Menstrual cycle effects on insulin sensitivity in women with type 1 diabetes: a pilot study.
BACKGROUND
Many women complain of difficulty maintaining euglycemia during the luteal phase of the menstrual cycle. This pilot study's objective was to evaluate possible differences in insulin sensitivity between follicular and luteal phases in women with type 1 diabetes.


METHODS
Women using insulin infusion pumps (n = 5, mean age 29.2 +/- 10.9 years, mean body mass index 24 +/- 1.8 kg/m(2)) underwent frequently sampled intravenous glucose tolerance tests during each cycle phase. Insulin sensitivity and glucose effectiveness were determined by Minimal Model analysis.


RESULTS
Non-insulin-mediated glucose disposal increased during the luteal phase (0.009 +/- 0.004 min(1)) versus the follicular phase (0.005 +/- 0.003 min(1)) (P < 0.05). Although no significant differences were found in mean insulin sensitivity between follicular (0.76 +/- 0.27 x 10(4)/min(1) /microU/mL) and luteal phase (0.58 +/- 0.26 x 10(4)/min(1) /microU/ mL), three of the five subjects had a decline in insulin sensitivity.


CONCLUSIONS
Elevated blood glucose during the luteal phase may increase insulin-independent glucose disposal. Some individuals appear more responsive to menstrual cycle effects on insulin sensitivity. Women should be encouraged to use available self-monitoring technology to identify possible cyclical variations in blood glucose that might require clinician review and insulin dosage adjustments.
Trout
Kimberly K
KK
University of Pennsylvania School of Nursing, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. kimberly@trout@villanova.edu
Rickels
Michael R
MR
Schutta
Mark H
MH
Petrova
Maja
M
Freeman
Ellen W
EW
Tkacs
Nancy C
NC
Teff
Karen L
KL
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007332:Insulin Infusion Systems; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D010865:Pilot Projects
D001786:Blood Glucose