Diabetes-Type 1 and adolescence

My 15 year-old daughter was diagnosed with Type 1 Diabetes at the age of 12. She currently wears an insulin pump. The last 2 months she has experienced very high blood sugars (300-600) around the time of her period. The blood sugars remain high for approx. 48 hours despite our best efforts (insulin every 2-3 hours and lots of water) to bring them down. After a couple of days she is back in the normal range. The pump is working fine and she has not had ketones either time as well. Can anyone explain if there is a possible connection between menstruation and difficult to control high bg levels and what else we might do to bring it down. Thanks you for your feedback.
                     Mom

[JDRF-Team-cg]

Hi GNMom,
I am also a Type 1 diabetic diagnosed at about the same age as your daughter. I also wear a pump. From my own experience I can say I have the same problem to this day. I have had diabetes for 30 years. My blood sugars do not run that high but I do find they range in the upper 200's and it does take extra insulin to bring them down. My suggestion would be to possibly change her diet during this time period. Maybe less carbs would make control easier. In addition I would discuss this with her doctor. A glucose reading of 600 is quite high, there may be other things that are impacting it. I know during my menstrual cycle I tend to eat more perhaps this is also part of the problem. Hormones control the menstrual cycle in a woman. Higher hormon levels generally will effect blood glucose levels. Some women find their blood glucose rises considerably, while others do not notice a difference. In some women, blood glucose levels are lower before and during their periods. Each woman needs to discover her own pattern.
I think she needs to figure out how her body works. She is young and is just learning how her body reacts to this.
I hope this was helpful.

[JDRF Team SGG]

From what I have read, the explanation is that certain hormones that are present in larger amounts before a woman's period actually are insulin-inhibitors, causing insulin resistance. Some women produce more of these hormones than others. In some women, the glucose levels run higher for several days, and then are followed by hypoglycemia when these hormones dissipate. At 16, your daughter is still maturing, and her hormone levels are still fluctuating. I agree that during those days, she may need to eat fewer carbs, for adding insulin just isn't going to help much if insulin-resistance is the real problem. I believe it is very important for ALL type 1 women to carefully monitor their monthly cycles so these days do not take us by surprise. In time, patterns will become more regular and she can figure out how to best care for her health during these hormonal swings. She has lots of company, for what you describe is pretty common.

[GNMom]

Thank you so much for the very helpful and comforting information. She has an appointment with her endocrinologist next week and hopefully we can receive additional guidance. Although it seems obvious, I had not thought of reducing carbs during this time. I will also be keeping better track of her cycles and teaching her to do so as well. Thanks again!
                  GNMom