One of my major frustrations with Type 1 diabetes is the effect my monthly cycle has on my blood sugars (and sanity). Prior to being diagnosed I suffered with the usual symptoms of generally feeling like a bloated cry baby for four or five days before my period started. Now I have another fun symptom to add to the mix - high blood sugars that are incredibly frustrating and difficult to bring down. This results in headaches, nausea and feeling grumpy. (Note that I have been told that my grumpy is not grumpy at all. To me it feels like I am a crotchety old bag who should not associate with others)
Since starting on the insulin pump I have been able to track the pattern quite well and am learning how to deal with the inevitable rise in sugars by being able to raise my basal rate. However it is definitely not an exact science and I still suffer with more highs than I ever like to see! You may remember a post I did awhile ago about when I had a severe low at the gym during the day. I tracked it all back to my hormones. I actually wrote down how my day went to send to my CDE. Here is the email I sent to her:
I woke up with a good number and worked out for 2 hours with stable numbers. My pre-lunch blood sugar was perfect and after lunch was fine as well. Then boom - the rise began. Before supper my sugars were 14.7. At first I felt rage and then realized the time of the month, calmed down and bolused for dinner (including a large correction bolus). Two hours after supper and I at 11.4, not terribly high but out of the range I like. I corrected as per my bolus wizard and before bed was at 9.8. Still higher than it should be but I did have some IOB (insulin on board). I woke up this morning at 12.4. Arghh. Corrected, dressed and off to work. Before breakfast I had dropped to 7.8 and bolused for breakfast. Two hours later I was at 13.9. I corrected and decided it was time to take action. I adjusted my basal rate as I had the month before and now I have my fingers crossed it will kick in. I tested just before leaving work and had only gone down to 13.6. I am hoping that with a workout and the increased basal rate my sugars will find themselves back in range by this evening.
This is the pattern for me usually for 4 to 5 days. However, the fun starts again when my period actually shows up and my sugars plummet faster than you can snap your fingers. I always go from fighting highs to fixing a ton of lows for at least three days. I have learnt to drop my basal quite a bit and so far this has worked but is a work in progress. My happy place is the two and half weeks where my basal rate stays steady and my sugars behave nicely :)
To give you an idea of what my basal rate does, here it is:
Two and half weeks (approximately) or hormonal bliss: 0.725u/hour
Four or five days before period starts: 1.0u to 1.1u/hour
Three or four days after period starts: 0.60u/hour
*I always leave my during the night (to counteract dawn phenomenon) at 1.3u/hour between 1:00pm and 8:00pm and have not had to change this so far.
I have taken to logging my pump settings in a little notebook I carry everywhere as how the heck is anyone supposed to remember all these numbers? Also I can almost guarantee that this pattern will work for a little bit and then the Type 1 diabetes train will change tracks and I will have to start all over again.
