I’ve posted quite a bit regarding my observation that diabetes education and blood sugar management strategies almost universally omit Female endocrinology. The male body is the default for most everything diabetes related.
This article discusses a study on snowplowing in Sweden with some surprising results (including economic) related to gender.
C’mon @allison, except for a couple of weeks a month, 9 months here and there, as well as the rest of the time it seems like basing things off of men is the perfect solution. /s
I’ve been home full-time for about ten months now and I’ve mastered many impressions of my husband in our weirdly stereotypical roles these days.
He said he never thought it possible that I could become an even bigger smartass. Evidently it was. 
Do you need special BG management strategies for doing the laundry and dishes?
I manage my blood sugar just by feelings. That’s what we little ladies have: feelings.
Your move. 
I’ve always been in touch with my feminine side…
Can you prove that? I would expect the opposite, hypothetically;
Most diabetes research is T2D, that is age related and females predominate in the older age groups (scroll down for the “Broad Age Groups” table). Hey, we’re out-numbered, run away, run away. (I’m in the 55-64 cohort.)
Gestational diabetes is a very significant area for the younger cohorts and it is heavily biased towards a limited group of female subjects.
Female cycles are way preferred for analysis over male cycles. I defy you to find a reasonable treatment of the effects of daily testosterone variations (the male cycle) on type 1 diabetes (the study I quoted is T2 related).
My purely hypothetical conclusion is:
Unlike in Sweden (or where I live for that matter) the studies don’t actually have a sex bias towards XYs.
As in Sweden the actual sex bias (towards XXs in this case) is circumstantial; relating to an underlying bias (in Sweden that women are expected to do the shopping, and this is a low value occupation, in our case that men are less likely to demonstrate diabetes therefore less important in a valid study.)
Well, yes, gestational does go to the women since men don’t have babies. Not really what we’re covering here though bc everyone freaks out about diabetic pregnancy so the pregnancy does get paid attention to.
I enjoy being defied to. That’s unusual. And fun.
Men don’t have periods. Women do. They also ovulate. Men don’t. We have lots of significant hormone events on a weekly basis that can significantly impact our insulin resistance yet there is no significant source of guidance out there. Most study conclusions state that women likely eat too much when we PMS and that’s why our blood sugar is high. Oh my word.
Standby…let me add a link here in a minute…
@jbowler, when it gets down to brass tacks, blood sugar management for insulin dependent diabetics is taught on the premise that your basal needs fluctuate throughout your circadian rhythm, plus when you are sick or extremely active/inactive. It all is taught on the premise of finding your level playing field on a repeatable daily basis.
Women are taught that this same thing exists for them EXCEPT when they are menstruating plus potentially during PMS. [That idea about those being the exclusive times their basal rates are different may or may not be true for all women.] But it is based on the idea that all insulin dependent diabetes is the same (male) except when women are being demonstrably woman-like [PMS and menstruation].
That’s my point.
@jbowler, there are numerous studies discussed on this forum about how women with Type 1 diabetes have worse glucose control and worse long-term outcomes than men with Type 1 diabetes, and also numerous studies showing that fluctuations in monthly hormones can precipitate ketoacidosis in women. It’s just frustrating that such an important topic that has such a huge impact on diabetes control gets virtually no attention when it has real-life consequences. Many women aren’t even told that hormones are a factor and only learn about it from online communities (this was the case for me). There are several threads on this site with women documenting the kinds of extreme changes in insulin needs that happen throughout every month and the monumental struggle it is to keep blood sugar close to target range during the majority of each month ('cause if we do nothing, it means spending 100% time out of range for weeks on end).
And that is about the be-end and all-end of it, right?
Men have hormonal fluctuations on a precariously repeatable daily basis. No daily stability here, sorry. So I think @T1Allison’s other points have just been totally, riotously, defeated by @T1Allison’s own arguments.
I find that a very weird example, because it can be argued both ways. Given Sweden’s efforts to get a gender equal workforce, one could very well argue that plowing the main roads is an act of feminism, because it facilitates women to get to their jobs, while only plowing the side roads perpetuates gender stereotypes.
With regards to medical research, it is beyond me how it is possible that there are still doctors who don’t know that heart attacks present differently in women. The example of heart attacks is repeated so often in the media. Yet I doubt the issue of misdiagnosis can be solved completely. While there is room for improvement, the lack of clear-cut symptoms will always be an issue. Fatigue is a symptom of many other health problems and doctors can’t treat every case of fatigue as a potential heart attack. Likewise, raising awareness among women about the symptoms of a heart attack, may increase the number of women seeking medical help, but no level of awareness will ever cause women to worry as much about fatigue as massive chest pain.
