Type 1, menstruation and menopause

LittleSue

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For years I've clearly needed less insulin and had more stable readings during that week, but DAFNE has made it clear that my carb:insulin ratio and basal dose needs to vary at various times during the month. Despite far better daytime control my HbA1c recently got worse, I realised I'd been concentrating less on adjusting overnight doses, blaming high am readings on dawn effect when I'd likely been high most of the night. So I decided to test overnight ad infinitum (trying to get a CGM on long-term loan) to really get a handle on what needs to change in which week.

Unfortunately I now suspect I might be approaching "the change" - which I guess will complicate things further.

I'd be interested to learn how others bs has been affected by menstruation and menopause. Is it usual for ratios/insulin resistance to change with menstrual cycle? (Basal dose varies by about 25%, bfast ratio varies between 1:1 and 1.5:1) HCPs have blamed this on ladies "eating chocolate when premenstrual" but that only accounts for it if the chocolate is extra carbs not covered by insulin, not if you adjust bolus according to carbs.

How does the menopause affect bs control, both whilst going through it and afterwards? Does being post-menopausal make bs more stable?

Thanks
 

jopar

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Hmmm, that week *gulp*

This is something that I've never seem to be able to sort, as my problems is that I have no standard reaction to a week, only verious propables to it... Sometimes I get a big drop and everything remains steady, other times my levels become unstable and are all over the place and others I get no reaction at all to my BG's...

So it's been a case that I have several plans of action to hand, and wait and see what one I need to use... for me DAAFNE did help a lot with building my plans, but the biggest help that I've had has been using a insulin pump, as I can use features like Temporay basal rates, also incrediments of very small amounts of insulin i.e 0.3 of a unit to correct my levels... Still not perfect but very helpful to say the least....
 

hanadr

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I was already post menopause when diagnosed T2, but I have very stable BGs. Mostly, because of the low carb diet. certainly I no longer get the PMS carb cravings, which used to sink me every time I tried to lose weight.
 

mere193

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first of all ı m sorry abouth my engilsh. I want to ask how ı can regulate my blood sugar. When ı get up in the morning it is always 240 -250.Before ı go to sleep ı masure it was 85. why can this happens. ı use noworopid for short time lantus for nigiht
 

totsy

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hya,
is this due to menstruation/menopause or not?
it can be caused by the dawn effect which happens to many people, if u google dawn effect there is plenty of info,hope this helps :)
 

crystal

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Oestrogen affects blood glucose levels, so as oestrogen fluctuates throughout the month, it must be having an effect on blood glucose control in women. I haven't come across any diabetes doctors who know anything about it though, while gynaecologists don't know anything about diabetes! Does anyone know a female gynaecologist with diabetes?

Good luck
Crystal
 
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ma5on

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My first post but something I've bored my husband about for months now!

I also find 'that' week completely different from the rest of the month. The week before I might as well be injecting water for all the good the insulin does for me, then as soon as I come on, it's complete control all the way (despite eating the same, if not worse!).....madness.

I can only assume that hormones the week before cause some kind of insulin resistance in my body, and I try and remind myself of this when I increase my doses by up to 50% and STILL wake up with a sugar of 15mmol. Once that week arrives, I enjoy pre-bed and morning sugars of about 4-5 mmol.

I have spent the last 2 years (been Diabetic for nearly 7 now) trying to get a good hold on my levels. The worst HbA1C I had was 14.7% and that kicked me into dealing with it instead of trying to ignore it and be 'normal'! To be honest I always felt I was messing up until I realised that for most of the month I'm pretty good.....it's the week before that screws things up.

Now I'm trying to go lower carb during that time to see if it helps....not easy when I'm craving bread and chocolate like you wouldn't believe!!! Am waiting for my hospital to loan me one of those glucose monitors.....I'll be fascinated to see what that reveals!

Glad I'm not the only one though....I don't really know any women diabetics so never had the chance to discuss it! :eek:)
 
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LittleSue

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Hi ma5on
Seems you're a bit like me. I don't really get increased bs the week before, but definitely a drop and bomb-proof control for the first 2-3 days.
Glad to hear I'm not alone. All I've got from the professionals before is 'sugar goes up due to chocolate cravings' or a (male) doctor insisting that all diabetic women's bs goes up during menstruation, despite evidence of the opposite in my bs book in front of him. For a few years I didn't inject at lunchtime on the first 2 days, even 1 unit and I'd be shoving carbs down all afternoon. DAFNE nurses did at least say it tends to go up beforehand and then drop when menstration starts (why does the wider medical fraternity only ever get half the message?), but still favouring the chocolate theory. Which is strange since DAFNE women should be able to cope with chocolate.
They have special combined clinics for diabetics/feet, diabetics/kidneys, pregnant diabetics etc. Maybe they should have clinics for diabetics with menopause/menstruation issues - get the diabetologists and gynae people together so they can't each blame the other condition!
I really want to get control of how each part of my cycle affects my bs but the clinic don't seem interested.
 

katiieb96

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Type of diabetes
Type 1
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Hi i was wondering if anyone could help me im 18 years old and i havnt ever had a period i feel really abnormal and have began to think that i am infertile but i didnt know if anyone else has had the same problem and if its anything to do with the diabetes ?
 

