How to navigate life changes as a female living with Diabetes
Understanding Change WILL Happen
“When it’s time to change, you have to rearrange, who you are and what you’re gonna be”.
If anyone is a Brady Bunch fan, you’ll know this line from the song where Peter is going through puberty, and his voice changes. As a female, I wished they had focused on what was going to happen for girls in this time of change in life.
Life brings a lot of change, sometimes more subtle than other times. Through all the years I have had the opportunity to work with females navigating life with diabetes, I have found there is not a different line of education for them. I do not mean in the general sense of how to do the basics of diabetes management – like carb counting, or how to take insulin.
I mean that education for females needs to be tailored from the start to represent the number of changes one may go through in life. Information about what to expect through the life cycles can mean less confusion as things shift and change.
We all age, going from baby to childhood and then into teen years to adulthood. However, the shift in hormones that impact a female through growth will differ considerably from a male of the same age. Not to say males have no impact from hormone shifts through growth stages, but females experience a lot more shift and it moves well into late adulthood.
A focus on what to expect ahead of that stage of life should be discussed along with how these changes will impact glucose management when living with diabetes.
When will a female expect variability, and how will it shift along with the other 40+ variables we may deal with daily? All the education given to those with diabetes reflects a baseline. We all have different variables and as a female, the variables will be hormone specific at times. This may also impact how we adjust for the other non-hormone-specific variables at different times in a lifecycle. With solid education, someone with diabetes should be able to evaluate and adjust around changes and if a person can prepare to know a variable is coming it would help ease confusion as there would be an understanding of “why” a shift is happening.
I like to have a plan to work from myself. While there is not always a reason for what I call a “Bad Diabetes Hair Day”, many times there is a cyclic reason specific to female hormones.
Consider the following as stages of female life cycle change.
Starting in the pre-teen/teen years prior to a menstrual cycle starting, you may notice a cyclic change in insulin needs (ages 9-16 are typical for a change in hormones leading to a menstrual cycle starting). If you track the rise and fall of BG and insulin needs, you may find it is happening about every month or so at the same time for pre-teens in this stage of life.
Once a menstrual cycle begins it can take about 1-2 years to regulate. At this time for women with diabetes, you may find additional ups and downs in glucose management due to the flux of hormones that have not yet regulated into a monthly cycle. Women who have glucose levels more managed may find it a bit less of a roller coaster up and down but will still experience needs that change until the cycle is regulated month to month.
The menstrual cycle for women includes many hormones that impact BG in each stage of the month. The cycle is a full 4-week time period of fluctuation up and down in hormones that will have an impact on BG management. Tracking can be a great tool in order to be able to figure out where to start with adjustments month to month.
Another time that adjustments will need to be made falls around the plan to be a mother. You may need to adjust to tighten up in the preconception stage depending on what your usual management plan looks like and where glucose range is compared to where it needs to be. Once pregnant there will be many changes in insulin need – times of sensitivity as well as resistance that seems considerable. It is good to know this is coming so you aren’t surprised as your needs change.
*I wrote a whole book on this with a colleague! Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management
Hormone changes last into later stages of life as well. During early perimenopause often between the ages of 40-60, levels of female hormones become variable and the menstrual cycle may seem up and down, length of the cycle may shorten or lengthen, and your body’s messages to you that menopause is starting may start to show up.
This stage of change can last over the course of several years so again, it is important to know that this is coming and be aware that what you are seeing as a shift in your DM management isn’t odd. This time of life is a rite of passage into a new time of life as the cycles will become more irregular. Many women think of this time as problematic even without diabetes, but our bodies are smart and if we learn the signals and watch the messages or “symptoms” we may be experiencing then adjusting for the shifts in glucose management may also be less problematic.
Do any of these points in life make sense for what you are or were seeing happen with diabetes management at that time?
If it seems to make sense, remember, you may be the one who must bring it up with your care team to find the best plan of action. Adjustment of doses, new technology, or sometimes it may mean a new medical caregiver who meets your needs better to help you navigate life with diabetes in the stage you are in.
Life with diabetes as a female means a lot of change and rearranging what you know into what you need it to be to meet your needs.
If you are at a stage in life where you feel there is extra support needed, reach out to our team at Integrated Diabetes Services. We have years of experience and have navigated all the cycles of life to provide personal experience with clinical knowledge for each person we have the opportunity to help.
June 2023 Newsletter
