Is Type 1 Diabetes Different for Women than it is for Men?

I read this article that’s been circulating the Internet over the past few days entitled “Men With Type 1 Diabetes Are Better at Blood Sugar Control Than Women” and I found myself thinking that maybe this isn’t such a surprise.  Although the media’s inflammatory word choice for the article title seems to imply “men do it better”, the actual study title, “Sex differences in glycaemic control among people with type 1 diabetes” and study content lean towards biological differences.

Why am I so interested in this study?  As a woman I truly believe that hormone balance is a key issue in my BG control.  In fact I’m sure of it because I’ve tested my theories in my own private lab (i.e. my body).  When my hormones are balanced, I’m proactive with my BG control, fine-tuning my basal rates and having reasonably good predictability of bolus outcomes.  Whereas, when my hormones are not balanced, suddenly my fine-tuned basal rates and boluses don’t work as well as they used to, my insulin resistance goes up, and I’m constantly chasing highs and treating lows.  Even PWDs who don’t have extra complications beyond a normal monthly cycle often mention having higher BGs the week prior to their periods.  Are there type 1 diabetes issues related specifically to women that we should be aware of?

I decided to look further into it.  First, I wanted to actually see the real study this media story was based on.  It took some digging but I found the Abstract and Poster submitted by Dr. Wild to the European Association for the Study of Diabetes (EASD).  The study divided individuals into 3 age groups, under 15, 15-24, and over 24.  womens life stages 3The final conclusion states: “In this cross-sectional analysis of international data, there was a small difference in glycaemic control in males and females in the youngest age group, however control of type 1 diabetes was poorer in women than men in the two older strata.  This association did not appear to be confounded by age or duration of diabetes.”   Seems reasonable to me that the youngest strata is the least different from males, in that most of that age group hasn’t started a monthly cycle yet.  (Yes, I’m sure there are also many other biological reasons to consider.)

Secondly, I looked up information about Dr. Wild and found an interesting recent article she authored related to female cycles, diabetes, and diabetes-disease correlations, entitled “Diabetes in women − A life-course approach”.  I’m hoping this means more future studies will be conducted related to PWDs and hormones.  The lack of information on this has been frustrating for me, to say the least.  A few specific women’s health correlations to diabetes from the article are below.  While most of the correlations are negative, I’m certainly not trying to be Ms. Diabetes Doomsday.  But I do feel that as PWDs, these are women’s health correlations that we should be aware of.  If for no other reason, than that our local OBGYN, Endo, or Primary Physician may not be (mine weren’t aware of quite a few).

And after all, let’s call a spade a spade; women do tend to be more complicated ^_^

  • T1 diabetes appears to be associated with a delay in menarche and with menstrual irregularities.
  • Diabetes is associated with less frequent ovulation and the ability to conceive was about 75% of that of a non-diabetic.
  • There is evidence to suggest that women with diabetes undergo earlier menopause than women without diabetes.
  • Women lifecycles 2Effect of pregnancy on pre-existing diabetes:  Pregnancy leads to increased insulin resistance and is associated with a higher frequency of hypoglycaemic episodes (and reduced hypoglycaemia awareness) in women with type 1 diabetes.
  • If you have gestational diabetes, you are at increased risk for developing subsequent T2 diabetes.
  • Odds of developing T2 diabetes were 4-fold higher for women with PCOS than those without.
  • Post Menopausal Hormone Replacement Therapy (HRT) in PWDs:  Given the risks of both diabetes and the menopause, each case needs to be evaluated on its individual merits. Do the vasomotor and osteoporosis benefits outweigh the risks of endometrial or breast cancer? A large meta-analysis found that women with diabetes taking HRT had significantly reduced insulin resistance (12.9%, 95%CI 19.8–51.7%), reduced fasting glucose (11.5%, 95%CI 5.1–18.0%) and reduced fasting insulin (20.2%, 95%CI 4.2–36.3%), compared to those taking placebo or no treatment.
  • HRT in PWOD’s:  A meta-analysis of 107 randomized controlled trials found a 30% reduction in the incidence of diabetes in women taking HRT vs no treatment or placebo.  They also found non-diabetic users had significantly lower abdominal adiposity and waist circumference and more positive lipid profiles than non-users. Again individual women need to weigh the risks and benefits of HRT.
  • A number of studies have repeatedly confirmed osteoporosis as a complication of T1 diabetes.
  • Women with T1 diabetes were 12.25 times more likely to report an incident hip fracture than women without diabetes.
  • A number of researchers have looked at the relationship between diabetes and endometrial cancer and consistently found an increased risk of endometrial cancer amongst women with T2 diabetes.   No association has been shown for T1 diabetes.