Drug research, not mentioned in the article, is another field mainly centered around men, except for areas such as breast cancer of course. That’s problematic, because drugs may work differently in women. I think researchers are well aware of that, but nobody knows how to deal with the statistical challenges posed by female hormonal fluctuations and the risk of teratogenicity or permanent infertility during clinical trials. It would be great if someone came up with a solution. Instead, too many people focus on flat-out denying the challenges or looking for conspiracies.
What kind of fluctuations would that be? And how do these influence BG levels? If these fluctuations exist, I haven’t noticed them.
I don’t think that study supports your claim. There’s no mention of male testosterone cycles or measurement of testosterone levels over time. They didn’t assess the influence of testosterone fluctuations on glucose levels during the day. They actually seem to assume that testosterone levels are quite stable, otherwise it wouldn’t make sense to classify subjects as hypogonadal or eugonadal based on their testosterone levels being lower or higher than 9.7 nmol/l.
Dang. I’m so good at arguing I defeated myself. I don’t know that I am worthy of such a compliment. 
Are you arguing that the medical community’s treatment of diabetes is substandard for men, as well? Then make that point.
Do you really think that diabetes strategies taught to both men and women are based on female body assumptions? Bc if anything, they are based on male body assumptions…but if you think they are based on completely fictitious assumptions that serve Neither gender, that could be a strong argument. But you haven’t made that argument yet.
I assure you that I cannot claim that my medical care has catered too much my female endocrine system. I have been told by nearly every provider I’ve ever had that it can’t possibly affect my blood sugar.
But maybe I’m riotously defeating myself again. I’m sure you’ll let me know!
[quote=“T1Allison, post:14, topic:9304”]
I have been told by nearly every provider I’ve ever had that it can’t possibly affect my blood sugar.
[/quote].
You’re right, providers are likely ignorant, certainly to hormonal fluctuations on the part of women, but, in general, also to the intricacies of diabetes management. This applies to endos as much as other medical staff. I’ve been told my low A1C levels must mean I’m having too many lows, for instance.
So, as my bosses would say, we’ve found the problem, where is the solution? I vote @T1Allison becomes a CDE or similar to help patients one on one, and maybe can do brown bag seminars for doctors that may listen. Or, maybe you become a good Endo yourself?
For those diagnosed in the dark ages, using single injection long acting lente once per day, the differences between genders didn’t matter much !!
Some doctors still operate on that model, even with newer insulins, pumps, cgms. I’ve had numerous discussions with endos, showing well documented logs and BGs, explaining correlations, but usually told its just coincidence.
Not worth much for the converstation @T1Allison, but a few months ago I was looking for a resource to discuss the impact of female hormones on BG. Do you remember who I asked to be on the team? It wasn’t a male endo. Or even an endo! 
I don’t know it myself, but I don’t have to. It’s enough just knowing that you know.
I don’t ever need to know everything, I just have to be smart enough to know who to ask.
I like that!
For general explanation to FUDders, my goal at FUD has always been to try to help others even more than I’ve been helped here…and I’ve been helped a LOT.
My hope is that with the expansion of the “pregnancy” category to the broader “Women’s Health” category here on FUD, plus continued discussion and highlighting of issues that affect women’s blood sugar, it could help lots of women who find their way here through frustrated Googling of topics that none of their doctors are well versed in.
People have to be aware that there’s a question to investigate before they can hope to find an answer. When I point out articles or studies that demonstrate a surprising result where gender is concerned, it’s not to say, “Look how bad we have it!” or “Look how you guys get everything!” It’s strictly to show, “Hey, I think there could something here we need to ask about that might not have been considered before.”
I think all people deserve the best care they can get. Considering how female endocrinology affects females is part of getting optimal care. And if male endocrinology needs more work, advocate for it! There is no trying to take something from anyone else in these discussions. It’s just to raise awareness for the betterment of all or at least for those directly affected.
Here’s a good NIMH link; it is 2016, but it’s still pre-Trump so probably believable:
It’s a review publication; it attempts to summarize the field for other researchers (so it is not a primary source, not appropriate for quoting in other science but actually good material for wikipedia if you are a contributor). It is aimed at T2D, but that is the dominant meme in the field so relevant here.
I’m still half way, if that, through it. There is a lot of information there and a lot of references (appropriate to a review paper), but I’m generally impressed by the quality of the paper so far. Worth reading.
si do i to a certain extent. after 53 yrs of type 1 you get to know your disease kind of intuitively, right?