Assessment of the Menstrual Cycle and Its Effect on Glycemic Control in a Sample of Egyptian Adolescent Females with Type 1 Diabetes: A Clinical Prospective Study

Objective: Assessing the effect of the menstrual cycle on glycemic control and basal insulin requirements in adolescent females with type 1 diabetes (T1D) receiving multiple daily insulin injections. Materials and methods: A clinical prospective study was conducted, involving 78 adolescent females with T1D, who were following at the Diabetes, Endocrine, and Metabolism Pediatric Unit (DEMPU) of Cairo University Children’s Hospital. We collected data on their ages at menarche and the regularity and duration of their menstrual cycle, and then followed them for 2 consecutive menstrual cycles during the late luteal, menstrual bleeding, and early follicular phases to observe the effect of hormonal variation on glycemic control and the need for basal insulin dose adjustments. Results: The median age of adolescent females with T1D was 17.3 years. Their median age at menarche was 13 years, and the median duration of T1D was 7 years. Forty-eight (61.5%) patients required modification of their basal insulin dose during the days of menstrual bleeding. Forty-four of them required an increase in their basal insulin by a mean of 10% of their usual dose, while 4 required a decrease in their basal dose by a mean of 9%. The remaining 30 (38.5%) did not require any change in their basal insulin during the days of menstrual bleeding. Conclusions: In adolescent females, individualized basal insulin dose adjustment, mostly an increase and less frequently a decrease, can prevent worsening of glycemic control and diabetic ketoacidosis during menses.