Diabetes and periods

[juliannaleit]

Hi everyone,

I was diagnosed with type 1 diabetes two years ago, so I still feel like a beginner sometimes. I don't always understand how this illness works. Over the past 6 months, I've noticed my blood sugar does its own thing around when I'm about to start my period. About a week before, it stays high no matter how much I exercise or how much insulin I take. I called my doctor and he said sometimes I need a double dose when my hormones are changing. I tried taking more insulin, but my blood sugar seemed stuck at 13.3 mmol/l.

Today, I was a little mad because I couldn't eat due to the high blood sugar, so I took 5 units of insulin and waited for it to go down. But it didn't go down. Actually, it went up to 15.7 mmol/l. Why does my period affect me so much?

I tried changing where I inject myself. I usually do my belly, but this time, I did my arms and thighs. I also used a new insulin, and even though I keep it in the fridge, it should be fine. But nothing is working! During those pre-period days, my blood sugar will suddenly drop in the middle of the night, and I'll wake up hypoglycemic.

 

[lovinglife]

Hi @juliannaleit & welcome to the forum

At the risk of cross posting as I’m T2 diet only controlled I still had periods when I was diagnosed and “the time of the month” always played havoc with my BG, all those changes in hormones is bound to have an effect, even ladies who don’t have diabetes of any type can have erratic blood sugar when on a period - then we have the menopause when we’re older! That was eye opening for me.

Hopefully some of our T1 ladies will be along to give you some tips and share their experiences soon

 

[Antje77]

I'm sorry to hear you're struggling with your diabetes around your period @juliannaleit .

Hopefully some of our T1 ladies will be along to give you some tips and share their experiences soon

I don't consider myself a lady but I do have periods (if erratically now I'm 47).

When I still had my periods regularly, up to a year or so ago, I always needed a lot less insulin in the days leading up to my period, so I anticipated by reducing both my basal and my bolus as soon as I saw those drops starting.
For others, it's the other way around, they go high before they start their period.

I think the best thing you can do is use your CGM (I'm assuming you use one) to find the patterns as well as you can so you can act on them.
What basal insulin do you use?
Depending on the brand, it may be worth adjusting your basal as well as your bolus for those days where you seem to be running high all the time.

During those pre-period days, my blood sugar will suddenly drop in the middle of the night, and I'll wake up hypoglycemic.

What about setting your low alarm a bit higher so your sensor will wake you up before you're actually hypo? That way you may be able to prevent the hypo instead of treating it.

 

[juliannaleit]

I'm sorry to hear you're struggling with your diabetes around your period @juliannaleit .

I don't consider myself a lady but I do have periods (if erratically now I'm 47).

When I still had my periods regularly, up to a year or so ago, I always needed a lot less insulin in the days leading up to my period, so I anticipated by reducing both my basal and my bolus as soon as I saw those drops starting.
For others, it's the other way around, they go high before they start their period.

I think the best thing you can do is use your CGM (I'm assuming you use one) to find the patterns as well as you can so you can act on them.
What basal insulin do you use?
Depending on the brand, it may be worth adjusting your basal as well as your bolus for those days where you seem to be running high all the time.

What about setting your low alarm a bit higher so your sensor will wake you up before you're actually hypo? That way you may be able to prevent the hypo instead of treating it.

I already set my alarm, but that's not my biggest issue right now. When I have low blood sugar at night and eat a little sugar, my levels spike up again quickly. On normal days, if I eat 20-30 grams of sugar when I'm low, it brings me back to normal (5-6 mmol/l). But before my period starts, even if I eat the same amount, it sends me into hyperglycemia (9-12mmol/l).

When my blood sugar is too high all day, I just feel awful. Sometimes it's really hard mentally..I've been using the Fiasp FlexTouch pen for insulin.

 

[Antje77]

When I have low blood sugar at night and eat a little sugar, my levels spike up again quickly. On normal days, if I eat 20-30 grams of sugar when I'm low, it brings me back to normal (5-6 mmol/l). But before my period starts, even if I eat the same amount, it sends me into hyperglycemia (9-12mmol/l).

So it looks like you found a pattern here, and you may be able to use it to your advantage.
You worked out that your normal hypo treatment of 20-30 grams is too much in the days leading up to your period.
So what about reducing the amount of carbs you use to treat a hypo in the days leading up to your period?

 

[juliannaleit]

So it looks like you found a pattern here, and you may be able to use it to your advantage.
You worked out that your normal hypo treatment of 20-30 grams is too much in the days leading up to your period.
So what about reducing the amount of carbs you use to treat a hypo in the days leading up to your period?

