Hormone roller coaster, also metformin

About a month ago I mentioned having been on a 3-day blood sugar roller coaster with a standard deviation that was shooting up over 100 for about 3 days running. I’d never experienced anything like this, so I added it to the list of things to track along with regular hormonal changes and insulin use. Yesterday I saw something similar. I ate a graham cracker that I made for our baby with food allergies and shot up to 180 within 30 minutes despite dosing for it. Today I noticed a similar pattern after eating a scone at a friend’s tea. Okay, 2. They were too darn good! But I had rocketed to 190 within half an hour. Both times I had eaten them with a starting bg somewhere between 70-90. What follows is a chart of insulin use over the last 3 months. When I compared the roller coaster SD days between last month and this month, they occur at remarably similar times. Days 4-7 of my cycle.

As a side note, when I began this experiment it was mostly to track whether metformin had made a difference (my NP recently told me I was not insulin resistent and didn’t need metformin, even though I was asking for it). Turns out, it had made a difference! While on metformin, my average TDD was 33 units. Since going off, it has been 44 units consistently.

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Sure sounds like you are experiencing insulin resistance. 50-60 units a day is pretty much where I was at about 15 years ago.

I didn’t start metformin till about five years later when TDD increased to about 90-100 units. It was great at keeping overnight highs to a minimum, but didn’t reduce TDD.

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My curve looks like your curve. Some days I use 30 and some days I use 60. Last Thursday 33. Last Sunday 55. Today 44. I am having a peak right now, so I may end up higher.

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[quote=“docslotnick, post:2, topic:1109, full:true”]
Sure sounds like you are experiencing insulin resistance. 50-60 units a day is pretty much where I was at about 15 years ago.

@docslotnick, I agree, and it worries me. I really want to avoid an increasing insulin resistance but don’t know how to accomplish that. My I:C ratio is hard to pin, owing to the dramatic hormonal swings above, but it’s probably on average somewhere around 1:6.

Have you noticed anything rhyme or reason to your hormonal swings, @kaelan, or do they mostly seem random?

I was surprised when I graphed it how similar these 3 months looked. I need much more insulin at the beginning of the cycle, less in the middle, and the last 10 days much more again. This is clearly a repeating pattern, but also new to me. I didn’t have major hormonal swings until recently (February was my first).

@Irish, this is such great observation and logging! I am so impressed!!! This is GREAT stuff!

This would be an amazing conclusion.

I could not quite read your curve. How many days did you use Metformin? Are you planning on using it again?

This is geat data again btw. Invaluable stuff. Your NP should check out your data.

Thanks, @Michel!
To clarify:

I began metformin on march 15 and stopped it April 14. I think that accounts for the second half of the red and the first half of the orange lines being lower than the other lines.

I was stunned to see how similar the hormonal patterns were over 3 months, something my NP also seemed to disbelieve. There are a few outliers, of course, but overall insulin needs take a dive around day 5 of my cycle and leap back up the last 7-9 days or so. Would love to see if other women struggle with similar patterns. I was so confused yesterday that a single graham cracker for which i had bolused could rocket me to the 180s. I didn’t connect the dots until the pattern repeated today. I imagine tomorrow will be similar, but by Friday I ought to be more stable.

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Hi @Irish. I also have huge swings in insulin requirements from hormones. It’s probably one of the most frustrating things about diabetes for me. I just got a prescription for metformin from my endo to see if it helps (just took the first pill this morning). I’m also hoping it will help me lose weight. I eat a very low-carb diet but have been stuck at the same weight for months now. My insulin dose is about 40-45 units a day even eating low-carb, so I probably do have a bit of insulin resistance related to weight, and am hoping metformin (in combination with low-carb eating and exercise) will help get me un-stuck.

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@Jen I can vouch for the help that metformin and SGLT2 drugs can give to T1’s with insulin resistance.

And as far as metformin is concerned there are benefits of taking it that are now being discovered. I wouldn’t be surprised if people who don’t have diabetes are soon taking metformin.

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Thanks for all that information! I had read similar studies, which is in part why I was interested in trying this medication. Anything I can do to reduce my risk of complications is a good thing.

I tried an SGLT2 inhibitor at the beginning of this year and liked it, but it caused two yeast infections in six weeks, so not worth taking if that’s what I have to live with. It did lower my insulin doses and I lost a bit of weight, and it seemed to limit how high my blood sugar went (highs were much easier to “turn around” in general).

My endocrinologist said to expect some decrease in the amount of insulin I take, but not as much as when I was taking the SGLT2 inhibitor.


@Jen That is exactly the benefit I get from the SGLT2 inhibitor that I’ve been taking.

When I started on it my endo told me to double the amount of water I was drinking every day in order to avoid UT infections. So far that has worked out well.