This. I saw my doc yesterday, and after explaining what I’ve been dealing with since my period returned in March (insulin resistance, morning sickness-like symptoms every couple of weeks, etc), we’re doing the oh-so-fun thing of mapping out my hormone levels this cycle with multiple blood draws to see what’s going on (I suspect my PCOS is out of control…). It would be so much easier if I could just read it with a meter, as I’m sure my hormone fluctuations are not fully consistent each cycle.
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Have you ever used an ovulation tester? It’s limited in what it can accomplish for us, but just curious.
Only when I was trying to get pregnant with my first. I generally can tell when I’m ovulating, though. It’s just every other part of my cycle that’s messing me up!
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Ovulation hormones be all like, “I can’t let you through, insulin.”
If I hadn’t had two super dramatic tanks in the last two days, I’d dial up more basal. But I’m already running a decent extra basal and I’m feeling a little gun shy after those drops…so stuck at 190 for now. 
So… you guys have been doing some serious work around here. I’ve just been alternating between rage-bolusing and rescue-cramming every couple of days while cursing and scratching my head.
I want to do this. I’m not sure there’s anything to it for me, and I’m also very sure there is. I don’t have the bandwidth though to track one more number, pattern, or calendar day. I just don’t. So then let me ask you… i read somewhere up there about “the drop”, which is a very intriguing idea and rings bells at the farthest, dustiest parts of my mind… are there general patterns all women follow?? Like a basic overall picture? And then let me ask… where could I find something like it? Just a simple “hormones and their effect on your already wacked out blood sugar… for dumbasses” Because I would need that.
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It appears to me that we FUDers might be writing the book on it right now.
My investigating so far has turned up overly generalized after overly generalized diabetes articles that all parrot the same scientifically inaccurate statements (“Most women see increased insulin needs 3-5 days before menstruation because that is when progesterone and estrogen are at their highest.” -note that this is not when those hormones peak)
I’ve posted everything I can find on it and all of my personal observations of my own insulin needs on and off of birth control.
I’ve been working on trying to get some respected people in our community to work on this project with me bc we all see (like, I talked to them and we all agreed out loud to this statement) that female diabetics are grossly underserved. I had some other leads, too, that so far haven’t panned out. But I’m still working on it.
Like anything, it takes a lot to get something rolling. People are busy. I get it.
In the meantime, I’ll keep working on it and posting everything I find. I hope we continue to get more observations posted from fellow FUDers bc we are our own best resource.
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Here’s the quick summation of what I understand to probably be true, but cannot know due to lack of information and study on this topic (I had a friend check and there are amazingly few grants out there for studying T1D):
- Are you in perimenopause yet or are you still in predictable cycling prior to perimenopause? (you don’t have to respond to that openly…but something you will need to know, likely)
- If you are not in perimenopause yet, that could make tracking this easier because theoretically your cyclical hormones will be more consistent each cycle than in perimenopause. But that still doesn’t mean that the spikes of hormones will spike to the same level each cycle.
- If you are pre-perimenopause, (bc I have not gone through perimenopause and have not read anything insightful on managing hormones in that phase yet so cannot speak to it at all), keep track of your cycle start date each cycle. Learn the signs of ovulation and keep track of your ovulation days and see if they are consistent each month.
- Progesterone is definitely an insulin-resistance generating hormone, so as it increases in our cycle, some of us (or all of us? no one knows) need more insulin to maintain normal bg. The collection of hormones that cause ovulation also cause insulin resistance (bc progesterone is not peaked at ovulation, but you get other hormones in the mix that cause significant insulin resistance during ovulation per my CDE).
- For me, I use temp basals to try to keep my bg normal all cycle long. I think my percentages are in the second post on this thread.
- What I look for is (a) what cycle day am I on? (b) what did my overnight fasting numbers do? (c) how did my routine breakfast and breakfast bolus work out? This is how I’ve always assessed my insulin sensitivity, even on MDI.
- Whatever you do, make sure your basal rates are correct in your “easy” week, week 2. There might be a small problem in my 4P-7P base basal rates because adding temp basal these last few days has lead to problems in that timeframe. It’s not food or boluses causing it b/c I controlled for that. I don’t see problems in that timeframe on a noticeable scale during week 2, but I sure have seen problems there this week.
