Sugar control during periods

Re: Sugae control during periods

short answer - YES I totally know what you mean.
not so helpful answer - I don't know of a way round it apart from keeping a track of the patterns, when there are patterns, and adapting as best you can. I know of some people who have different programmes on their pump and use totally different ratios at different times of the month. It's very common (but almost never discussed in diabetes textbooks, so I don't think many doctors truly realise what a huge problem it can be).
slightly hopeful answer - I used to have similar problems quite badly, having to halve my insulin dose on the first day of my period, then gradually as the month went on increasing it. But then the problem just went away by itself, after a few years. By the time I was 30 I wasn't really noticing a difference whatever time of the month it was.
Fingers x'd that happens for you too!

Re: Sugae control during periods

I do think the old curse is a problem for us lady diabetics. Heck, I've lost count how many times I've heard "bgs often rise during the time of the month" - yet everyone's clueless on how to tackle it!

On the DAFNE forum we do have a group of us trying to work out how to tackle this problem - and there has been news that they will be adding a new section to the DAFNE guidelines regarding the cycle and it's effects - but unfortunately, research takes time. At least the DAFNE rules can help you make it your own personal science experiment lol. As is the case with how different the period can be itself, how your condition is effected varies from person to person so I know I'm not expecting similar situations when it comes to what to do.

I'm currently working with my boyfriend to help me work out what's going on. Haven't nailed it yet. I've found that if you can work out your cycle then it does become a bit easier to workout when to expect trouble. I find that I rise for a bit, adjusting accordingly, but then my body decides to bomb and I have to put everything back down again! Very frustrating vicious cycle - and then you've got to wait until next month to see if the pattern repeats itself! Argh!

Re: Sugae control during periods

Otenba said:

On the DAFNE forum we do have a group of us trying to work out how to tackle this problem - and there has been news that they will be adding a new section to the DAFNE guidelines regarding the cycle and it's effects - but unfortunately, research takes time.

Click to expand...

also, everyone's responses are so different that getting it right for one person won't necessarily help the next.
Really interesting though Otenba - if I go on the DAFNE forum what's the thread name, is it easy to find? I'd be interested to learn about it.

Re: Sugae control during periods

YES YES AND YES :lol:

I really do struggle with my Cycle and control ,but I do have to say that since changing insulins I think that it is looking a bit more steady this time, so I hope that I may not have the Hypo's I used to have on the Lantus...time will tell.

Bumble, you are certainly not alone and there is help out there (I hope). My Diabetic team have referred me to a Gyn/endo who runs a clinic for female sex hormones, for PM syndrome ect...I also get this REAL bad ,coupled with swinging BG. From increased needs for insulin to real sensitivity to it, we thought it would be best to go and get a good look at my whole hormone profile during my Cycle and how it can be helped to improve my control...which is out of my control fora number of days of the month, due to hormones...which I'm sure you are familiar with :roll:
If you really suffer, you could see about this. I don't know what treatment route would be on offer but at least I will know what hormones are causing me the problems ,so we can try to treat it. I will let you know if I get any joy.

As far as I know and I am only just heading down this route so it's not etched in stone :wink:but I find my BG begins to rise 7/8 days before the first day of my Cycle, so my insulin needs. This is caused by Progesterone which raises BG. Testosterone comes into play here to stop the Progesterone getting too high, also Thyroxine plays a big part in reinforcing the Progesterone. If you are low on Testosterone this may cause you problems with PMS ,poor BG control ect.
Then the progesterone levels drop on the first day of your cycle, ie, when menses start. Then my insulin needs decrease big time and I am soooo insulin sensitive for 3/4 days ...then a gradual increase in insulin starts again...Does that pattern sound familiar to anyone else .

As Snodger said we are all different but I would be interested from any of you ladies if you found that your insulin levels/needs increased on the day's before your period and then you needed to drop it back once you came on?

I do feel I have got a good handle on what happens with my cycle now but it did take a bit of working out and to be honest a bit of recognition from my endo that it was a "real" problem,My symptoms are quiet extreme though, but on the DAFNE I met a couple of ladies with exactly the same problems...and some who were not bothered by this at all and never had been, so we are all different.

Sorry for long ramble, I hope you get some help if you feel you need it. If you would be interested in what I find out from my appointment with the Ob/Gyn regarding the hormones that effect us around this time and what help there is for us, PM me and I will let you know if I find anything out to help us.

