Introduction There are some reports on changes in metabolic state during the menstrual cycle (recurrent ketoacidosis, hypoglycemia and hyperglycemia). The purpose of this study was to elucidate the impact of menstruation on metabolic control and daily living in adolescents with insulin-dependent diabetes.
Methods The subjects were 79 teenagers, 14 to 20 years of age, with insulin-dependent diabetes. Only 26 patients agreed to participate. 6 patients did not complete the study. Data from 6 consecutive menstrual cycles were obtained. Metabolic control: blood glucose by self-monitoring recorded daily, insulin doses, hypoglycemic events, and physical activity were recorded in a diary. Food intake: 24 hour food-intake diary, 2 days weekly. Weight: the participants weighed themselves twice weekly. Psychosocial conditions: 4 questions about social and emotional support were included.
Results There are no variations in metabolic control in diabetic adolescents during the menstrual cycle. There are individual variations in metabolic control, even if no systemic variation was found in the measured variables during the menstrual cycle. Hypoglycemia appears more frequently in the week of menstruation, with no relation to increased doses of insulin.
Conclusions Even if the influence of menstruation on metabolic control was not demonstrated, the impact might be greater in occasional individuals, as evidenced. Estrogen makes cells more sensitive to insulin, while progesterone makes cells more resistant to insulin, though not simultaneously or to the same degree so women are affected differently. Some patients experienced mood swings and food cravings; more carbohydrates and fats can also affect blood sugar levels.
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