Step by step guide to how I chased one particular blood glucose spike resulting from a hot flush. From food eaten the previous evening, CGM trends and dosing decisions, I hope this will provide additional insight into the difficulties of managing type 1 diabetes and peri-menopause and my frustrations when I am sometimes told that it must be down to incorrect dosing for my evening meal.

If I sweat, must I be hypo? No!…. and knowing the best way to try to tame the resulting blood glucose spike following a hot flush has been a huge challenge. What works for me will not be right for everyone and it is only with the self-funding of CGM and the safety net of alarms that I have felt able to experiment.

My first awareness of changes to my insulin requirements in the morning came just over 10 years ago when my initial frustration with my daughter’s inability to walk in a straight line, on our way to junior school, suddenly became the realisation that she was not the one with the problem. I was having a hypo…..

One of the fascinating things to see on my peri-menopausal journey is how my overall background insulin requirements have been changing. There is a general downwards direction to basal rate doses but not in an ordered way. There are a lot of bumpy up and down movements around this general downwards trend that make identifying a basal rate that provides a good fit, a huge challenge….

As I approach the menopause, there have been days where I feel like I am starting over with a completely new diagnosis of T1. Patterns I had identified and the tried and tested techniques for managing them can no longer be relied upon. So what are the key changes I have found?

An article from Balance magazine in May-June 2006 entitled “All Change” stated: “Unsurprisingly, for women with diabetes, the menopause can be more complicated … you may notice that your blood glucose levels go up and down more than usual … you may also experience stronger and more frequent episodes of low blood glucose … sleep deprivation in turn causes further fluctuations in blood glucose levels and poor control.” So why have conversations about the menopause not been initiated by HCPs at my hospital appointments? Isn’t it time for this to change?