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Inicio Medicina Clínica (English Edition) Glycemic changes during menstrual cycles in women with type 1 diabetes
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Vol. 146. Issue 7.
Pages 287-291 (April 2016)
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Vol. 146. Issue 7.
Pages 287-291 (April 2016)
Original article
DOI: 10.1016/j.medcle.2016.05.034
Glycemic changes during menstrual cycles in women with type 1 diabetes
Cambios glucémicos durante el ciclo menstrual en mujeres con diabetes mellitus tipo 1
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Lucrecia Herranz
Corresponding author
, Lourdes Saez-de-Ibarra, Natalia Hillman, Ruth Gaspar, Luis Felipe Pallardo
Unidad de Diabetes, Departamento de Endocrinología, Hospital Universitario La Paz, Madrid, Spain
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Table 1. Characteristics of women with and with out cyclic changes in glycemic during the menstrual cycle.
Abstract
Background and objective

To determine frequency of women with type 1 diabetes showing menstrual cyclic changes in glycemia, analyze their clinical characteristics, and assess the pattern of glycemic changes.

Patients and methods

We analyzed glucose meter readings along 168 menstrual cycles of 26 women with type 1 diabetes. We evaluated mean glucose, mean glucose standard deviation, mean fasting glucose, percentage of glucose readings >7.8mmol/L and <3.1mmol/L, and mean insulin dose in 4 periods for each cycle. A woman was identified as having cyclic changes when mean glucose rose from early follicular to late luteal in two-thirds of her menstrual cycles.

Results

A percentage of 65.4 of the women had cyclic changes. Characteristics of women with and without cyclic changes, including self-perception of glycemic changes, were similar with exception of age at diabetes diagnosis (22.5 [7.5] vs. 14.4 [9.5] years; p=0.039). In women with cyclic changes mean percentage of glucose readings >7.8mmol/L rose from early follicular (52.2 [16.3] %) to early and late luteal (58.4 [16.0] %, p=0.0269; 61.0 [16.9] %, p=0.000).

Conclusion

Almost two-thirds of women with type 1 diabetes experience a menstrual cycle phenomenon, attributable to an increase in hyperglycemic excursions during the luteal phase. Enabling women to evaluate their weekly mean glucose from their meter and exploring the causes of hyperglycemic excursions during luteal phase should ensure more accuracy when giving instructions for diabetes management in women with premenstrual hyperglycemia.

Keywords:
Menstrual cycle
Glycemic change
Type 1 diabetes
Resumen
Fundamento y objetivo

Determinar la frecuencia de mujeres con diabetes tipo 1 que experimentan cambios glucémicos durante el ciclo menstrual, analizar sus características clínicas, y evaluar el patrón de los cambios glucémicos.

Pacientes y métodos

Analizamos las lecturas de los glucómetros a lo largo de 168 ciclos menstruales en 26 mujeres con diabetes tipo 1. Evaluamos la glucemia media, la desviación estándar media, la glucemia media basal, el porcentaje de lecturas >7,8mmol/l y <3,1mmol/l, y la dosis de insulina media en 4 períodos de cada ciclo. Se consideró que una mujer tenía cambios cíclicos cuando la glucemia media se elevó entre la fase folicular temprana y la fase lútea tardía en dos tercios de sus ciclos menstruales.

Resultados

El 65,4% de las mujeres experimentaron cambios cíclicos. Las características de las mujeres con y sin cambios cíclicos, incluyendo la autopercepción de cambios glucémicos, fueron similares, exceptuando la edad de diagnóstico de la diabetes (22,5 [7,5] frente a 14,4 [9,5] años; p=0,039). En mujeres con cambios cíclicos el porcentaje medio de los valores de glucosa >7,8mmol/l se elevó entre la fase folicular temprana (52,2 [16,3] %) y la fase lútea temprana y tardía (58,4 [16,0] %, p=0,0269; 61,0 [16,9] %, p=0,000).

Conclusión

Casi dos tercios de las mujeres con diabetes tipo 1 experimentan fenómenos del ciclo menstrual atribuibles a un incremento de las excursiones hiperglucémicas durante la fase lútea. Posibilitar que las mujeres evalúen su glucemia media semanal a partir de las lecturas de los glucómetros, y explorar las causas de las excursiones hiperglucémicas durante la fase lútea podría garantizar una mayor precisión al impartir instrucciones para la gestión de la diabetes en mujeres con hiperglucemia premenstrual.

Palabras clave:
Ciclo menstrual
Cambios glucémicos
Diabetes tipo 1

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