Managing PMS and blood sugar: A T1D guide

For women living with Type 1 diabetes (T1D), managing blood sugar is a constant balancing act. But throw in the hormone shifts that come with premenstrual syndrome (PMS), and things can feel even more unpredictable. PMS is already a tricky time for many women, with symptoms ranging from mood swings and bloating to headaches and fatigue. When you add T1D to the mix, blood sugar levels can become harder to control due to hormonal fluctuations that impact insulin sensitivity.

Understanding how PMS affects your blood sugar and adopting strategies to manage this unique challenge can make life a lot easier during this time of the month. Here’s our guide on managing PMS and blood sugar for women with T1D.

The link between PMS and blood sugar

During PMS, the body undergoes a significant hormonal shift. This typically happens in the luteal phase of the menstrual cycle, which is the period between ovulation and the start of menstruation. The two key hormones at play here are oestrogen and progesterone, both of which can impact blood sugar control.

As progesterone levels rise during PMS, so does insulin resistance. This means that your body might need more insulin to keep blood sugar levels in check. On top of this, many women experience food cravings—especially for carbs and sweets—due to hormonal changes, which can cause additional blood sugar spikes.

A study published in the Journal of Diabetes Science and Technology showed that women with T1D often experience higher blood sugar levels and increased insulin needs in the week leading up to their period. These fluctuations can make it harder to stick to a regular diabetes management plan.

Why does insulin resistance increase during PMS?

Progesterone is the main culprit when it comes to insulin resistance during PMS. As it rises in the luteal phase, it dampens your cells’ ability to respond to insulin efficiently. When this happens, glucose stays in your bloodstream longer than usual, causing your blood sugar levels to rise.

Oestrogen, which also rises during the luteal phase, has a more complex relationship with blood sugar. While oestrogen is known to improve insulin sensitivity, the exact balance between oestrogen and progesterone during PMS can tip the scales, leading to increased insulin resistance.

PMS symptoms that affect blood sugar

The hormonal changes during PMS don’t just impact blood sugar directly—they can also affect your overall well-being in ways that make managing diabetes more challenging. Common PMS symptoms that may interfere with blood sugar control include:

• Food cravings: Many women experience a strong desire for sugary and carb-heavy foods during PMS, which can cause blood sugar spikes.
• Fatigue: Feeling tired or run down can make it harder to stay active, leading to less movement and potentially higher blood sugar levels.
• Mood swings and irritability: Stress hormones like cortisol can rise during PMS, further complicating blood sugar management. Increased stress levels can also lead to emotional eating.
• Water retention: Bloating and water retention are common during PMS, but can make it more difficult to monitor weight changes or insulin needs.

Practical tips for managing PMS and blood sugar

While PMS-related blood sugar swings can feel frustrating, having a strategy in place can help. Here are some practical steps to help you manage your blood sugar during PMS:

1. Track your cycle and blood sugar patterns

Understanding how your blood sugar levels change throughout your menstrual cycle is key to anticipating fluctuations. Many women with T1D find that their insulin needs increase during the luteal phase, while they may require less insulin at other times.

Consider using a period tracking app or keeping a menstrual diary to note any recurring patterns in your blood sugar levels. This can give you a clearer picture of when you’re most likely to experience insulin resistance and help you adjust your diabetes management plan accordingly.

2. Adjust your insulin dosage

Since insulin resistance tends to increase during PMS, you may need to increase your insulin dose during this time. Some women with T1D find that they need up to 20-30% more insulin during the luteal phase. Speak to your healthcare provider about adjusting your insulin dosages based on your personal patterns.

3. Stay active

Exercise is a great way to keep blood sugar levels stable and reduce insulin resistance. Even moderate physical activity, like walking or swimming, can help counteract the hormonal effects of PMS on your blood sugar. Plus, exercise can improve mood, reduce bloating, and boost energy levels, making it a great tool for managing PMS symptoms.

4. Choose balanced snacks

PMS cravings can be tough to resist, but opting for low-GI (glycaemic index) snacks can help satisfy your sweet tooth without causing sharp blood sugar spikes. Foods like nuts, seeds, whole grains, and vegetables paired with protein-rich dips (like hummus or Greek yoghurt) can help keep cravings in check and your blood sugar more stable.

5. Stay hydrated

Drinking enough water is particularly important during PMS, as water retention can make it harder to gauge your insulin needs. Staying hydrated can also help reduce bloating and prevent unnecessary blood sugar swings.

6. Practice stress management

Stress hormones like cortisol can increase during PMS, and this may contribute to higher blood sugar levels. Finding ways to manage stress—whether it’s through meditation, yoga, deep breathing exercises, or simply taking time for self-care—can help keep your blood sugar more stable.

When to speak to your healthcare team

If you notice significant changes in your blood sugar levels during PMS, it’s important to talk to your healthcare provider. They can help you develop a more tailored insulin management plan to better cope with hormonal fluctuations. Additionally, if PMS symptoms are interfering with your diabetes management, discussing options such as hormonal treatments or supplements (like magnesium or B6) with your doctor may help.

Final thoughts

Managing T1D is already a full-time job, and PMS can feel like it throws a spanner in the works. But by understanding how hormonal changes affect your blood sugar and taking proactive steps, you can keep your diabetes under control, even during that tricky time of the month. Tracking your cycle, adjusting your insulin, and making small lifestyle changes can go a long way in making PMS more manageable for women with T1D.

Don’t forget that everyone’s body is different, so finding what works best for you might take a bit of trial and error. But with the right strategies in place, you can navigate the challenges of PMS and blood sugar like a pro.