T1 and menstrual hormones

[RosiePalmer]

Hi,
I notice I have high sugars in the week before I get my period, and I know that progesterone affects insulin uptake. Can anyone give me any advice on how you adapt your insulin ratios and basal around your menstrual cycle?
Many thanks

 

[sninge]

Hi Rosie
I have exactly the same, I call it ' black week ' and have a separate basal set on my pump to deal with it! Im not sure if you are on a pump? Its not straight forward, the time of day I become resistant can but not always vary from month to month! Im always most resistant from midnight to about 5am but can also be resistant other times of the day as well. Once my monthly arrives then basal need to go back down then mid cycle im extra sensitive so basals drop even more! I never realised all this until I went on a pump and the libre! Good luck!

 

[RosiePalmer]

Hi Rosie
I have exactly the same, I call it ' black week ' and have a separate basal set on my pump to deal with it! Im not sure if you are on a pump? Its not straight forward, the time of day I become resistant can but not always vary from month to month! Im always most resistant from midnight to about 5am but can also be resistant other times of the day as well. Once my monthly arrives then basal need to go back down then mid cycle im extra sensitive so basals drop even more! I never realised all this until I went on a pump and the libre! Good luck!

Hi! Yes sorry, forgot to say I am on a pump. Interesting about the night time resistance. I suppose it is a bit of trial and error.
Thank you

 

[Juicyj]

Hi @RosiePalmer yes it's fairly common amongst t1d menstruating females, I explored all possibilities once upon a time, including speaking to a male GP who dismissed my comments saying it was unrelated ! another GP recommended a full hysterectomy !

It's just a case of applying a revised basal pattern but setting reminders too as leaving yourself in this mode come period would leave you fighting lows,

I am now using the Tandem Slim with control IQ pump which automatically administers insulin based on dexcom readings and since using this I don't seem to suffer as much with the days leading up to my period any more which has been a major plus.

 

[Zhnyaka]

when my gynecologist (she also has the qualification of an endocrinologist) prescribed hormonal contraceptives to me and everything got much better, but we picked up contraceptives for a long time so that their side effects and the side effects of insulin did not lead to anything bad

 

[Niamh1]

I get the same thing. A few days my periods start my sugar level increases and when I finish the week after I go low. I spoke to a dietician and she recommended the pump. speak to your nurse or dietician about this. About the insulin I am on nova and trisba for the evening I have lowered my long time insulin but my sugars went higher like i said if you cant get the correct insulin ratios ask for a pump.

Hope this helps

 

[RosiePalmer]

Hi @RosiePalmer yes it's fairly common amongst t1d menstruating females, I explored all possibilities once upon a time, including speaking to a male GP who dismissed my comments saying it was unrelated ! another GP recommended a full hysterectomy !

It's just a case of applying a revised basal pattern but setting reminders too as leaving yourself in this mode come period would leave you fighting lows,

I am now using the Tandem Slim with control IQ pump which automatically administers insulin based on dexcom readings and since using this I don't seem to suffer as much with the days leading up to my period any more which has been a major plus.

That sounds great, I am hoping to move to a looping system in the summer when fingers crossed it's free. For now I am on a libre and Medtronic.

Can I ask, what increases you do in insulin ratios/ temp basals and around what day of your cycle you make the adjustment on? Don't worry if you don't remember.
Rosie

 

[RosiePalmer]

when my gynecologist (she also has the qualification of an endocrinologist) prescribed hormonal contraceptives to me and everything got much better, but we picked up contraceptives for a long time so that their side effects and the side effects of insulin did not lead to anything bad

Thank you

 

[RosiePalmer]

I get the same thing. A few days my periods start my sugar level increases and when I finish the week after I go low. I spoke to a dietician and she recommended the pump. speak to your nurse or dietician about this. About the insulin I am on nova and trisba for the evening I have lowered my long time insulin but my sugars went higher like i said if you cant get the correct insulin ratios ask for a pump.

Hope this helps

Thank you

 

[Juicyj]

That sounds great, I am hoping to move to a looping system in the summer when fingers crossed it's free. For now I am on a libre and Medtronic.

Can I ask, what increases you do in insulin ratios/ temp basals and around what day of your cycle you make the adjustment on? Don't worry if you don't remember.
Rosie

For me personally I was upping my bolus each day by around 25-30%, but this wouldn't be the same for everyone, it very much depends on the individual, I didn't increase my basal as this could easily run into the start of my period when my levels would then decrease so didn't want to have an overlap, it was just corrections as and when I needed them.

 

[In Response]

It is definitely common. The Type 1 "guru", Dr Bernstein's approach is that all women should be on the pill because our hormones are too difficult to manage. Sadly, this is not uncommon within healthcare - many medical trials do not allow women of child bearing age to participate.

I always adopted an increased basal (but did not change my bolus dose) to manage it.

 

[RosiePalmer]

It is definitely common. The Type 1 "guru", Dr Bernstein's approach is that all women should be on the pill because our hormones are too difficult to manage. Sadly, this is not uncommon within healthcare - many medical trials do not allow women of child bearing age to participate.

I always adopted an increased basal (but did not change my bolus dose) to manage it.

Thank you. Can I ask what basal increase you did? I've heard 15 percent is about right?

 

[In Response]

Thank you. Can I ask what basal increase you did? I've heard 15 percent is about right?

I found I needed to increase my basal by 40% for a couple of days.
As with almost everything diabetes, we are all different and need a bit if trial and error to find out what works for you.
I would recommend a small increase rather than just going for a full 40%.

 

[Finnlee]

I increase by 30% for the few days just before my period, then need to decrease by about 30% for a few days before I ovulate (I call it my 'magic week' because I feel like I can eat anything and inject the bare minimum insulin). I don't take much basal, so I find it easier to adjust my bolus.

I usually have one dinner just before my period where I need 50% extra insulin (then my period starts the next day), and one dinner where I need 50% less insulin (then I ovulate a few days later). Because I know those curve balls are coming, I plan my meals so I can have more or less food if I need it without feeling uncomfortably full or hungry.

Every person, and every cycle, is different. What works for you this cycle might not work next cycle, but being aware of your insulin sensitivity or resistance definitely helps.

 

[Antje77]

Thank you. Can I ask what basal increase you did? I've heard 15 percent is about right?

It's really something you need to work out for yourself.
There are massive differences between people, I need to decrease my insulin right before my period and during the first two days or I'll go low all the time.