Menopause /Diabetes Blues.

[Sal54]

So. I have to ask. Or is it just me?
I became a type 1 diabetic 1 week after my 40th birthday.
Once I'd got to grips with my diabetes all was well.
I even had 3 years of training at my local gym with a P. T. Instructor.
In November 2019 I was at my fittest & I felt on top of the world.
Then I got a strange worse than flu illness that totally knocked the strength & breath out of me & everything changed. Since then I've suffered Covid twice more.
Then in June 2020 I started to become pre menopausel & that's she my blood glucose started to rise & a year later I was fully into the menopause & since then it's been very, very difficult to control my diabetes.
It's been as high as the early 20s & now I've got my readings down to 15 & below. It seems the only way I can get the great low reading like I had before is if I eat very little & nearly No or actually No carbs or anything remotely sweet!
That's not practical or good. And I'm on the highest HRT patches & tablets.
It doesn't help that I haven't seen a type 1 diabetes nurse since January 2020. The local nurse I saw at my previous doctors (I moved to Southport in July last year) saw elderly type 2 diabetics & was very dismissive of me. Treated me like I didn't have a clue about diabetes, even though I had education from a dietician for the first 6 months of being a diabetic. All she said was No, No, No & didn't want to hear my side of things.
Finally after trying for over a year & waiting months after a cancelled appointment to see a nurse who can deal with type 1,s I'm wanting to know if anyone can relate to any of what I'm saying please?
It would be nice to know I'm not alone.

 

[mashedupmatt]

Hi @Sal54 and welcome to the forum - obviously I cannot give any direct experience of Diabetes and the menopause, but I do know that the change in hormone balance can affect your blood gloucose and it has been proven that when Oestrogen levels fall, it can increase your insulin resistance - there are drugs that can help with this, along side your insulin but you do need to see a specialist to get them prescribed! Unfortunately the standard of healthcare across the country varies in a massive way - do you have a local diabetes centre at a hospital you could get in touch with? You should have an annual diabetic review too, where you should have the opportunity to speak to specialist nurses etc. Sorry you've had a bad experience of this and sadly I'm sure you're not alone - but you found us now though and we're all here to help and support each other, so I hope you get the answers and help you need

 

[gail2]

hello @Sal54 welcome to the forum I went thou the menopause and it affected my BG so you are not alone. i think the diabetic care u have recieved is cack and you should complain about it Dont be put off As mashedumatt has said u need to hae a anural review
good luck
gail

 

[Sal54]

Hi @Sal54 and welcome to the forum - obviously I cannot give any direct experience of Diabetes and the menopause, but I do know that the change in hormone balance can affect your blood gloucose and it has been proven that when Oestrogen levels fall, it can increase your insulin resistance - there are drugs that can help with this, along side your insulin but you do need to see a specialist to get them prescribed! Unfortunately the standard of healthcare across the country varies in a massive way - do you have a local diabetes centre at a hospital you could get in touch with? You should have an annual diabetic review too, where you should have the opportunity to speak to specialist nurses etc. Sorry you've had a bad experience of this and sadly I'm sure you're not alone - but you found us now though and we're all here to help and support each other, so I hope you get the answers and help you need

Thank you so much for that fab answer. I know that menopause affected diabetes as I've read about studies into the issue. But I didn't know I could get medication to help. I do have an appointment to see a nurse at the local health Centre next Wednesday & I'm going to show her this answer.
Nice to say Hi to you to.
It doesn't help that I'm now also waiting for a full assessment of my autism.
Don't know how you found them but I've found some of the nurses horrible & yet other nurses have been so nice.