You might also be interested in these related posts:

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories

First Things First: Hormones and Insulin Requirements

My Fitbit Flex: A Delightful Surprise

Just got a new Fitbit Flex.  So far, I’ve only used it for two days, although two days was enough to have me feeling a bit like Wonder Woman with her indestructible wrist cuffs.

Fitbit_Wonder_Woman_cuffsWith logging diabetes data on my OmniPod, CGM, and BG tracking app, why on earth would I want yet another data entry device to worry about?!  Turns out one of the most attractive things about the Fitbit is that it isn’t subject to any of the proprietary B.S. that all my other devices fall victim to when it comes time to actually view the data.  It’s so simple to use that I can see my data with no more hassle than looking at a mobile app or website, it syncs automatically via WiFi, and works across all operating systems and platforms!  It’s open API and integrates with lots of mobile apps, giving it even more functionality.  Bonus: I don’t have to pierce my body to get it on, deal with calibrations, site changes, alarms, or discomfort.  I just wear it like a bracelet and essentially forget about it.  It’s providing me with a sense of freedom in patient generated data (PGD) that I’ve longed for with my diabetes devices.  Because it’s so much easier than what I’m used to, I’m actually motivated to set activity goals and complete them.  What a treat!

Fitbit_gollum_and_ringI know a lot of Fitbit users like to keep in touch via social media and share their data, but something else I really love about the Fitbit is that I don’t have to share.  This is my data and mine alone!  I’m not required to whip it out and share it with physicians at every turn in the road.  I don’t have to scramble to have all my data-entry ducks in a row, only to have my Endo pour over it (in 5 minutes flat!) offering the inevitable praise here and reprimand there.  It’s my Fitbit…my secret…my precious…


You might also like Big Diabetes Data Requires Big Analyses

Big Diabetes Data Requires Big Analyses

If you’re anything like me, you’re currently clocking data on your CGM, your insulin pump, your BG meter, and any other number of devices including mobile apps for diabetes, fitness, or menstrual cycle, and wearable fitness devices like Fitbit.

It’s easy to look at one post-meal high and make a judgment call.  But it’s really hard to look at months worth of data and try to pull out patterns to really improve overall BGs and health.  Websites that integrate with my OmniPod and CGM (and are Mac compatible…don’t get me started on this…Gah!) only have the capability to really track BG and carb counts well.  But we all know it’s the type of carbs, not the number of carbs that really matters.  Also, was I especially active on a particular day?  Stressed from a big meeting at work?  Having PMS?  So many variables to consider!

big diabetes dataSince I already have all the BG and insulin data on my pump, meter, and CGM, (that I’ve laboriously collected!) I literally fantasize about just uploading those items to a single program online and then using apps of my choice to input details about my other “life variables,” such as food, exercise and activities, moods, monthly cycle, etc…..and finally (here’s the kicker) have the apps sync their data with the existing pump/meter/CGM data online in the same program!  Perfect!  Easy!  Right?  No way!

As you’re probably well aware, most of our diabetes meters, pumps, and CGMs have proprietary software and/or limited relationships with other diabetes-device companies.  So, based on who manufactured our devices, we’re all pretty much limited to one or two platforms for viewing the data…and those options sadly don’t integrate with apps we’re using to track our food, fitness, etc.

