Introduction

Women may have noticed that they experience unique health challenges during their life. Some health concerns may begin at puberty and continue through the adulthood. Diabetes may cause impact on their reproductive, mental, cardiovascular and bone health.

Changes in insulin requirement during menstrual cycle

Women with diabetes may need to adjust the dose of insulin during their menstrual period or ovulation. Episodes of low & high blood sugar levels tend to occur more often in women. High blood sugar levels may result due to hormonal changes e.g when oestrogen levels are naturally high, body may be resistant to its own insulin or injected insulin. Hormonal changes may also cause an increase in craving for sugary foods during the premenstrual phase. Blood sugar levels are observed to be higher few days before and after menstrual periods.

Diabetes may impact differently in different women. If insulin sensitivity is changing during menstrual cycle, it is best to check blood sugar levels 3-4 times daily before, during and after menstrual periods or ovulation. Adjustment in doses maybe done according to the test results. This will help in personalising the insulin needs and management of diabetes in every woman. Most women tend to develop their own pattern of insulin requirements, and these requirements remain fairly consistent for every menstrual cycle. In case, woman has irregular cycles, then patterns of insulin requirement may not be consistent.

Insulin and women

Both basal insulin and bolus insulin does may need to be adjusted in guidance from your doctor.  If using CSII pump, an alternate basal pattern specific to monthly or hormonal changes can be programmed. Trial and error and detailed record-keeping will help determine appropriate insulin requirements to achieve and maintain blood glucose control.

Women who are perimenopausal and those who are in menopause will also experience hormonal fluctuations and may require changes in their insulin doses. Detailed record-keeping to identify trends and patterns will assist in the determination of appropriate adjustments. Food cravings during perimenopausal period are triggered by an increase in progesterone and can make it more difficult to control your blood sugar.

Natural management of diabetes

Cravings can be managed by trying sugar-free and fat-free versions. Women should also have a proper exercise routine. This will help in regularising the hormones and reduce the requirement for insulin. If you have been taking a lot of sugary foods lately, then check your fasting blood sugar levels and take insulin accordingly. Yoga will help provide the exercise regime during periods. Nishamalaki is an herb that is available in ayurveda for managing sugar levels naturally.

A study reports that the risk of developing type 2 diabetes mellitus (DM) is significantly higher among women with long (40 days or more) or highly irregular menstrual cycles compared with women with a usual cycle length of 26 to 31 days.