Periods and diabetes 3 September 2021 Periods and their effect on blood glucose levels is as individual as each person’s journey with diabetes. No two bodies are the same, and neither are our responses to the cocktail of hormones, glucose and insulin. International balancing act Woman all around the world are not only balancing the daily demands of diabetes but also the effect menstrual cycles have on glucose levels. The menstrual cycle can often result in high glucose levels during the different phases. Dr Apoorva Gomber, a doctor who lives with type 1, says she has heard many young women complain about glycaemic difficulties, especially in the pre-menstrual (PMS) phase. “I often get frustrated chasing my blood sugar graphs on a continuous glucose monitor weeks before my periods – sometimes for a few days to over a week,” Dr Gomber writes in “Periods and Diabetes: What you need to know”. “Despite high doses of insulin, I feel unsuccessful when I can’t achieve the levels I want. This lack of control is a real thing and I’m sure I’m not alone.” Not alone Dr Gomber most certainly is not alone. There are many hormonal changes during a woman’s menstrual cycle. The surge and downfall of certain hormones determines when a woman ovulates. After ovulation, which usually occurs around the 13-15th day of a cycle, there is an increase in the levels of the hormone progesterone. The progesterone levels are naturally higher during the second half of the menstrual cycle and are responsible for temporary and relative insulin resistance. Insulin resistance This can last for up to a few days before easing. Dr Gomber says most females complain of increased insulin requirements to combat this resistance and then find themselves running above range. This can also happen in the premenstrual phase. We shall overcome How do you overcome it? There is no easy answer. Obviously, you can alter your basal (long-acting) insulin requirements but there is no formula for everyone. The most important piece of advice from Dr Gomber is “Do not beat yourself up about it!” Once your hormone levels fall back into range, your insulin sensitivity will improve. “I often try to exercise and do some form of relaxing activity to manage this stressful time,” Dr Gomber advises. Easy checklist In summary, here are some important things to keep track of: What is the length of your cycle?How long does your period last and how heavy is it?FatigueBlood glucose levelsWeightCravings For more detailed information about diabetes management and your menstrual cycle, get in touch with your endocrinologist, gynaecologist or credentialled diabetes educator.