Insulin resistance with menstrual cycle?

[LooperCat]

Afternoon friends, I need to consult the female half of the T1 hive mind on this one!

Do any of you ladies find that the week before your period results in higher readings and a degree of insulin resistance? And if so, how do you counter it? I’m finding that my “foot on the floor” Novorapid dose at stupid o’clock in the morning is only delaying the dawn liver dump rather than stopping it during this week, and I’m spending most of the morning in the 8s and 9s injecting two or three units with little effect. I’ve only really started noticing this in the last two cycles, as I’ve been using the “menstruation” tag in the MySugr app, and could search the dates when I spotted the IR. While I’m regular, I’m notoriously rubbish at keeping track of my cycle.

I’m on Tresiba, so changes to that take a day or two to make any difference, although I am upping it by a unit for this particular week. I’m confident the dose of that is correct, as my Libre trace shows a flat profile all through the night. I take 18 units of Tresiba at 8am and a unit or two of Novorapid at whatever point in the few hours before that my liver decides to wake me with a dump, somewhere between four and seven. No point in setting an alarm for that, my liver wakes me with a dollop of cortisol that tells me the glucose dump will happen soon, so I inject then.

My usual 1 unit will bring me down by 2mmol in the mornings, 3mmol the rest of the day. I usually have a low carb breakfast around 10am.

Any suggestions as to how I can stop these morning highs would be gratefully received, thank you <3

 

[Engineer88]

Ugh, I feel for you. you can tell I have one week in four where my levels are all higher which might be easier to deal with.

Have you considered a pump? Only because this sounds like a TBR would be perfect

 

[LooperCat]

Thanks for the reply, it’s a pain in the backside (or similar area), isn’t it?

I have thought quite seriously about a pump, but I really don’t think I could handle the thing being attached to me all the time - I can just about handle my Libre sensor. I have Asperger’s, and the strangest things can overwhelm me and make me freak out - something constantly being on my skin being one of them. I couldn’t handle contact lenses for the same reason! The sensor I can deal with because the alternative is fingerpricks, which are a million times more sensory-overwhelming. I don’t actually mind multiple injections, welcome to the weird and occasionally wonderful world of my brain!

 

[NicoleC1971]

I was totally against being attached too but have a pump and it is useful for this kind of thing as I can have an hourly drip of insulin that can be varied. My PMT basal rate drops in both more in the dawn times and more overall (20% plus of my normal dose).
If you are taking tresiba over 24 hour period is it possible that the insuin is just petering out as you get to the end of the night/ Never took that insulin but I know they don't always have a flat profile as the manufacturer claims. I used to do better on a split dose that allowed the peak effect to arrive at the same time as the dawn rise.

Also there are some free apps to track your cycle if like me you are regular but don't notice until it arrives!

 

[LooperCat]

I was totally against being attached too but have a pump and it is useful for this kind of thing as I can have an hourly drip of insulin that can be varied. My PMT basal rate drops in both more in the dawn times and more overall (20% plus of my normal dose).
If you are taking tresiba over 24 hour period is it possible that the insuin is just petering out as you get to the end of the night/ Never took that insulin but I know they don't always have a flat profile as the manufacturer claims. I used to do better on a split dose that allowed the peak effect to arrive at the same time as the dawn rise.

Also there are some free apps to track your cycle if like me you are regular but don't notice until it arrives!

I really can’t entertain the idea of the pump, sadly. I can only wear a bra for a few hours at a time before I get completely overwhelmed by the fact that it’s there, even with a super comfortable one. Sometimes even my own hair is too much to bear! The autistic brain is a wonderful place... I’m going to have to find a way around this with MDI, I think. I’ve had a couple of doses of shingles so most of my abdomen is super sensitive, so attaching anything sends shivers down my spine. I know it sounds defeatist and pathetic.

Tresiba is supposed to last a good 36 hours and has a totally flat profile, I’ve switched from Lantus, which barely makes 16 with me so I’d split my doses on that. The rest of the month my Libre traces are flat and even, so I’m confident the Tresiba is working as it should. It’s just dealing with these stubborn morning highs, the rest of the day is great. I do have a period tracker but keep forgetting to input the info into it. I shall try harder on that one! But thank you for all the advice

 

[NicoleC1971]

I really can’t entertain the idea of the pump, sadly. I can only wear a bra for a few hours at a time before I get completely overwhelmed by the fact that it’s there, even with a super comfortable one. Sometimes even my own hair is too much to bear! The autistic brain is a wonderful place... I’m going to have to find a way around this with MDI, I think. I’ve had a couple of doses of shingles so most of my abdomen is super sensitive, so attaching anything sends shivers down my spine. I know it sounds defeatist and pathetic.

Tresiba is supposed to last a good 36 hours and has a totally flat profile, I’ve switched from Lantus, which barely makes 16 with me so I’d split my doses on that. The rest of the month my Libre traces are flat and even, so I’m confident the Tresiba is working as it should. It’s just dealing with these stubborn morning highs, the rest of the day is great. I do have a period tracker but keep forgetting to input the info into it. I shall try harder on that one! But thank you for all the advice

You are not pathetic and pumps are no magic bullet. I am just sorry that you get woken up with that liver dump although if you are so sensitive to a hyper then that's a good sign that you are getting great sugars most of the time.xxx

 

[LooperCat]

In a way, it’s quite cool that it does wake me, because the time is too variable to set an alarm. I get quite a start, heart rate is up a little and I feel quite awake. If I don’t inject a unit or two then (depending on what the Libre says), I get a rise into double figures, but if I do then I can be flatlining all day, which is really worth the rude awakening! I usually read for half an hour or so and can then doze off again for a couple of hours. I’m not a morning person, even if my liver is!

 

[LooperCat]

Update!

Period started yesterday and my morning level was back to normal this morning. Went to bed on a 5.9, liver woke me at 7.2 at five o’clock (thanks for that), so I took two units of Novorapid and went back to sleep until my alarm went off at eight. BG was 5.8. So it’s definitely a PMT thing...

 

[Engineer88]

What about using fiasp to top up your normal insulin if you can nail down the exact days its needed?

 

[LooperCat]

What about using fiasp to top up your normal insulin if you can nail down the exact days its needed?

I’m going to ask about Fiasp at my next appointment in five months time. We made the switch to Tresiba at my last one, and my consultant didn’t want to change both at once. Next time I see him, I’ll have plenty of data regarding that tricky week!

 

[Engineer88]

I wouldn't change full time personally, I've seen too many poor reactions. But I have asked for some to deal with stubborn highs. could you email him or any other way ask?

Generally I tell my consultant what I want and he does it (because we agree not because I'm a dictator!)

 

[LooperCat]

That’s a good idea, I’ll wait another month so I have three months of definitive data, and then ask. My consultant is pretty amenable.