Jane Milburn

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Hi katiieb96, please, please go to see your diabetic doctor or if you don't have one, see your Gp. I don't want to worry you but there may be a problem there which is conected to diabetes and /or your general diet. When you know what the problem is, it will help you in feeling more normal as the doctors can and will help you. Please let me know how you get on :) x
 
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RuthW

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My experience is not straightforward because I had a hysterectomy, but didn't have my ovaries removed so it is not clear when exactly I went through or whether I am going through the menopause phase. I have had a rise in my hb - quite a big one from 7-ish to 9-ish but I don't think that was all attributable to hormonal changes - I have been much more sedentary and gone through a big family crisis too.

So I was having more difficulty controlling my blood sugar but the reasons for that are not clear. After years of diabetes, my injection sites were shot too. Now I have a pump, I can control my blood sugars but my muscle to fat ratio is still much worse and I put weight on much quicker than I used to.

Another difference I can definitely vouch for is the loss of a waist line. That sounds trivial but it isn't really. Visceral fat is really bad for you into terms of cardio-vascular disease etc. I am still a reasonable weight - I just squeeze into the top end of my "correct" BMI, but it is much harder to lose weight and when I put it on it definitely goes to the belly and not the bum now.

When I were a lass (from Manchester, when it was still in Lancashire), I was very fit and energetic, and I found that exercise controlled most of my "period problems", including blood sugar. So I can't say that "women's problems" have been a big issue for me until I got fibroids in my forties. That was why I had the hysterectomy. But if I am having or have had a menopause, can't say I have noticed it, frankly. None of the nightmarish symptoms some women describe so just the flipping belly fat for me!
 
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Juicyj

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Hi @RuthW - I have just read your post as I believe I am in my menopause, lots of symptoms that now seem to fit with this. I am seeing my doctor tonight to discuss.

I have put on alot of belly fat, a stone in the last year, which I can't shift even though I low carb and exercise, struggling with BG levels throughout the month, was just normally a blip for about 10 days which to quote a post above, is simply like when taking insulin I am just injecting water, but now there's no pattern and have been running high for the past 2 weeks. Also irregular periods and low moods.

I am trying to find out how other women have coped with this and what treatments/methods work best - can anyone share their stories ?
 

ann34+

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I always had enormous changes every month anyway, expected but not predictable so i was used to just going along with things testing, testing, and more testing - no choice really. So it was not too much of a shock coming into what the docs call the peri-menopause . docs explained that some cycles become anovulatory in some women before menstruation stops. It means even more difficulties re Type one for some women, and can go on for ages but even after that things dont stop! My GP at the time said when i was asking when things would settle re erratic blood glucose variations ( talking about common menopause symptoms, which i was lucky enough not to have many of) that she had patients who still had a sort of a cycle re hot flushes at age 75! ). It seems many women still produce hormones, so blood glucose can remains unpredictable, or take a while to calm down. As to waist fat, metabolism changes mean many of us need a lot less cals than we had when younger! Also best to get thyroid tested regularly as large numbers of older women get hypothyroid disease, and it is common in type one women. Even better get checked for thyroid autoantibodies - these dont mean you will get thyroid disease but you will get regular checks thereafter if positive.
Hi, Juicy, i have just seen you asked about treatments as well as methods of dealing with erratic control round pre menopause time etc, Methods i used were just more testing, and no treatments, other than more soya, and more variety of veg and fruit, i had read at the time that there was no word for hot flushes in Japanese, and that there was not much written about menopause symptoms in Japan, and that the Japanese diet might account for this. (there may be different information now). My GP warned against HRT, regarding the risks, especially of some cancers, so, though the first month was prescribed in hospital , i never took it. Looking back it was all pretty ok, and would have been absolutely fine had there been available some sort of accurate closed loop system re diabetes control. Perhaps there soon will be.
 
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Anaelena

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Perimenooause is that period before menopause and can start 10 years before you actually reach menopause. It has been a monster for me. They should be able to check your hormone levels and recommend natural treatments which I have been doing . Before menstruation I usually have to double my basal rates and even then they remain high.