FUDiabetes

Basal Rates and Hormones

So glad to know I’m not the only one seeing this. Figuring out the basal rate component has dropped my average bg by 40 points in the last two weeks. A 15%-25% basal increase (about 2 units total for me per 24 hour) can save me 8 units of correction doses through the day which really don’t do anything…which is unnerving to keep throwing insulin at it and seeing nothing happen. Like, “is this all going to break loose and cause a crazy drop?” is always in the back of my mind. Thank you for sharing your experiences and I look forward to lots of collaboration in helping all of us ACHIEVE better self-care. I really think this turns keystone rules of thumb on their head and this should have been studied by the medical community LONG ago. It’s up to us. Appreciate ya!

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I think I’m headed where you both currently are. As I’m still honeymooning, my bump up in numbers flatlines me at about 120 right now (where before I’d sit around 80), and corrections never get it back below 100, which I know isn’t terrible, but I’d love to figure out tips and tricks to handle this before it jumps higher as the disease progresses.

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Thanks for starting this thread, it has me pondering a few things :thinking:.

I was diagnosed in the Post Menopause stage and I simply assumed that hormone changes were not impacting my BG in any way at all - I need to rethink that assumption. I’m going to do some research of my own.

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I’m incredibly grateful for comparing notes here already. I’m vacationing with four families in one house (I.e. Uncontrolled chaos w one kitchen and no sleep) at the beach this week w high hormones/insulin resistance. Fortunately, knock on wood, these recent hormone re-realizations are helping me have the best vacation blood sugar I’ve ever had. I’m having a great time w my boys and I haven’t missed moments in the water due to waiting out blood sugars this time around. :+1::+1:

Edit: best vacation blood sugar ever until my son’s soft pretzel came w cheese and he wanted to share it with me. No one told me there would be dipping cheese. I’m only human…back to walking laps!!

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This! thank you, after a mere 38 yrs with T1 I decided to try and master my hormone fluctuations. I wonder if I can just go on the pill and forget the whole thing.

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Sooooo…in researching progesterone, estrogen and menstrual cycle/blood sugar medical guidance…where are these “many women” who “report that their blood sugar increases 3 to 5 days before their period”? Lots of websites cite this generic “fact”, but I do not see a source anywhere. Maybe I am missing something?

Also, why are so many of these articles claiming that Progesterone and Estrogen are at their highest nearly immediately before your period? They’re not. Any hormone chart of menstrual cycles shows that they typically peak between Week 3 and Week 4, and decline for days leading into menstruation. Making lots of allowances for individual experiences being varied, I just can’t wrap my head around why the medical community claims that hormones CAN impact your blood sugar…but just in the vacuum of 3 - 5 days prior to your period…because, Why??? If that’s anecdotally true, cool. But to claim it’s based on the science of our hormones, that’s an incorrect conclusion in my book.

“Changes are due to two hormones, estrogen and progesterone. When these hormones are at their highest level just before your period, they affect another important hormone, insulin, which may, in turn, cause blood glucose to rise.”
http://www.womenshealthmatters.ca/health-centres/diabetes/reproductive-and-sexual-health/

“Again, you’ll notice insulin resistance and higher blood sugar levels around the time you ovulate and in the days right before your period is expected to begin.”
https://www.ontrackdiabetes.com/related-conditions/how-improve-blood-sugar-control-during-your-period

“Many women find their blood sugar tends to be high 3-5 days before, during or after their periods.”
https://www.diabetesnet.com/about-diabetes/people-diabetes/women-diabetes

"Many report their blood sugar tends to increase 3 to 5 days
prior to the beginning of their period. " & "The hormones which control the menstrual cycle also affect
blood sugar levels. There are 2 main hormones involved:

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My personal methodology on tracking needs for basal increases and decreases from another thread:

This is one of those issues that, IMHO, comes back to (sorry for the usage) Your Mileage May Vary. Speaking as one experiencing perimenopause, mileage varies… a LOT.

A whole LOT. I can no longer predict, based on BG values, what is happening, is going to happen, or happened. It’s all…over… the m’f’n place. During a 6-month period-free place, my BG’s were the most stable they’be been. Huge indication to me of other hormonal involvement (than during those times I was experiencing more regular hormonal pushes).

Last week I spent a few nights awake due to night sweats and general inability to sleep, as well as some emotional/mood swings (poor hubby has seen me cry recently watching WALL-E… a cartoon - for crying out loud - please forgive the pun :laughing:)… ay yi yi.

That being shared, BG’S were crazy. Running 240-330. Yuck. I’m using a 670G and it can’t keep up with these types of fluctuations, so it’s on manual which allows me to sugar-surf the eff out if it.

I say poo on the medical community claiming a particular time-frame wherein ‘things’ should be happening. Things just aren’t clockwork.

Would you want to start a Perimenopause/Menopause thread? I’ve been thinking about it myself but am more zeroed in on the birth control front currently.