 

[Leadinglights]

So. I have to ask. Or is it just me?
I became a type 1 diabetic 1 week after my 40th birthday.
Once I'd got to grips with my diabetes all was well.
I even had 3 years of training at my local gym with a P. T. Instructor.
In November 2019 I was at my fittest & I felt on top of the world.
Then I got a strange worse than flu illness that totally knocked the strength & breath out of me & everything changed. Since then I've suffered Covid twice more.
Then in June 2020 I started to become pre menopausel & that's she my blood glucose started to rise & a year later I was fully into the menopause & since then it's been very, very difficult to control my diabetes.
It's been as high as the early 20s & now I've got my readings down to 15 & below. It seems the only way I can get the great low reading like I had before is if I eat very little & nearly No or actually No carbs or anything remotely sweet!
That's not practical or good. And I'm on the highest HRT patches & tablets.
It doesn't help that I haven't seen a type 1 diabetes nurse since January 2020. The local nurse I saw at my previous doctors (I moved to Southport in July last year) saw elderly type 2 diabetics & was very dismissive of me. Treated me like I didn't have a clue about diabetes, even though I had education from a dietician for the first 6 months of being a diabetic. All she said was No, No, No & didn't want to hear my side of things.
Finally after trying for over a year & waiting months after a cancelled appointment to see a nurse who can deal with type 1,s I'm wanting to know if anyone can relate to any of what I'm saying please?
It would be nice to know I'm not alone.

You could try making contact with these people as it sounds as if you need some support with getting your condition better managed whether that is a review of your insulin regime or help with diet given your changed situation re the menopause.

Community Diabetes Team :: Mersey Care NHS Foundation Trust

www.merseycare.nhs.uk

 

[Sal54]

Hi there & thank you. Yes I agree with you. Since 2020 I seem to have been ignored. I'm seeing a nurse next Wednesday & I'm going to show her his answer to my questions.
All I've had is nurses saying I'm fat & I must be eating the wrong things!
All I want is for someone who's willing to work with me & help me sort this problem out.

hello @Sal54 welcome to the forum I went thou the menopause and it affected my BG so you are not alone. i think the diabetic care u have recieved is cack and you should complain about it Dont be put off As mashedumatt has said u need to hae a anural review
good luck
gail

Hi Gail.
Thanks so much for your comment & yes I agree since 2020 I've been feeling ignored.
I've been told I'm fat & eating the wrong things.
Some nurses have been horrible & some so nice.
I'm seeing a diabetic nurse next Wednesday & I've got all my info from when I did my training & my last 3 diabetes diary's. To show an obvious difference.

 

[Sal54]

You could try making contact with these people as it sounds as if you need some support with getting your condition better managed whether that is a review of your insulin regime or help with diet given your changed situation re the menopause.

Community Diabetes Team :: Mersey Care NHS Foundation Trust

www.merseycare.nhs.uk

Thanks. Yes it's a nurse from community diabetic care that I'm finally seeing next week as long as the appointment isn't cancelled again.

 

[mashedupmatt]

Don't know how you found them but I've found some of the nurses horrible & yet other nurses have been so nice

I must be one of the lucky ones as mine have always been nice, however having to wait 8 weeks after my diabetic review with a specialist nurse has annoyed me a bit (seeing as the results came back within a few days) - unfortunately you seem to have slipped through the net for the past couple of years - ironically when you needed it most - I Hope your appointment goes well next week (and isn't cancelled of course!) - and if you have any other questions in the meantime, please fire away - there are many people on here who can help 🙂

 

[Inka]

Welcome @Sal54 🙂 I had a lot of problems during perimenopause, one being totally erratic blood sugars. Fortunately for me, HRT has helped a bit. I know you’ve said you’re on the max dose, but maybe a different type would help a little?

I read a helpful blog from a lady with Type 1 who had similar problems during peri. I’ll see if I can find it later. She said she learnt what kind of day it would be blood sugar-wise during the morning (ie would she be running high that day, or prone to suddenly dropping low? That helped her have plans to initiate on each kind of day.

However, it sounds like you’re constantly or mainly running high - is that right? If so, looking at your basal dose is the first step. It’s not unusual to have to make large reductions or increases to that during this time of hormonal change - and to have to change it a number of times too. Then look at your meal ratios. If they vary day to day, aim for a middle one, then adjust according to your results by either adding insulin or carbs.

