Female hormones are an incredibly huge part of any type 1 diabetics life. They have such an overarching impact on the way our body responds to insulin, and unfortunately within healthcare settings, they are heavily overlooked and nowhere near enough education is provided in order to support us in knowing exactly how to navigate our management around our cycle phases.

More often than not, the answer is to stick to some sort of hormonal contraception that masks the impact of hormones but often causes shifts in other ways. It also does not solve the problem of managing your diabetes in the future, once you decide you no longer want to remain on the contraceptive.

In the over 1000 type 1 diabetics I have worked with, not a single woman has been unaffected by their hormonal cycle and in the same sentiment, not a single one had been given the proper tools to get this under control.

I am going to tell you the key features you need to be tracking and have an awareness of when it comes to your hormonal cycle and type 1 diabetes in order to get things under control.

• Your cycle regularity - this is going to be an indication of whether you can work more closely with anticipated dates, or if you will need to gauge the shifts by being in tune with your body and its physical symptoms.

• Your physical symptoms of your hormones, listening to your bodies tell tale signs of things like ovulation and PMS.

• You should start tracking how easy or how difficult management feels per phase, this is going to indicate to you when your sensitivity peaks and troughs. For example - during follicular my management felt seamless and normal, but during luteal it felt sticky and unpredictable.

• In addition to the above, log any physical trends you can determine within your blood glucose patterns. For example - during ovulation I was experiencing more aggressive dawn phenomenon than usual, or during menstruation I was experiencing more low blood glucose following my meals. This is going to help you prepare for any management transitions you need to make with your rates and settings. 

• Track how effective you feel your baseline rates felt in correlation to the cycle phase - for example, my basal during follicular worked great, but during luteal it felt weak and I kept on trending up.

Once you have tracked your full cycle, indicating these notes and logs alongside it, you will be able to see the random high days within your month are way less random than you anticipated and can usually be put down to some sort of hormonal shift and you can use this information you have gathered to start making accurate adjustments to your rates to accommodate when your bloods are more resistant vs when your bloods are more sensitive.

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An important note:

For some individuals, there is a slower progression between phases, think of it a little like a radio dial, where you may find your basal needs go up slowly but surely before reaching their peak at the height of resistance, and then drop off in the same manner and sensitivity picks back up.

Whereas for others, the shift in sensitivity can be far more aggressive and abrupt, responding more like a lightswitch, where your basal needs go from their lowest to their highest overnight.

You need to identify what this looks like for you in order to apply structure to your transitions. 

Something you must also be aware of when putting this together, is that everyone's cycles are different and there is no right or wrong way for your blood to respond, there are more common scenarios than others, but nothing is out of the question when it comes to the shifts you may encounter.

I am going to outline one of the more common trends we can anticipate to see cycle round so you can begin to build a picture of how your insulin and timing needs may need to shift to accommodate your cycle pattern and the impact it has on your diabetes.

• Early menstruation: Commonly, the first 1-2 days, there can be some lingering or residual resistance from the height of luteal resistance, however it may slowly start to decline and you will likely start to see sensitivity coming back into fruition.

• Late menstruation: The further into the bleeding phase that you get, the more sensitive you can become, this often leads to the lower end of your insulin needs and shorter end of your pre bolus timings, where insulin can feel more like rocket fuel than insulin.

• Follicular: This is typically when you are closest to your baseline and truest form of sensitivity, it is really the only appropriate time to be conducting any kind of basal or sensitivity testing, because you will get the most accurate results.

• Early Ovulation: Resistance starts to set in and insulin needs may start creeping up, as well as the need to extend things like pre bolus times and closing the gap between bolus interludes when splitting doses.

• Late Ovulation into Early Luteal: This progresses and continues on the same path

• Late Luteal: The height of resistance when your diabetes will typically be the hardest to manage, you will typically need more insulin during this timeframe as well as more time for your insulin to do its job, be mindful of timing and avoid stacking insulin in this phase.

If all of this feels like a bit of a minefield, don’t worry, we have lots of content and support available through our Elevate Membership to help you better understand the impact of hormones on your body and blood sugars, and you are not alone.

We as women are let down within the education system regarding how to thrive with our management around our cycle and instead are left to struggle and fend for ourselves, without any support or education on how to get a hold over what's going on.

If you take anything away from this, let it be to start intricately tracking your cycle and try and become as in tune with the physical shifts as possible, this is your best indication of when and how things are changing which gives you a head start on adjusting your rates to accommodate.

The information shared within this article is intended for educational purposes and should not replace personalised medical advice from your healthcare team.

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Hormones are one of the most overlooked aspects of Type 1 diabetes management. Inside our Elevate Membership, you'll find additional education, resources and community support designed to help you better understand your body and blood glucose patterns

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