Hey there, fellow diabetes warriors and friends! If you’ve been following my diabetes journey, you might remember my previous post about handling Type 1 Diabetes and those pesky hormonal fluctuations during the menstrual cycle. Well, today, I’m here to fill you in on the latest developments in my ongoing quest for better blood sugar control.

Progesterone, the Luteal Phase, and Diabetes

Let’s start with a quick recap: in the menstrual cycle, women experience hormonal changes that can wreak havoc on blood sugar levels. The luteal phase, which typically occurs in the second half of the cycle, is when progesterone levels surge. This hormone, besides its role in preparing the uterus for pregnancy, can throw a wrench into our diabetes management.

Progesterone essentially makes our cells resistant to insulin, meaning we need more of it to keep our blood sugar in check. The days leading up to menstruation, when progesterone is at its peak, can be particularly challenging for those of us with Type 1 diabetes.

The Evolution of My Insulin Pump: From 670G to 780G

Since my last blog post on diabetes and the menstrual cycle, I’ve upgraded my diabetes management game with the Medtronic 780G insulin pump. If you read my previous post, you might recall that I had been using the 670G. Well, let me tell you, the 780G is a real game-changer when it comes to handling the insulin needs associated with the menstrual cycle. With the 670G, I would switch into manual mode on some days because the Auto Mode couldn’t keep up with my needs, but the 780G algorithm is better.

With the 780G, I’ve experienced a notable improvement in managing those progesterone-induced insulin requirements. It’s more responsive and quicker to adapt to my changing needs, which is a significant step up from the 670G. But, and here comes the caveat, it still takes about a day to fully adjust.

Above is my time in range for the worst day during my last menstrual cycle. This was the day where the pump was trying to adapt to my increased need. I only got 75% in range on that day. I usually get time in range in the high 80s during the last half of my cycle, and during the beginning of my cycle, some days are even 97%! I have even had a few 100% in range days.

I accept that there may be a day where it’s only 75%. Although, I also think that there is still room for improvement. I do hope Medtronic (and other Insulin Pump manufacturers) are looking into options to better serve women — could the insulin pump detect hormones? Or perhaps, ask the user for menstrual cycle day, and adjust accordingly?

The Luteal Phase “Trick” with My 780G

Okay, let’s get into the nitty-gritty of how I’ve been handling this hormonal rollercoaster with my 780G insulin pump. Instead of constantly tweaking basal rates and carb ratios, which can be quite a hassle, I’ve developed a simple yet effective “trick.”

During the luteal phase, especially in the days leading up to menstruation when progesterone levels are at their peak, I bump up my mealtime bolus by at least 30% more than my usual dose. This trick compensates for the insulin resistance that progesterone brings, and it’s been a game-changer in keeping my blood sugar in check.

I do this by inputting a higher number of carbs than I’m actually going to eat. When I am carb counting or carb guessing, I round up and then add more carbs. If needed, safeguard will reduce the basal to stop me from going low, but typically during the late days of my menstrual cycle, I don’t have any problem with going low — I am lucky if I can manage to stay in range.

Additional Strategies for the Menstrual Cycle Dance

But wait, there’s more to this dance. Here are a couple of extra strategies I’ve found helpful:

• Eating Lower Carb on Later Days: As my menstrual cycle progresses, I’ve noticed that opting for lower-carb meals can help keep my blood sugar stable. It’s like my body becomes extra sensitive to carbs during this time.
• Boosting Exercise: A bit of extra physical activity can do wonders for managing blood sugar fluctuations during the menstrual cycle. It’s not about training for a marathon, but finding ways to stay active that work for you.

Beware the Drop-Off

Now, a word of caution: insulin requirements can drop suddenly as you transition from the luteal phase to the start of your cycle. For me, it’s typically around Day 2 when I’m most likely to experience low blood glucose. On Day 2, I literally had a low blood glucose event in the middle of the night, and this signaled the transition from being insulin resistant to being insulin sensitive. See the CGM graph on my insulin pump below. Can you see the hypo?

To stay ahead of this, I adjust my carb counts downward and sometimes raise the target blood glucose in safeguard mode on my 780G. If the auto corrections are causing an issue, they can be disabled in the SmartGuard Settings, and the target blood glucose can be adjusted.

Conclusion

So there you have it, my fellow diabetes warriors – an update on my journey, armed with the Medtronic 780G insulin pump, to conquer the challenges of diabetes and the menstrual cycle. It’s about finding what works for you and making the most of the tools at your disposal.

Remember, diabetes management isn’t one-size-fits-all. Sometimes, you’ve got to get creative, and your insulin pump can be your partner in crime. Stay strong, keep on rocking that insulin pump, and know that we’re all in this together! 💪😊

Please discuss any insulin pump changes with your healthcare team. If you have found this helpful, please share this with your health care provider. If you have other strategies that have helped you, or experiences to share, please leave a comment below. Thank you in advance for your help in sharing and participating here!

Related Blog Posts

• Menstrual Cycle and LADA Diabetes and Insulin Sensitivity
• Menstrual Cycle and Varying Insulin Needs, re-visited

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Additional Information

• Periods and Type 1 diabetes
• How Your Menstrual Cycle Can Affect Your Diabetes