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Everyday Challenge: Menstruation and Blood Glucose

Managing blood glucose levels during the menstrual cycle

My blood sugar levels sometimes seem to go haywire around the time of my periods. Is there anything that can be done about it?

As if there wasn’t enough to contend with when trying to manage blood glucose levels. For women in their reproductive years, add another variable to the equation: menstrual cycle hormones.

Clinicians have long suspected that insulin sensitivity may change during certain phases of the menstrual cycle. As far back as 1942, it was noted that diabetic ketoacidosis (DKA) was much more common within two to three days of the onset of menses, also known as the luteal phase.

Even in women not living with diabetes, changes in insulin sensitivity during the menstrual cycle have been demonstrated; a decrease in insulin sensitivity is routinely seen during the luteal phase. Studies suggest that the hormone progesterone, which is present in large amounts only in the luteal phase of the menstrual cycle, plays a key role in decreasing insulin sensitivity and raising blood glucose levels in women with diabetes.

Find your pattern

It might be useful to keep track of when your periods begin for several months to see if there are blood glucose patterns associated with your menstrual cycle phases. A blood glucose meter or continuous glucose monitor may help you to evaluate monthly trends to see if glucose peaks or valleys tend to occur around the onset of menses. A pattern that repeats for three consecutive monthly cycles may warrant a discussion with your diabetes care team. Some women who experience a pattern of pre-menstrual hyperglycemia and/or post-menstrual hypoglycemia may benefit from a gradual adjustment to basal insulin levels around the time of their period.

And don’t ignore the possibility that some behavior changes may also affect daily highs and lows. Changes in exercise patterns, food choices and stress levels before or during your period may impact glucose control. Talk with someone on your healthcare team about strategies for managing your blood sugar with these types of changes.

Gary Scheiner, MS, CDE*, is a Certified Diabetes Educator and Masters-Level Exercise Physiologist who has lived with type 1 diabetes for more 28 years. He was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators, and has written six books, including Think Like a Pancreas. Scheiner and his clinical staff provide diabetes management consultations worldwide via phone and the Internet through his practice, Integrated Diabetes Services. Scheiner is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2015 The DX: The Diabetes Experience

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