September 10, 2000
Question from Yahoo.com:
I am 29 years old and was diagnosed with diabetes at age 11. I have excellent control (HbA1cs of 4.5-5%). I take four shots and check blood glucose seven to eight times a day, but I have been having huge blood sugar swings. I believe these swings are due to menstrual cycle hormone fluctuations. I use the Fertility Awareness Method described in "Taking Charge of Your Fertility" by Toni Weschler so I have a very good idea of where I am in my cycle. Page 47 provides a chart listing the four primary reproductive hormones and their varying levels throughout a women's cycle. I am wondering which of the hormones (FSH, estrogen, LH, and progesterone) affect insulin sensitivity. It seems as though my insulin needs drop dramatically the first week after my period and increase around ovulation, becoming higher until menstruation begins. Is this consistent with the effects the different hormone levels have on insulin sensitivity? What specific hormones affect the blood sugar and how?
Clearly insulin sensitivity and thus glucose control will vary during a monthly cycle. This has been reported in many studies. However, how each specific hormone affects glucose metabolism is not absolutely understood (i.e., the published results are variable). Probably progesterone has the most impact on glucose metabolism. I would like to refer you to an article published in Seminars in Reproductive Endocrinology, Vol 12, No 2, May 1994 by Carol Levy et. al. You should be able to obtain this through your local library or if you live near a medical school, from the library there.