One thing I will say is to be wary of going too low in carbs. Too few carbs can increase insulin resistance, which is the last thing you want at this time. During a particularly annoying time, I tried low carb and found it made things harder. My blood sugar ran high and was stubbornly hard to get down.

 

[everydayupsanddowns]

I read a helpful blog from a lady with Type 1 who had similar problems during peri. I’ll see if I can find it later. She said she learnt what kind of day it would be blood sugar-wise during the morning (ie would she be running high that day, or prone to suddenly dropping low? That helped her have plans to initiate on each kind of day.

Was that Annie Cooper @Inka ? She’s lovely! An ex-nurse who lives with T1 and did a lot of voluntary work to try to get the menopause recognised and acknowledged as a serious issue for 50% of people living with T1. Certainly not something to be dismissed @Sal54

Sorry you’ve been having such a tough time with your diabetes @Sal54, and how patchy your diabetes care has been since Covid. Hope the appointment goes well with the community care clinic

 

[rebrascora]

Hi and welcome from me too.

Really sorry to hear you are going through such a rough spell and with poor support. You really need to ask for a referral to a specialist diabetes clinic, not a diabetes nurse at a GP practice (usually a practice nurse who has been given a bit of inhouse training on diabetes to manage Type 2 patients) unless he/she is a qualified DSN (Diabetes Specialist Nurse) who is usually hospital based but possibly doing a day clinic at a GP practice once a month. These DSNs are highly qualified to specialise in the management of diabetes and particularly more complex cases like Type 1 and some Type 2s on insulin.

Can I ask which insulins you are using and do you have a Libre or Dexcom constant Glucose Monitor or are you still relying solely on finger pricks to get your levels?


Have you had an intensive education course like DAFNE (Dose Adjustment For Normal Eating) or similar local course. Usually a full week or one day a week spread over several weeks?

When was the last time you changed your basal )long acting) insulin dose? Have you learned how to adjust your basal insulin to get that dose as close as possible to optimum to keep your levels stable in the absence of food and bolus (fast acting) insulin. It is so much easier and less frustrating/less of a battle to manage your diabetes when your basal insulin dose is correct and just a couple of units can make a massive difference. I have to regularly adjust my basal doses to maintain good diabetes management. If I am having to fight it and it is frustrating, then it is almost always because I need an increase in basal insulin. Some people need to increase it for winter and decrease it for summer but a few people find it can be the other way around. Also, many of us have to increase it for illness. It may be that the virus you had caused your body to kill off more of your insulin producing beta cells bringing your honeymoon period to an end and that together with the change in hormones has meant that you need to review your basal dose(s).
I have found HRT patches have helped enormously but if I forget to put a new patch on for a week or so, I have a couple of unstable days until I get things balanced again. Using a patch every 3-4 days it can be difficult to maintain a routine and remember when a new one is due, so unfortunately I regularly forget and sometimes go a fortnight before I realise. That was one of the reasons I had a nasty hypo last night.... because I hadn't applied one for a fortnight and so insulin resistance increased and then applied one the night before last and have promptly had a nocturnal hypo because I didn't take the hormone effect into consideration when I was adjusting my basal dose last night and only considered the fact I hadn't done much exercise yesterday or the day before and would therefore need a bit more.... but of course with hindsight, I also needed less due to the HRT patch. If I used them regularly as I am supposed to, I wouldn't need to factor that in because it keeps my hormones steady, but the lull over a couple of weeks and then surge has an impact.

As regards other medication to help diabetes management with hormonal issues, I think there is just Metformin which is prescribed to women with PCOS as well as people with Type 2 diabetes. It can help with insulin resistance.

In your situation, the first thing I would do would be to look at your basal insulin and perhaps do a basal test to see if it is holding you steady in the absence of food and bolus insulin and adjust if necessary. There is guidance on basal testing here....

