O, wait HAHA. It took me a while to figure out what you were talking about. Just fixed it 
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This is what I’m guessing as well because of the progestin!
Ugh, yes. Haha sooo much basal testing to do and so little time over those few days in week 2!
But yes! Cheers! I feel like a pioneer on this one, which is pretty cool. Let’s just publish a paper with our FUD’ers data (sample size of 6?) I feel like Nature will take us
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interesting! I feel like it’s got to be dependent on all our individual hormonal fluctuations. So crazy, but I’m looking forward to really tracking my sensitivity/resistance so I can add my trends!
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I was cool with being 22 and having that kind of handle on my hormone understanding… I just wasn’t sure you wanted to be me. 
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Wait, so brief recap of cyclical hormones (just making sure I get this right) and how they may relate to blood sugar/insulin activity. Each hormone’s actions:
- Progesterone = increase in insulin RESISTANCE = decrease in insulin SENSITIVITY = overall higher blood sugar
- FSH and LH and estrogen - this is a big question mark? But I’m guessing because of some documented elevated sugars during ovulation that -->
- FSH and LH = increase in insulin RESISTANCE = decrease in insulin SENSITIVITY = overall higher blood sugar
- Estrogen = increase in insulin RESISTANCE = decrease in insulin SENSITIVITY = overall higher blood sugar
?
Please correct me if I’m wrong!
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It’s not necessarily that simple, since some reactions are to hormone withdrawal (or other fluctuations in the hormones), and not just to the hormone level per se. At least that’s true with most other effects of hormones (on mood, behavior, physical symptoms), so I’m guessing could be the case for insulin sensitivity and other metabolic factors. I see increased insulin resistance during high estrogen parts of my cycle and increased insulin sensitivity specifically during progesterone withdrawal, for example.
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I don’t know that anyone knows for sure. Pregnancy D books discuss how increasing progesterone throughout the pregnancy increase your need for insulin. And that your drop in progesterone in the first trimester causes the drop in insulin need (which was fairly significant for me). So I’d say that it’s generally understood that progesterone causes insulin resistance. My cycle experiences definitely support that.
Estrogen I’ve never gotten a straight answer on from anyone. The last time I asked an expert, they said that the ovulation spike in insulin needs that I see is from the other hormones in addition to the estrogen…like FSH and LH, I assume?
If anyone finds any detailed literature about this topic, I would love for it to be shared on one of these threads.
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Looking at explanations of the decrease in insulin need in first trimester:
CONCLUSIONS —Observations in the DIEP cohort disclose a mid–first-trimester decline in insulin requirement in type 1 diabetic pregnant women. Possible explanations include overinsulinization of previously poorly controlled diabetes, a transient decline in progesterone secretion during the late first-trimester luteo-placental shift in progesterone secretion, or other hormonal shifts. Clinicians should anticipate a clinically meaningful reduction in insulin requirement in the 5-week interval between weeks 7 and 12 of gestation.
I find it interesting that “overinsulinization of previously poorly controlled diabetes” gets first mention, followed by decrease in progesterone, then other hormonal shifts as the potential explanation.
I see the routine theme in female diabetes topics that the researchers don’t know the answer, but their top hypothesis is typically to blame the patient for poor control in some way. Yet the researchers still themselves don’t understand the mechanisms. So we’re supposed to understand the mechanisms and be well-controlled why?
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It’s a reach but if you experience increased insulin resistance in the few days before and after ovulation then it could be pointing to estrogens role in added resistance since LH and FSH are pretty notorious for peaking in a smaller time frame around ovulation
I’m going to go on the hunt for literature on these hormones even if it’s more in vitro style because I’m just so amazed at the complexity of all these hormones and how they interact (and how there’s an absence of clinical studies here 
)
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I am on Mirena and this is an update for the trends that I noticed regarding my insulin needs for week 1 (and a little bit on week 4)
Week 1:
- Days 1, 2, and 3: I am more insulin sensitive overnight and in the morning. I used a temp basal of -10% overnight and that seemed to work (without doing any official test but I stayed stable overnight). I found that my morning basal 8AM-11AM was causing me to drift down (whereas normally I stay steady) so I used a temp basal of -20% and that worked great for me. I did not find any other sensitivity at different times of day
Week 4:
- I am less convinced of these week 4 trends so I’m planning on testing out my theories in a few weeks when I hit week 4 again with better carb and taking notes on what I’m eating
- All Week 4 (and possibly week 3): I experienced insulin resistance associated with meals. (I did not notice this trend but my CDE did). My basals seemed to be fine over the days and nights (I wasn’t drifting up like I was expecting I would.) However, I consistently experienced spikes after meals (meals that I eat frequently and know what amount of insulin normally works for me that I normally do not have spikes for.)
