My boyfriend’s 17 year old daughter, diagnosed with type 1 diabetes at age 12, told us that her doctor put her on the strongest birth control pills because her period is so bad that it is affecting her blood sugar. For the last three or four months, she has been hospitalized with ketoacidosis every month just before her period begins, and her sugar levels are affected one week before and one week after. So, she only feels good one week a month. Can your period affect your blood sugar levels to the point of ketoacidosis? Is it common for a doctor to prescribe birth control to correct this problem?

I doubt that the hormonal changes associated with ovulation are enough to affect blood glucose control to the point of DKA [diabetic ketoacidosis]. The idea of birth control pills is to maintain an even hormonal level. Even though estrogen may affect glucose levels, this should be manageable with adjustments in insulin dosing. The highest dose birth control pill contains 50 micrograms of estrogen (Ovcon-50), and the e majority of pills contain 30-35 micrograms (LoEstrin 1.5-30, Ortho-Novum 1-35).

My recommendation would be to use the lower dose contraceptive along with more aggressive management of glucose with insulin, and in this situation, an insulin pump may be very useful. I would suggest consulting with another endocrinologist for a second opinion.

OWJ