My current work-a-round solution for viewing OmniPod and CGM data (on a Mac) is Diasend, however even here you need a Clinic ID# (or to register as a non-US citizen) or your CGM tab will be grayed out.  I also use the mySugr app for logging (btw…I love mySugar), Google Cal for my monthly cycle and HRT, and just started tracking activity and sleep with a Fitbit Flex.  I make it work but it’s still me piecing together data from four different locations.

fitbit open apiFortunately (and just in the nick of time if you ask me) the US is at the beginning of a wave of personalized, data-centric healthcare, sometimes called the Quantified Self.  A lot of new data collection platforms designed for non-PWDs (like Fitbit and Lose It!) are using open APIs, which means they share and can integrate data.  After years of finding work-a-rounds and “making do” I feel like the current big data trend in healthcare is finally going to make my fantasy a realty…in the very near future.  So, everyone put down your proprietary diabetes devices for a second and raise your glass!  Here’s to hoping!


Super interested in the Quantified-Self movement like me?  Here are a few really cool recent articles:

Will An App A Day Keep The Doctor Away? The Coming Health Revolution (Forbes)

Solving America’s Big Health Care Challenges With Big Data (Huffington Post)

How Patient Generated Data Changes Healthcare (Information Week Healthcare)

I Ate an Entire Tube of Glucose Tabs During the Night: So Much for My SoloHealth Station Assessment

Wednesday night was date night for my husband and I, just a relaxing dinner for two.  We planned to make it an early night (since I had a cold) but didn’t want to get home before the kids were in bed (sorry sweeties…we love you but mommies and daddies sometimes need a little break).  So, we stopped at the drug store to pick up a couple of things, where we spotted the SoloHealth Station and, being in no rush to get home, decided to give it a whirl.

Love Tester MachineOk, I confess we were a bit like kids playing around with the old-school “love testers” at the fairgrounds.  “My turn, my turn! Yeah, take that test too! Giggle, giggle.”

Turns out my husband could stand to work on improving his sleep patterns, but me? I passed all the tests with flying colors, including BMI, Blood pressure, Sleep Assessment, and a Health Risk Screening.

SoloHealth Station

I’m not the most photogenic person. My husband is forever laughing and calling me out for “talking” during the picture.

However, last night I definitely wasn’t’ the shining example of health portrayed by my friend, the trusty SoloHealth Station. Last night I was low, low, low.  Don’t you wish there was an easy or obvious answer for every bout of irregular blood sugar readings?  I may feel guilty when I miscalculate my carb intake and end up high or low…but at least I know why!  I find it infinitely more frustrating to be left guessing…or to have irregular blood sugars for some other reason that I have no control over, like an illness.  While I do have a pretty wicked head cold right now, I’ve already had it for about 5 days and usually being sick raises my sugars instead of lowering them.  Last night my CGM woke me at least 4 or 5 times!  A couple of those times I was only a little low, so I just popped a single tab or two and fell back asleep (thinking the issue would be over).  Only to be woken again, and again, and again.  Finally I was woken in the 40s and upon dragging myself out of bed I realized that my menstrual flow had gone haywire in the night and was extremely heavy.  Huh? Now I’m sick, having hard-to-ditch low blood sugar in the middle of the night, and a heinous menstrual cycle?!  Is this the Universe’s cocked-up way of letting me know it’s Friday the 13th?  Not funny Universe…not funny.

Dexcom CGM low nightAs bad as it is, I’m thankful for my CGM and the peace of mind it provides in situations like this.  What could have happened if I didn’t have it?  After all, I was pretty zonked out on cold medicine.  This isn’t the first time since having my second child and going back on HRT 6 months ago that I’ve had a crazy girl cycle.  Guess it’s time to bite the bullet and go to see the Dr again just to be on the safe side and make sure I’m not missing anything (short of the Universe’s evil Friday the 13th plan, of course).  But, it’s also definitely one of those mornings where I wish I could just catch a break.  I wish I could just be an average Joe, someone who could actually use the SoloHealth Station (with it’s simple metrics and variables) to get a realistic snapshot of my health.  Sigh…