I do think there is a LOT of room for YDMV for women within the regular cycles phase of life, and for women entering perimenopause and for women in menopause. But why isn’t there research? Why isn’t there more dialogue? Why are articles saying “most” women will see increased insulin resistance 3-5 days before their period claiming that this is based on the timing of the highest levels of estrogen and progesterone in the female cycle when that statement isn’t even factually accurate? Progesterone doesn’t peak then, nor does estrogen. I would also like them to cite a resource when they keep repeating this as solid knowledge.

I can gladly accept YDMV if people are actually tracking it to know that there is variation. But how do we know that if everyone in the medical community says, “I don’t know. It’s weird. It’s different and hard to track.” Bc that seems to be where we’re at from what I’ve seen. Maybe I’m wrong.

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With all of the technology we have and all of the data tracking, I have to imagine diabetic women will have better patient outcomes and better quality of life if some research and dialogue is spent on these inevitable life processes. I just have a hard time continuing to exist in the darkness on this huge topic. Maybe I’ll find out there’s nothing we can do to make it better for everyone (I don’t think you’re saying that, btw), but I am going to try. And hopefully women telling their experiences on FUD will start that change. I appreciate you putting your experience out there and I hope it evens out for you soon! And then you can tell me how to ride it out! :stuck_out_tongue_winking_eye:

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I just swung from needing +15% basal to needing -15% basal over the course of a few hours.

  1. I’m glad I was eating routine foods so that this basal change wasn’t obscured.
  2. I was impressed by how many extra carbs I needed due to the excess basal I was carrying (chocolate, 3 glucose tabs, cookie, milk, juice box). And I underbolused dinner just in case.
  3. I am glad to be on the pump to be able to fine tune temp basals pretty quickly rather than being locked in on shots.
  4. Thank goodness my Dexcom is behaving well (with confirmation finger sticks).
  5. I wish there was a better way to handle this part of my biology.

I wonder how quickly other women’s basal needs change? This all happened between 4pm and 9pm tonight.

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@T1Allison

Hey, you stole a picture of my dexcom. That’s pretty much how my day went today.

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I’m not on basal yet (but really need to be at least for 3/4 of the month!), and this just adds another concern to starting it while still doing MDI. :worried:

This sounds pretty similar to me. I’ve even heard this called “The Drop” by some women. It’s one of the biggest reasons I benefit from the pump. This is (and intense activity) are the two things that can lead to lows that last four to nine hours for me and only end when I suspend my pump.

Since I’ve been tracking my cycle with my Fitbit, I’ve noticed that my basal has slowly inched up over the past week or so (currently in week four of a five-week cycle). I’ve adjusted basals upwards, but I’ve also had problems with lows if I increase too quickly. And there seems to be something weird going on with boluses, where I go high after many meals but not all, but if I try increasing my bolus amount, I go low. Typically when I was eating low-carb I could just increase my basal and increase my carb and correction ratio only slightly (which I’ve already done), but it seems if I’m going to eat carbs I’m going to have to be more aggressive, and figure out the few times I don’t need to be aggressive…

@Pianoplayer7008, I hear ya. Couple of thoughts:
You are already WAY ahead of the curve, IMO, because (a.) you see that your hormones probably influence your specific insulin needs, (b.) you’re engaging with other women to see what their experiences are and how that might relate to your needs, (c.) you’re already tracking it, and (d.) you use CGM.

When I started on MDI in 2006, I was without CGM. I was without any guidance as to if/how hormones impacted my insulin needs. Granted, I was on birth control which in retrospect seemed to dampen the magnitude of the swings, but I was without a whole lot of tools and a whole lot of knowledge. I’ve observed, tested, tinkered and tracked for years to try to figure this out. You’re ahead of all of that.

You can probably do a pretty darn good job rising to the occasion on MDI. Whether you take a once daily basal or twice daily basal, just tracking it will empower you to triage in the interim of “perfect” doses. Obviously if you are carrying too much long-acting insulin for what your body needs in the moment, be conservative with bolus dosing. And the reverse is true.

You got this. We all got this. Especially if we keep sharing our experiences/trials/successes. Comparing notes is probably the best thing we can do until I figure out something better on a large scale for all women. :wink: That’s my goal, anyway.

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I can see why it’s called “The Drop”. I like that. It fits.

Check this out:

Breakfast SPIKE today. I only ate half of what I planned. I was level at 150 last night after running -15% overnight, so I switched to +0% at 7AM. Granted, I didn’t sleep well last night trying to keep an ear out for what my body might throw at me next, but this spike is pretty epic concerning I eat the same breakfast every morning as one of my controls.

My point with this image is that I, too, struggle with bolus behavior during basal fluctuations. This was very unexpected. And given how much it is coming down, I believe my +0% basal is correct right now. I typically switch from -10% to +0% within 12-24 hours of cycle re-start.

Knowing which lever to pull, and how hard, is SO challenging in female diabetes. It’s a whole 'nother animal, in my book.

I’m glad your FitBit tracking seems to be adding some clarity for you! I really need to start doing that, too.

@Jen, holy smokes…I definitely need to reduce my dinner boluses when I’m in insulin sensitive days. Holy cow. I trimmed down my dinner bolus but not by enough. I’ve already supplemented dinner with two juice boxes, two chocolates and a cookie over the last 90 minutes. Breakfast and lunch didn’t behave this way today or yesterday…I don’t think…

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