Take care

Re: Sugae control during periods

Snodger said:

Otenba said:

On the DAFNE forum we do have a group of us trying to work out how to tackle this problem - and there has been news that they will be adding a new section to the DAFNE guidelines regarding the cycle and it's effects - but unfortunately, research takes time.

Click to expand...

also, everyone's responses are so different that getting it right for one person won't necessarily help the next.
Really interesting though Otenba - if I go on the DAFNE forum what's the thread name, is it easy to find? I'd be interested to learn about it.

Click to expand...

Yeah, sorry about not posting the thread links...
http://www.dafneonline.co.uk/forums/4/topics/483
http://www.dafneonline.co.uk/forums/4/topics/801
http://www.dafneonline.co.uk/forums/4/topics/955
http://www.dafneonline.co.uk/forums/4/topics/1001
These are the main threads that members have started (in date started order, oldest to newest).

DAFNE encourages you to make adjustments to your individual needs so please don't assume that it's another "all the same for everyone" deal. Once you've worked out your body's needs with the assistance of something like the DAFNE course, you're well on your way a lot quicker than in the guesswork cloud diabetics often have to live in without courses like DAFNE.

Feedback regarding DAFNE can be found here too:
http://www.dafneonline.co.uk/forums/1/topics/218

Re: Sugae control during periods

Otenba, thanks for the links - really interesting reading.

Fallenstar, for some reason I'd got in my head you were a bloke! now I have to rethink what you 'look like' in my head.

Re: Sugae control during periods

:lol: No Snodger I'm a chick!
Imagine Elle Macphereson...yeh, her ..but I'm a lot taller and a lot better looking :wink: :lol:

Re: Sugae control during periods

Hi everyone!

I get exactly the same! High BGs and increasing insulin resistance for about 8 days before the period starts and then crash! Hypo! It drives me mad! My insulin to carb ratio can vary from around 1:8 pre-period to 1:15 or less on the first day and the 3 or four days following day 1. Just to make matters worse, my cycle is unpredictable - often about 6 weeks, but sometimes longer and sometimes less. I can now guess when my period is going to start by how my BG is behaving instead of the other way around :lol: I only got diagnosed with diabetes because i was having blood tests and seeing a gynae because I'd started constantly bleeding - it was like 3 cycles without a break! I got anaemic and the tests showed diabetes. As soon as I cut the carbs, the bleeding stopped and since my diabetes has been controlled, my period has gone back to its usual unpredictable cycle :roll: Both the gynae and endo say the two things are not connected, so reluctantly i've had to take their words for it. I'm in my mid 40s now, so I guess the hormone levels are changing again and i have more of this to look forward to!

Smidge

Re: Sugae control during periods

Very interesting. I've just switched insulins from a twice daily injection of mixed insulin to basal/bolus (levimer and novarapid). The switch was just before my period started and i've had a couple of minor hypos whilst being on. I put it down the hypos down to the new regime. Maybe it was time of the month that caused them. I'm seeing my DN again tomorrow evening, so will ask her what she thinks.

Re: Sugae control during periods

Hi there, I replied to another thread recently on this topic & found a useful article on the insulin pumpers website. http://www.insulin-pumpers.org.uk/menstruation/ you may not be on a pump, but might find it useful to read anyway; you are certainly not alone as all these replies show. I'm just waiting for my BGs to rise in the next few days so that I can start my first experiment on increasing my basal insulin & see what happens.

Re: Sugae control during periods

Hi,

Ever since diagnosis I have had problems and when i have mentioned it to my consultant (who is female) she kept telling me that diabetes shouldn't intefere with cycles. It was only when i was put on the pump that my DSN took it seriously and gave me another profile on my pump so I didn't have hypos.

The good thing is since i have been irregular if i have a cluster of hypos my hubby knows whats coming :lol: :lol: :lol:

Josie

Re: Sugae control during periods

I have only recently realsied that there might be a pattern to this with me, so... I made a note last month of the day my period started and day 28 will be next Wednesday. My cycle always a few days short of 28 & guess what? I had three hypos on Tuesday during the first 12 hours of the day & I've been struggling to get my BGs down ever since.

Now I accept that I may have reacted to the hypos & released glycogen to send me high after the third one (12:00 Wednesday), but come Wednesday night, I was 9.6 before dinner. Now that could be due to a miscaluation on my carb, but I disassembled my sandwich to weigh the bread & also weighed my fruit, so I was unlikely to be too far out. However, at 01:30 the next morning I was 10.7. I had 1.5 units to bring me down, usually plenty to drop me 5%, but was still 9.9 at breakfast.

