Wednesday, July 9, 2014

Teens, Menstruation and Type 1 Diabetes

Hopefully my title was nice and clear, because if you do not want to "talk", ie. read,  about periods, pads and type 1 diabetes, this is NOT the post for you.  

However, if you are like me and am parenting little ladies, whom also happen to be living with type 1 diabetes, than you might want to know more about the effects of menstruation.  

A few years ago, it occurred to me that certain changes were happening which also started to wreck havoc on blood sugars.  The changes were mostly physical with growth and development, but a few were noticeably, ahem, well... emotional too.  

One day, my sweet baby went from being happy-go-lucky, to bursting into tears over an imagined hurt to then, running into my arms for a giant cuddle and then back out screaming, AGAIN.  Yes.  All true.  And it all happened in about 30 seconds.  

A quick blood glucose check and a number would zoom from 120 mg/dl to 360 mg/dl without stopping at 'GO' or collecting $200.00.  An Monopoly game reference because suddenly, it seemed as though this stage of parenting was a never-ending circle around the board.  Some days, I just wanted to sit on Boardwalk and enjoy every minute with her, but other days had me slumming in the low-rent district of emotions.  Please, please, please.. give me a time-out in the jail section.  I kid, of course.  I really wanted to land her in jail.  I kid, again.  Sort of.  Until we roll the next set of dice, get a doubles, and everyone is happy once more.

While we navigated that time period of life, we also realized that up ahead was the realization that menstruation was going to pop right out - and probably when we least expected it.  

So I prepared and helped her with books, supplies, chocolate and anything else that I thought might be good.  Being the mom that I am, I shared my own personal tween horror story of how it happened, just so she could feel comfortable and relaxed.  

What neither she nor I knew, was how a period would effect blood sugars.   And that, more than anything, is what I want to share with you.  This is the kind of stuff that no one really likes to talk about, however, we all need to know about it.

In the days leading up to menstruation, specifically about two or three (some may find longer or shorter), we find that blood sugars tend to sharply increase, most likely due to an increase in estrogen production a.k.a, dreaded female hormones.   Like a normal 100 mg/dl rises to about 200 mg/dl.  We find that correcting with short bursts of fast-acting often helps combat the increase, especially if you wear a CGM and can watch the numbers.  However, some moms have told me that they find success with adjusting their daughter's basal rates by adding a separate plan for that time of the month into their insulin pump settings.  Set it and forget it, which might work best for a lot of teens.

Then, after the first day of the cycle, we notice that their is a sharp drop in blood sugars.  This is partly why I haven't adjusted the basal rates as the drop can appear at any time in the first or second day following - it seems overnight is a great time to find that drop.  Yuck.  So, I feel more comfortable with keeping a tight control on correcting and not having to worry about switching back to our regular basal program.  Really, this is whatever works best for you, though.  

A couple of more tidbits from our friendly pediatrician were to know that teens with type 1 diabetes are at a potentially higher risk of having a yeast infection if their blood sugars are higher for prolonged amounts of time.  A natural remedy and potentially a good way to ward of this situation (besides keeping blood sugars in check) is to add yogurt to your diet.  We were also encouraged to make sure that we kept our daughter hydrated to help with lessening cramping as I was concerned over giving acetaminophen as it makes the CGM numbers a tad wonky and I like to rely on that.  

Above all, while life goes on, I try to be kind-hearted and know that while I may feel sometimes like we are stuck on a Monopoly board, this is not an easy time for teens living with type 1 diabetes.  Sometimes, the best medicine is a good movie and a lot of chocolate.

Just be sure to count the carbs and dose for it!  


Anonymous said...

Thanks for writing about this, I haven't seen anyone else do so. My daughter is struggling because everything is not regulated yet (and possibly won't be for another year).

Naturally Sweet Sisters said...

I haven't read anything either... seems strange to not read much because this is a significant effect on BG. The more prepared we are, the better it will be for our young people.

Naturally Sweet Sisters said...

I haven't read anything either... seems strange to not read much because this is a significant effect on BG. The more prepared we are, the better it will be for our young people.

Kerry said...

Thank you for posting this. I got the "everyone is different" answer from the Endo when I asked about this. We also noticed a sharp rise in numbers in the days leading up to it...but not every month. My daughter is 14, almost 15 and finally getting more regular so I'd really like to get a general pattern observed. It is curious that there isn't more information on this.

I really want to learn how to study my daughters numbers and patterns and gain better control. Would you be willing to help me learn either through a post or email? I'm to sure where to start.

Anonymous said...

I think people talk quietly, at meetings and at camp instead of out loud (and forever) on the Internet.

Naturally Sweet Sisters said...

Nothing to be ashamed of.... it is what it is. Much as any chronic occurence within the human body. If we always whisper, it will always be followed with a stigma. I am parenting the motto that our bodies - All of it - are beautiful.

Best bet for keeping it through patterns? I think a calendar is a great way to start. The second and more comprehensive step is a spreadsheet. Either through recording it under excel or as a feature to explain bg readings. Animas has a handy area where you can add back in what was happening during that blood sugar period. I LOVE that feature. Not sure about Medtronic or the blood sugar meters, but you may be able to check and see if that could work too.