Cyclic Changes in Glycemia Assessed by Continuous Glucose Monitoring System During Multiple Complete Menstrual Cycles in Women with Type 1 Diabetes
Abstract
Many women with diabetes notice changes in glucose control perimenstrually. To describe the pattern of changes in glucose control throughout the complete menstrual cycle, and the reproducibility of these changes, we performed a pilot study evaluating glycemic profiles continuously for three cycles in four women with type 1 diabetes. All participants had hemoglobin A1c <7.5% and regular menstrual periods off oral contraceptives. They used Medtronic MiniMed (Northridge, CA) Continuous Glucose Monitoring System (CGMS) devices continuously for three complete menstrual cycles, checked capillary glucose measurements six times daily, changed their own sensors every 3 days, and were seen seven times per menstrual cycle to download data and draw blood. Prolonged monitoring was safely carried out over three consecutive menstrual cycles. We observed two different patterns of glycemic control in relation to the menstrual cycle in these women. The first pattern, seen in two women, was characterized by increased frequency of hyperglycemia in the luteal phase. One of these women also had a hyperglycemic peak in the follicular phase. In the other two women, no characteristic cycle-related pattern was noted. The glucose profiles appeared reproducible between cycles in all women, but varied between women. Thus the menstrual cycle has a reproducible effect on glucose control in a subset of women with type 1 diabetes. Prolonged use of continuous glucose monitoring was safe in the subjects studie…
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Fourteen studies were included in the systematic review.
“We included 14 studies published between 1990 and 2022, with sample sizes from 4 to 124 patients.”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
The literature on the relationship between the menstrual cycle and insulin sensitivity/glycaemic control in type 1 diabetes is discordant.
“However, the literature in this field is discordant, and the pathophysiological mechanism underlying IS changes observed during different phases of the MC remains still unclear [12,13,14].”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
Some studies show that the glycaemic worsening in the luteal phase affects postprandial glucose.
“Since, according to some studies, this worsening affects postprandial glucose [13,19,22]”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
The pathophysiological mechanism underlying insulin sensitivity changes observed during different phases of the menstrual cycle remains unclear.
“However, the literature in this field is discordant, and the pathophysiological mechanism underlying IS changes observed during different phases of the MC remains still unclear [12,13,14].”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
It is unclear whether fluctuations of other hormones (such as GH, steroids and androgens) over the menstrual cycle are related to variability in glucose control.
“Finally, it is still unclear whether fluctuations of other hormones (such as GH, steroids and androgens) over the MC are related to the variability in glucose control [13,16].”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
The increase in progesterone in the luteal phase would determine an increased risk of hyperglycaemia.
“On the other hand, the increase in progesterone in the luteal phase would determine the increased risk of hyperglycaemia [13,23].”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [13]
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References 32 · Cited by 55
- Authors
- Goldner, W. S., Kraus, V. L., Sivitz, W. I., Hunter, S. K., & Dillon, J. S.
- Affiliations
- University of Iowa (US)
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2004-08
- Volume
- 6
- Issue
- 4
- Pages
- 473-480
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W2028349187
- Cited by
- 55
- References
- 32
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Iowa Research Online (The University of Iowa) (submittedVersion)
- Funders
- Eli Lilly and Company
- Office of Research and Development
- National Institutes of Health
- National Center for Research Resources (M01 RR 00059, M01RR000059)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 1 diabetes, menstrual cycle, glycemic control, continuous glucose monitoring, luteal phase, follicular phase, hyperglycemia, reproducibility, women with diabetes, sensor safety
- MeSH terms
- Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hyperglycemia, Menstrual Cycle, Middle Aged, Monitoring, Ambulatory
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