Fluctuations of Hyperglycemia and Insulin Sensitivity Are Linked to Menstrual Cycle Phases in Women With T1D

Autor: Sue A. Brown, Christian A. Wakeman, Molly McElwee-Malloy, Boyi Jiang, Marc D. Breton
Rok vydání: 2015
Předmět:
Adult
Blood Glucose
Pancreas
Artificial
medicine.medical_specialty
Time Factors
Special Section: AP Using Non-Glucose Data in the Control Algorithm
Endocrinology
Diabetes and Metabolism
media_common.quotation_subject
medicine.medical_treatment
Biomedical Engineering
Pilot Projects
Bioengineering
Infusions
Subcutaneous
Models
Biological
Artificial pancreas
Insulin Infusion Systems
Insulin resistance
Risk Factors
Internal medicine
Internal Medicine
Humans
Hypoglycemic Agents
Insulin
Medicine
Prospective Studies
Menstrual Cycle
Menstrual cycle
Glycemic
media_common
Type 1 diabetes
business.industry
Blood Glucose Self-Monitoring
Insulin sensitivity
Equipment Design
medicine.disease
Diabetes Mellitus
Type 1
Treatment Outcome
Endocrinology
Female
Insulin Resistance
business
Closed loop
Biomarkers
Zdroj: Journal of Diabetes Science and Technology. 9:1192-1199
ISSN: 1932-2968
DOI: 10.1177/1932296815608400
Popis: Background: Factors influencing glycemic variability in type 1 diabetes (T1D) may play a significant role in the refinement of closed loop insulin administration. Phase of menstrual cycle is one such factor that has been inadequately investigated. We propose that unique individual patterns can be constructed and used as parameters of closed loop systems. Method: Women with T1D on continuous subcutaneous insulin infusion and continuous glucose monitoring were studied for 3 consecutive menstrual cycles. Ovulation prediction kits and labs were used to confirm phase of menstrual cycle. Glycemic risks were assessed using the low- and high blood glucose indices (LBGI and HBGI). Insulin sensitivity (SI) was estimated using a Kalman filtering method from meal and insulin data. Overall change significance for glycemic risks was assessed by repeated measures ANOVA, with specific phases emphasized using contrasts. Results: Ovulation was confirmed in 33/36 cycles studied in 12 subjects (age = 33.1 ± 7.0 years, BMI = 25.7 ± 2.9 kg/m2, A1c = 6.8 ± 0.7%). Risk for hyperglycemia changed significantly during the cycle ( P = .023), with HBGI increasing until early luteal phase and returning to initial levels thereafter. LBGI was steady in the follicular phase, decreasing thereafter but not significantly. SI was depressed during the luteal phase when compared to the early follicular phase ( P ≤ .05). Total daily insulin, carbohydrates, or calories did not show any significant fluctuations. Conclusions: Women with T1D have glycemic variability changes that are specific to the individual and are linked to phase of cycle. An increased risk of hyperglycemia was observed during periovulation and early luteal phases compared to the early follicular phase; these changes appear to be associated with decreased insulin sensitivity during the luteal phase.
Databáze: OpenAIRE
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