Yes, that's correct. Before my period, my body is very sensitive to sugar. Normally, 20-30 grams of sugar will bring my blood sugar back to normal. But before my period, it takes double or triple that amount.

Today, I tried an experiment. I woke up with a relatively good blood sugar level. Until 13:00, I didn't eat anything, just coffee with a sweetener. My blood sugar stayed somewhat stable. Then, I got hungry, so I took a double dose of insulin instead of my normal dose because I need more insulin before my period. However, it still didn't seem to have any effect. I had a veggie salad from Tesco with Caesar cream (almost no carbs, but my blood sugar still spiked really high.) So, no matter how much insulin I take, it seems my body is extremely sensitive to carbs, and the insulin isn't working. Right now, my blood sugar is 16 mmol/l (288mg/dl), and the insulin just isn't working. For some reason, my body won't accept the insulin until late evening or night, when it finally decides to accept it.

I'm just trying to figure out how to get through those days when my blood sugar is too high. It gives me awful headaches and makes me feel terrible mentally. My eyes are "full of water," and it's hard to see clearly. It seems like not eating anything is the only option..My doc isn't being too helpful in my case. He just says it's normal and blames hormones. So, I thought I'd ask you all on here if you had any other ideas.

 

[Hopeful34]

Fiasp works well for some people, but not for others, so it may be worth trying a different insulin, or have you thought about an insulin pump which makes it easier to manage times like this.

Personally I find Fiasp works well, but it can seem like water when my levels are high, and it takes a lot more insulin and a long time for my levels to return to normal, so I get where you're coming from in terms of having to wait to eat.

When I was having periods, I needed a lot more insulin in the week before I came on, and then less than normal for the first few days of my period.

As @Antje77 said, trying to find patterns helps. I gave up eating breakfast, and found that helped.

 

[juliannaleit]

When I was having periods, I needed a lot more insulin in the week before I came on, and then less than normal for the first few days of my period.

Same here! And yes, I also gave up eating breakfast.

Thanks for all the input, everyone. I'm really grateful you all shared your thoughts. It's clear I should speak to my doctor about possibly switching to a different insulin or even finding a new doctor. Hearing your perspectives has helped solidify that decision for me.

 

[Hopeful34]

Bear in mind it could also be that a different basal insulin would suit you better (or not). Sometimes it can be a bit of trial and error finding what works best for you at that time.

How are your levels outside of the time of the month?
Have you done any basal testing recently, particularly the week before your period?

 

[juliannaleit]

Bear in mind it could also be that a different basal insulin would suit you better (or not). Sometimes it can be a bit of trial and error finding what works best for you at that time.

How are your levels outside of the time of the month?
Have you done any basal testing recently, particularly the week before your period?

Thank you for asking. Overall, my blood sugar levels have been pretty good lately. I've been working from home on my laptop but staying active in between tasks. Hyperglycemia doesn't happen very often, and heavier hypos are also quite rare since I wear a Freestyle Libre sensor. The only times it's been a problem are around my period or when I'm stressed. For some reason, during those times, my body doesn't respond to insulin.

About a month ago, I went on vacation in Cyprus. I'm not sure if it was the heat or all the activity (I'm usually very active), but I rarely used insulin. The whole time, my blood sugar was lower, right around 4-5 mmol/l, but it never dropped below that. I didn't need much insulin at all when I was there.

I also forgot to mention that my doctor prescribed me cholesterol pills during my last visit. They did big blood tests in the spring and found my cholesterol was high. I'm 28 years old, very active, and eat healthy. My doctor didn't really explain why my levels were high. I wasn't even told if high cholesterol could cause my blood sugar to spike sometimes. That might be why my body doesn't always accept the insulin I take. He also mentioned those pills could lower fertility.

 

[ianf0ster]

If the 'cholesterol pills' are statins, then they could raise your blood glucose levels a bit. Steroids can do that as well.
Edited to say steroids can...

 

[Hopeful34]

The only times it's been a problem are around my period or when I'm stressed. For some reason, during those times, my body doesn't respond to insulin.

Stress and hormones are notorious for raising blood sugar, and we're all different, but a lot of us need more insulin to cope with them.

I'm not sure if it was the heat or all the activity (I'm usually very active), but I rarely used insulin.

A lot of people find they need less insulin when it's hot (some need more), and activity can lower or raise blood sugar depending on the type of activity. Holidays are hopefully a relaxing time, so we're not stressed and insulin needs reduce. It could well have been a mixture of all of these.

As you're fairly newly diagnosed, you could still be in the honeymoon phase, where your pancreas splutters out insulin periodically.