Thread 'Basal Testing Made Easy'

Jul 5, 2011

Here's a link for basal testing, which will hopefully clear up the myths for anyone starting on their pump journey
http://diatribe.org/issues/13/learning-curve
Plus this might help as well.
http://diatribe.org/issues/26/thinking-like-a-pancreas

• Pumper_Sue
• Replies: 49
• Forum: Pumping and Technology

• 

If it was me, I would want to find out if the appointment you have is going to be with a qualified DSN not just a Diabetes Nurse (ie a practice nurse who has had a bit of training) and if not, then push for a referral to a diabetes clinic where you will get better support from knowledgeable staff who are very experienced at managing Type 1 diabetes.

 

[HayleyR]

Hi @Sal54 a very warm welcome from me too 🙂 . The support you are receiving or rather not receiving is appalling. The level of support I have can't be faulted at Diabetic Clinic with regular Diabetes consultant appointments, eye screening and options of seeing a dietician etc. I have a diabetes review at the local health centre but that's really just to have bloods taken, feet checked etc. I really think it would help you to push for a Diabetes Clinic referral for where you should get specialist help. I did that many years ago and haven't looked back. You can also ask away here as there are lots of us to help support you!

 

[JimmyBlue]

I must be one of the lucky ones as mine have always been nice, however having to wait 8 weeks after my diabetic review with a specialist nurse has annoyed me a bit

@mashedupmatt I feel your pain, got my results back for a blood test on 8th of Jan (test on 7th) and have now had my review part 2 appt cancelled twice. Now have to wait until 3rd March. All down to staff sickness.

 

[Sal54]

Hi @Sal54 a very warm welcome from me too 🙂 . The support you are receiving or rather not receiving is appalling. The level of support I have can't be faulted at Diabetic Clinic with regular Diabetes consultant appointments, eye screening and options of seeing a dietician etc. I have a diabetes review at the local health centre but that's really just to have bloods taken, feet checked etc. I really think it would help you to push for a Diabetes Clinic referral for where you should get specialist help. I did that many years ago and haven't looked back. You can also ask away here as there are lots of us to help support you!

Thank you. I know the support I'm getting is crap. It was good before Covid, 2020. Then I moved, changed doctors & that's when it all went wrong. I've moved again to another area & it's been so difficult to get the help I need. I feel completely let down by the NHS.

 

[Sal54]

Welcome @Sal54 🙂 I had a lot of problems during perimenopause, one being totally erratic blood sugars. Fortunately for me, HRT has helped a bit. I know you’ve said you’re on the max dose, but maybe a different type would help a little?

I read a helpful blog from a lady with Type 1 who had similar problems during peri. I’ll see if I can find it later. She said she learnt what kind of day it would be blood sugar-wise during the morning (ie would she be running high that day, or prone to suddenly dropping low? That helped her have plans to initiate on each kind of day.

However, it sounds like you’re constantly or mainly running high - is that right? If so, looking at your basal dose is the first step. It’s not unusual to have to make large reductions or increases to that during this time of hormonal change - and to have to change it a number of times too. Then look at your meal ratios. If they vary day to day, aim for a middle one, then adjust according to your results by either adding insulin or carbs.

One thing I will say is to be wary of going too low in carbs. Too few carbs can increase insulin resistance, which is the last thing you want at this time. During a particularly annoying time, I tried low carb and found it made things harder. My blood sugar ran high and was stubbornly hard to get down.

OMG. Wow its like you totally know what I'm going through. For the last 6 months I've been trying low carb. But it's not working. Eating normally doesn't seem to be working either. I'm at a loss. So I've big hopes on my first nurse appointment in 5 years on Wednesday.

 

[Sal54]

Hi and welcome from me too.