- To answer your question about The Drop, I got that phrase from @Jen. This refers to the sometimes steep change in insulin sensitivity after your cycle restarts. I need to drop from +15% or so down to -15% or so within 12 hours of cycle start. My CDE said some women don’t see that drop until Day 2 of the new cycle.
Ultimately, I’ve talked to the professionals I really respect about all of this. I was told that I was one of very few women that they have worked with who has really tracked and really nailed down what my hormones are doing and what my insulin needs are as a result of that.
This is not a topic that has nearly any useful information out there that I have yet found. Either there is no scientific experimentation on a large enough scale to make large conclusions on the topic, or parts of it appear not to have ever been studied at all. I’m still looking, and maybe I’m wrong, but we are the trailblazers here from what I can tell. The gift of CGM will make this much more accessible to women to track…if they KNOW to track it and how to track it. I tracked it on fingersticks alone, even when I was on birth control and had muted hormonal fluctuations, but the fluctuations in basal needs were still there every month.
We need to change the narrative. We deserve better information and guidance.
*A note on Sugar Surfing during times of hormone flux: be careful with it. I have to sit back and see what a spike is doing first to be best able to tell if it is a result of insufficient basal or insufficient bolus. If you always jump on rises with a correction bolus as a woman, I think you won’t be able to get to the “why” as quickly. I log all of my correction doses, too, and as they increase each month, that’s more evidence that my basal rates need to increase. So if you do Sugar Surf, track it with your FANCY NUMBERS that you love (
) and then examine if that means you truly need more basal. A little extra basal for hormones will accomplish what three correction doses cannot accomplish in my body.
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I replaced my Fitbit with an Apple Watch… does anyone know the quick answer to wether or not apple tracks, too??
Just looking at Google, it looks like there are several apps that you can use to track your cycle (mostly geared towards fertility) with your Apple watch. One that is mentioned is an app called Clue optimized for the Apple Watch. Another one listed is Glow.
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Holy crap… you can get apps for your watch?? I’ve basically just been using mine as a timer. 
Will have to look at that today. Thank you for looking! And I read your responses this morning…that’s for real stuff. I’m trying to process it… and figure out where to start.
I’ve got some women over in my Facebook group who try to talk hormones to me, and I just glaze over. I’m not proud. I’ve included a link here in hopes they could come over and talk it with someone who knows what they’re talking about. 
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I would love to get more women to join this conversation. I’m just one person with one set of experiences. There is likely huge variation over the group of us, but we cannot know that until we get more stories out there. Thanks!
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I printed out my Dexcom graph for the last 24 hours and put notes on it to show some of what I mean. I was on a brand new Dexcom sensor yesterday but it was pretty accurate based on fingersticks.
Yesterday was Day 17 for me, probably peak ovulation hormones. My point in posting this is to show what a difference of even 5% in my basals makes for me. Due to some lows between 4PM-7PM the prior two days with an extra basal of 15%, I didn’t want to go any higher than 15% yesterday. I was stuck in the 160-200 range all day. I bumped up my basal from 15% to 20% at 8PM and then the numbers settled down in a lower range and stayed decently steady (for a day 1 sensor reading) the rest of the night. I’m using +20% today and am going to see how it goes…but I know to be very careful with any correction doses in the 4PM-7PM window since something screwy is happening there for me. UPDATE: I semi-basal tested the 4PM-7PM timeframe today and I dropped 90 points in that time. No wonder I tanked hardcore two days ago when I took a strong correction dose at 4:30PM. Will have to basal test that segment for real during my next week 2 to see if anything pops up there…got a couple different theories to work out.
So anyway…despite the Dexcom jumping a bit yesterday, it still demonstrates what it is that I’m looking for when I decide to increase a basal setting due to hormones. If I get the correct increase, it will move my numbers to hovering in a different range (i.e. lower)
.
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So it’s taken three juice boxes so far to arrest the descent I had going from 5PM-7PM+ while carrying an extra 20% basal for hormones.
I will re-test the basal rates next “week 2” chance I get, but if my base basals (my week 2 basals) were THAT far off, I feel like I would’ve noticed something by now.