Cue the TBR on my pump. I put it on 110% as I didn't want to go too far & had readings of 5.7 3 hours after breakfast & 4.3 at 13:00 before lunch - perfect. Then I was 11.2 at dinner time!!!. I had a correction bolus with my evening meal but had risen to 13.3 at bedtime so I raised my TBR to 120% (that's about 3.3 units over 24 hours more than usual). This morning was fine with 4.3 at breakfast, but after my usual breakfast I soared to 16.8 after 3 hours!! Unheard of; breakfast is the meal that I maintain the best control with. I'd managed to get it down to 11.2 2 hours later, but I'm now thinking that I may have to increase my basal again to 130% & maybe increase my insulin/carb ratio for the next couple of days until my period starts.

Don't let anyone tell you it's a figment of your imagination. It may have taken me years to notice it (and thanks to this forum, I now have), but the pattern is definitely there. It may not affect everyone, but for those of us that it does, it can't be ignored.

Re: Sugae control during periods

Snodger said:

Otenba, thanks for the links - really interesting reading.

Fallenstar, for some reason I'd got in my head you were a bloke! now I have to rethink what you 'look like' in my head.

Click to expand...

You know Snodger, I'd assumed that you were a bloke too, sounds like a name from the Beano :lol: :lol:

Re: Sugae control during periods

Well....

I stayed at 120% TBR on my pump though until about 5 hours after my period started.

My BG 3/12 hours after lunch that day was 5.5 which is well below what I expect after a meal (I always get big spikes, usually into double figures until about 3- 3/12 hours after a meal - never been able to change that as it drops back to where I started by 5 hours after the meal). So I cancelled the TBR at that point & was hypo 2 hours later. Perhaps I should have cancelled the TBR as soon as my period started, but this one time experiment seems to prove the theory that my need for insulin will rise significantly about 2-3 days before my period starts & then get back to normal pretty much immediately.

Time to start adding that little anomaly into my coping strategy. Why is diabetes sooo complicated?!!

Re: Sugae control during periods

Interesting post ladies!! I have recently changed from twice dialy injections to MDI's starting with a basal of 8 and rising to 14 five days ago when I seemed to be averaging around the mid to low 7's before breakfast - thought I had it cracked!! Then this morning back up to 12.4, how dissapointing;( but interestingly (now I have read what you guys have to say) the first day of my period. So what would the advice be - would I raise the basal for a few days, raise the bolus for my first meal of the day or just stick with it and hope it goes back when my period is finished? I have tried to contact my Diabetic nurse but am still waiting for her to get back to me. Any advice welcome.....

Re: Sugae control during periods

Hi Esther
It took me quiet some time to work out my insulin ratio's for my cycle days, so don't rush...test,take note and over time it will hopefully fall into place for you...we are all different.

with me it is the 8/10 days before menses that my Basal needs start to rise, and slight Bolus .....I need to cut right back for the first and second day of my period...on other insulins I had to sometimes not take any at times for the first two days, hypos were that bad :shock:

I have spoken to a number of girls about this now and most seem to have the raised insulin needs building up to menstruation, then hypo or go low when on a period.

Take your time ,it is all new to you on the new regime but in time you will get it all sorted.

Re: Sugae control during periods

Take your time us the best advice. Many people seem to need more insulin in the days leading up to the start of their period, but the need drops away almost immediately it starts, with some suddenly needing less than usual for a day or two.

When I noticed that it might be an issue with me, I started with just a slight rise in my pump basal (maybe 1u on MDI basal insulin) & tested 7 times per day to see how it went. This month I was a little more agressive & went for a 20% increase in my basal which seemed to do the trick. Next step is to cancel that extra 20% as soon as my period starts (much harder on MDI I accept) h see if I avoid the hypo.

Good luck. It's thanks to this forum that I've recognised this issue. Well worth being a member.

Re: Sugae control during periods

Esther1411 said:

So what would the advice be - would I raise the basal for a few days, raise the bolus for my first meal of the day or just stick with it and hope it goes back when my period is finished? I have tried to contact my Diabetic nurse but am still waiting for her to get back to me. Any advice welcome.....

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Personally I think I'd start by leaving the basal alone and playing around with the bolus ratio, especially if it is particularly a morning issue. It means that if you get it wrong, you can correct again quite fast - whereas bolus can take a couple of days to really make a difference.

Also, I don't know what others think - is it overall insulin resistance people are getting, or is it related to certain times of day like Esther? I think when it happened to me it was more about how much I needed to cover carbs rather than how much I needed as background, but I can't remember now and I don't get such fluctuations these days.