- Again, just trends, but next week 3 and 4 I am going to be better about recording what I’m eating and will try adjusting my ICR down so my boluses will be more aggressive for meals
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I am intrigued by the fact that you’d still have these hormonal spikes with Mirena – doesn’t it have progesterone in it and so people aren’t supposed to get periods?
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Mirena releases progestin (similar to progesterone), but the release is fairly local to the uterus and does not seem to be notable systemically.
the lowest amount of hormone in the blood for any type of progestin-only birth control—lower than the average amounts for: the implant, the mini-pill, the shot
And most women on Mirena are still experiencing normal cyclical hormones:
Many women using the Mirena (75-85%) are having their usual hormonal cycles after a year and still releasing an egg. The main way these IUDs work to prevent pregnancy is by keeping cervical mucus thick so sperm can’t get through the cervix to meet with an egg.
Because Mirena is known to thin the uterine lining, it is associated with decreasing menstrual bleeding and is often prescribed to women with heavy menstrual bleeding.
In a clinical trial of Mirena in women with heavy periods, the majority had an 80% reduction in bleeding as early as 3 months, and a greater than 90% reduction at 6 months.
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It is worth noting that research suggests Mirena has one of the highest risks of depression of any HBC—higher than most birth control pills. That still happens in a minority of people using it, so many folks do tolerate it without a problem, but it’s something to be aware of and monitor. I know as someone with a progesterone-sensitive joint condition, I definitely felt systemic effects of it (increased my hypermobility and pain) and learned this is a common experience for people with my condition. So it seems like for a number of people anyway, effects of Mirena’s progesterone go well beyond the uterus. My reproductive hormone researcher colleague says a lot of it just isn’t all that well understood yet, and in this field, often people assume a thing works a certain way and it gets passed along via MDs as fact, despite little evidence behind it.
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O my so this month has been different !
Week 1: days 1-3 I used a temp basal of -10% overnight and mornings and that kept me stable, not drifting up or down. Day 4 I kept dropping alllllll day - I wasn’t expecting that based on last month. Looking back on it, I suspect I needed a temp basal of -10 or -20% all day. Day 5, I worked out in the morning and I should’ve done a temp basal from the start, but I was battling lows all day, did -50% on boluses and was still running low. (Most of the time morning workouts don’t run me THAT low all day (I’ll normally just adjust boluses slightly)). I think it was a mixture of my cycle and workout, but I really ended up using 50% of my normal TDD and had two bags of skittles combatting the lows. Kinda blew my mind I felt cured of diabetes LOL. Retrospectively looking at it I wished I’d just cut back on basal majorly for week 1, but I’ll try that next month 
I’ll post on my week 4 trends once I get a chance to analyze that data with my meals
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When you say week 1, do you mean that week 1 begins the day your period starts?
My basal needs are always highest during my period. I still find it mind boggling that you would experience the opposite.
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My basal needs tank anywhere from a day before starting to 12 hours after. It makes Days 27/28/29/30/31 really exciting bc who knows when it will start and who knows when I’m gonna drop like a rock?!
Keeps life exciting for me. Bc exciting is what I’m going for these days. 
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This is exactly my experience as well.
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@Katers87, yes I mean week 1 as when I get my period! I think I’m more insulin resistant week 4. I’m mind blown at the variability of this!!!
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Looks like you all have a pretty similar pattern around the start of your period. I’m the oddball here 
…
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I wish I had something resembling your pattern bc it might give me more reliable benchmarks for when to look for the sensitivity transition. With how my body works, I have to watch for and wonder when my cycle will restart, and watch for and wonder when my insulin sensitivity is going to decide to change…which gives me a week of playing it SUPER safe with my blood sugar decisions and eating and bolusing which is a major PITA. If my sensitivity changed after my period start every time, at least I could just cuss being a woman while wondering when my period is going to hit and then I could separately cuss being T1D when the sensitivity transition happened after that. But I have to cuss all of it at once for a week in my scenario! LOL!
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