So…since I can’t retest those basal rates for a few weeks…my other theory is that I need less temporary extra basal during high hormone times when I’m active (coming home to solo parenting of active little boys) than when I’m sedentary (office work/sleeping). That’s the only significant thing I can pinpoint for what’s going on this week. I get home, I hit the ground running, and that extra temp basal that was barely able to keep my blood sugar grounded at 160 or 190 is now doing the “I’m going to slowly, imperceptibly, persistently drive you into a long low” routine.
Thoughts? @Jen, have you seen this?
I just did my part by posting a very reverse-sexist joke request for women to come join and am surprised that no one has responded. 
It wasn’t that bad… but I did post it to my group, and I did explain we were looking for women, and then I did make a joke that may have been unnecessary. I got one heart from Misty, my new girl, and 498 people are yet to respond… so I’m crossing my fingers.
As far as what you have posted, which has been amazing, do you have a graphic that is like “you are here” and points to day one of your cycle… and then gives a basic, dumbed down overview of what one might expect? I understand you’re waaaaay beyond that and even somewhat disapproving of the blanket application that I’m looking for, but I feel like I might need to enter there… where maybe, by process of deduction, I can figure out what to take away?? Maybe? Oh, and I don’t think I’m in orrimenoaise yet, which I’d be happy to answer cuz I already publicly talked about my pee pee… and we’re all friends… but I’m not positive. According to the last couple of rounds of various tests, the doc says she has no reason to believe I’m there yet… oh, and I do still have a predictable and consistent cycle. So.
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So thinking more…again…still…what’s a Basal Rate really do? what does it address? It combats hormonal changes throughout our day like Dawn Phenomenon and the Second Window of Circadian Low (afternoon basal rates that tend to be lower…maybe?)?
I’ve never understood the “math” on basal rates. Like how a tenth too many units of insulin for a few hours in a row can spell trouble for me. Is a basal rate really dealing with hormone resistance more than sugar? Maybe a basal rate sets the platform for the bolus to work…because the basal is holding the insulin resistance at bay while the bolus sneaks by?
Does this question make sense? Do any of the larger community want to weigh in? @Eric? @Beacher? @bkh? @ClaudnDaye @Sam
That’s right. I tagged you all on this thread. Looking for wide input on this and everything. Hope I didn’t offend anyone I didn’t tag. I want to hear from any FUDer on this.
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Or perimenopause … or mayonnaise. And in case anyone missed my intimate details in the first round, here they are again. And I can’t believe I’m being bashful like we’re in 1952… 
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Are you asking what is basal insulin?
If so, Basal literally means “background”, and basal insulin is the background insulin that is constantly active in all bodies (diabetic or not) to keep blood sugars from spiking (during fasting hours).
Basal insulin is programmed to keep the blood sugars stable in the absence of food.
So, “basal rate” is the hourly insulin rate that we each must figure out for ourselves that keeps or bgs as flat and low as possible (during fasting hours). Bolus is to cover the post prandial BG spikes.
Sorry if you weren’t asking that question!
Hormone spikes, Dawn phenomenon and all that would be dosed by bolus unless it was pattern enough that you could work out into your basal rates… they would need to be unchanging though.
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Right…but what does it DO?
Does it combat hormones that we all, men and women, face daily due to circadian rhythm, etc? Or does it battle a slow trickling out of sugar from our liver? What does basal really do?
If my basal needs were always constant, I’d find the right rates and not question it. But due to the variability of my rates and my crashes this week…it makes me want a clearer answer as to what the basal insulin is really doing. Hopefully that helps?
So if my basal rates are correct for low hormone times over the whole 24 hours…but then those rates are not correct on the same scale (i.e. +20% is not foolproof for the whole day)…what does that mean? Does that mean that hormones interfere more with basal insulin if I’m not moving? Does that mean that there is an exponential relationship between insulin resistance and my activity level during high hormone times?
No.
When fasting, the body steadily releases glucose into the blood to our cells supplied with energy.
Basal insulin is needed to keep blood glucose levels under control, and to allow the cells to take in glucose for energy.
The only way I would program hormone spikes into the basal rate profiles would be if they occurred at the same time each day.