mindful food choices, incorporating strength training and movement, prioritising good quality sleep, and managing stress where we can.
One small step at a time 
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