Women’s Hormones and changing insulin requirements

Writing concerning my daughter here: Do any of you women with T1D have difficulty adjusting your insulin needs depending on your menstrual cycle? She is on a Medtronic pump and some weeks she is high, other weeks she is low. How do you women adjust so it is not always a game of catch-up.

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I once promised myself that I would never again comment on a post about pregnancy or other women’s health issues. Well, I hope this link is helpful.

Scott Benner, podcaster and primary diabetes caregiver of his T1D daughter, discusses this very issue with Jenny Smith, T1D and certified diabetes educator. Please excuse this male interruption!

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Many of us do, yes. I used to struggle with this a lot but since getting the T-slim X2 with Control IQ I barely notice any swings from hormones anymore as the pump can handle those on it’s own with only occasional input from me.

If she can track her cycle and figure out when her insulin needs change you can set up a profile on her pump for higher or lower basal to compensate. Or just make a higher basal and lower basal profile and just have her switch over as soon as you notice her trending higher or lower regardless of where she is in her cycle.

I have four different basals on my pump for each cycle. Sometimes I only use three of them.

  1. I use the “default” basal 1-2 days into each cycle and use this until ovulation.
  2. Second basal starts from ovulation and the next 7-10 days, this is 20% higher than my “deafult”.
  3. 5-7 days before next cycle I use my third basal, this is 30% higher than my “default”
  4. The highest basal is for the last 1-2 days before next cycle. This is 80 % higher than my “default”. I do not always use this last one but compensates with hefty bolusing and temp basalas when needed.

Thank you Terry, I’m looking forward to passing it along and hope I can comment on the benefits.

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I think she is ready to change to the T-slim and I think she will do much better. Thank you for the ideas.

Hi Ray1…what I have found useful is just doing temp basals for the days I need them. For me, that includes up to 3 days around ovulation. Then up to 4-6 days during the PMS timeframe, into the first couple of days of my period. I have found that I consistently need an additional 20% basal during these times. My cycles are woefully irregular, as my hormones are aging. I have the feeling if she is younger and has regular cycles, her number of days will be much more predictable.

I also had this problem when I was in my late teens/early twenties! For the longest time, I thought I was losing my mind. Using MDI was very challenging and was on the roller coaster. When I switched to an insulin pump, I was able to set a different profile for the 2 week before the start of my period when I would be low all the time and than a different one, once it started when I would be much higher. I never had a regular cycle, so I would just have to watch and wait for the lows to start before I switched profiles.
Technology can be a great tool when dealing with these kind of monthly cycles. Keeping my fingers crossed she gets it figured out🤞

You’ve all been so helpful and I appreciate it so much. And yes she felt like she was losing her mind and it was causing some depression. I’ve forwarded everything to her and she’s adjusting her regimen without feeling like she’s totally out of control. With 5 kids she has plenty to keep up with. Thanks again!

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