Alterations in Glucose Metabolism During Menstrual Cycle in Women With IDDM
Abstract
Objective To examine the hormonal mechanisms underlying the variability in glycemic control during the different phases of the menstrual cycle in women with insulin-dependent diabetes mellitus (IDDM). Research design and methods Hyperglycemic (11.7 +/- 0.1 mM), hyperinsulinemic (24 +/- 3 mU/L) clamp studies were performed in 16 women with IDDM during the follicular (day 8 +/- 1) and luteal (day 23 +/- 1) phases of the menstrual cycle. Seven of the patients (group 1) experienced worsening glucose control during the luteal phase, whereas nine patients (group 2) did not. Results In group 1, glucose metabolism fell from 30.2 +/- 3.8 mumol.kg-1.min-1 during the follicular phase to 24.5 +/- 2.0 mumol.kg-1.min-1 during the luteal phase (P = 0.09), whereas in group 2 it increased from 18.5 +/- 1.2 to 23.2 +/- 2.3 mumol.kg-1.min-1 (P = 0.03). The decrease in glucose metabolism during the luteal phase in patients in group 1 was associated with a significant rise in the serum estradiol levels from the follicular to luteal phase (164 +/- 39 vs. 352 +/- 59 pM, P = 0.006), whereas this rise was not observed in group 2 (334 +/- 156 vs. 423 +/- 74 pM, NS). Changes in other reproductive hormones (progesterone, testosterone, dihydrotestosterone, androstenedione, luteinizing hormone, follicular-stimulating hormone, or prolactin) were not related to the differences in glucose uptake in the two groups. Conclusions 1) Marked heterogeneity in glucose metabolism is seen throughout the menstrual cycl…
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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 [15]
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 [15]
Estradiol may contribute to the increased risk of hyperglycaemia, and its lowering increases the risk of hypoglycaemia.
“On the one hand, estradiol may contribute to the increased risk of hyperglycaemia, and its lowering increases the risk of hypoglycaemia [15].”
From Menstrual Cycle, Glucose Control and Insulin Sensitivity in Type 1 Diabetes: A Systematic Review (2023) · cites this paper as [15]
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- Authors
- Widom, B., Diamond, M. P., & Simonson, D. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1992-02-01
- Volume
- 15
- Issue
- 2
- Pages
- 213-220
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1991241159
- Cited by
- 87
- References
- 0
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 2 · 2018: 1 · 2017: 3 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 6
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (5P30-DK-36386)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 1 diabetes, menstrual cycle, glucose metabolism, insulin sensitivity, estradiol, luteal phase, follicular phase, glycemic control, glucose uptake, hyperinsulinemic-euglycemic clamp
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follicular Phase, Humans, Hyperglycemia, Insulin Infusion Systems, Luteal Phase, Menstrual Cycle, Glucose Clamp Technique
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