Really sorry to hear you are going through such a rough spell and with poor support. You really need to ask for a referral to a specialist diabetes clinic, not a diabetes nurse at a GP practice (usually a practice nurse who has been given a bit of inhouse training on diabetes to manage Type 2 patients) unless he/she is a qualified DSN (Diabetes Specialist Nurse) who is usually hospital based but possibly doing a day clinic at a GP practice once a month. These DSNs are highly qualified to specialise in the management of diabetes and particularly more complex cases like Type 1 and some Type 2s on insulin.

Can I ask which insulins you are using and do you have a Libre or Dexcom constant Glucose Monitor or are you still relying solely on finger pricks to get your levels?


Have you had an intensive education course like DAFNE (Dose Adjustment For Normal Eating) or similar local course. Usually a full week or one day a week spread over several weeks?

When was the last time you changed your basal )long acting) insulin dose? Have you learned how to adjust your basal insulin to get that dose as close as possible to optimum to keep your levels stable in the absence of food and bolus (fast acting) insulin. It is so much easier and less frustrating/less of a battle to manage your diabetes when your basal insulin dose is correct and just a couple of units can make a massive difference. I have to regularly adjust my basal doses to maintain good diabetes management. If I am having to fight it and it is frustrating, then it is almost always because I need an increase in basal insulin. Some people need to increase it for winter and decrease it for summer but a few people find it can be the other way around. Also, many of us have to increase it for illness. It may be that the virus you had caused your body to kill off more of your insulin producing beta cells bringing your honeymoon period to an end and that together with the change in hormones has meant that you need to review your basal dose(s).
I have found HRT patches have helped enormously but if I forget to put a new patch on for a week or so, I have a couple of unstable days until I get things balanced again. Using a patch every 3-4 days it can be difficult to maintain a routine and remember when a new one is due, so unfortunately I regularly forget and sometimes go a fortnight before I realise. That was one of the reasons I had a nasty hypo last night.... because I hadn't applied one for a fortnight and so insulin resistance increased and then applied one the night before last and have promptly had a nocturnal hypo because I didn't take the hormone effect into consideration when I was adjusting my basal dose last night and only considered the fact I hadn't done much exercise yesterday or the day before and would therefore need a bit more.... but of course with hindsight, I also needed less due to the HRT patch. If I used them regularly as I am supposed to, I wouldn't need to factor that in because it keeps my hormones steady, but the lull over a couple of weeks and then surge has an impact.

As regards other medication to help diabetes management with hormonal issues, I think there is just Metformin which is prescribed to women with PCOS as well as people with Type 2 diabetes. It can help with insulin resistance.

In your situation, the first thing I would do would be to look at your basal insulin and perhaps do a basal test to see if it is holding you steady in the absence of food and bolus insulin and adjust if necessary. There is guidance on basal testing here....

Thread 'Basal Testing Made Easy'

Jul 5, 2011

Here's a link for basal testing, which will hopefully clear up the myths for anyone starting on their pump journey
http://diatribe.org/issues/13/learning-curve
Plus this might help as well.
http://diatribe.org/issues/26/thinking-like-a-pancreas

• Pumper_Sue
• Replies: 49
• Forum: Pumping and Technology

• 

If it was me, I would want to find out if the appointment you have is going to be with a qualified DSN not just a Diabetes Nurse (ie a practice nurse who has had a bit of training) and if not, then push for a referral to a diabetes clinic where you will get better support from knowledgeable staff who are very experienced at managing Type 1 diabetes.

@mashedupmatt I feel your pain, got my results back for a blood test on 8th of Jan (test on 7th) and have now had my review part 2 appt cancelled twice. Now have to wait until 3rd March. All down to staff sickness.

Thanks for the info Rebrascora. I don't know that much about my basal insulin. I started with it at 20 units. It's now at 32 units, once a day, at night. I learned the Dafne way 14 years ago when I first became a type 1. I have noticed my readings can change. If I don't eat it does fall. If I don't eat carbs or very little it's more manageable. But right now I'm feeling so lost. My appointment is with a diabetic nurse who deals with type 1s. I've also another appointment next week. Im feeling confused at the moment. But because of all the great, helpful people on here I now don't feel so alone.