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Original Articles

Alterations in Glucose Metabolism During Menstrual Cycle in Women With IDDM

  1. Barbara Widom, MD,
  2. Michael P Diamond, MD and
  3. Donald C Simonson, MD
  1. Department of Internal Medicine, Joslin Diabetes Center, New England Deaconess Hospital, and Brigham and Women'S Hospital, Harvard Medical School Boston, Massachusetts Department of Obstetrics and Gynecology, Yale University School of Medicine New Haven, Connecticut
  1. Address Correspondence and Reprint Requests to Donald C. Simonson, MD, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215.
Diabetes Care 1992 Feb; 15(2): 213-220. https://doi.org/10.2337/diacare.15.2.213
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Abstract

Objective — To examine the hormonal mechanisms underlying the variability in glycemic control during the different phases of the menstrual cycle in women with insulin-dependent diabetes mellitus (IDDM).

Research Design And Methods — Hyperglycemic (11.7 ± 0.1 mM), hyperinsulinemic (24 ± 3 mU/L) clamp studies were performed in 16 women with IDDM during the follicular (day 8 ± 1) and luteal (day 23 ± 1) phases of the menstrual cycle. Seven of the patients (group 1) experienced worsening glucose control during the luteal phase, whereas nine patients (group 2) did not.

Results — In group 1, glucose metabolism fell from 30.2 ± 3.8 μmol·kg−1·min−1 during the follicular phase to 24.5 ± 2.0 μmol·kg−1·min−1 during the luteal phase (P = 0.09), whereas in group 2 it increased from 18.5 ± 1.2 to 23.2 ± 2.3 μmol·kg−1·min−1 (P = 0.03). The decrease in glucose metabolism during the luteal phase in patients in group 1 was associated with a significant rise in the serum estradiol levels from the follicular to luteal phase (164 ± 39 vs. 352 ± 59 pM, P = 0.006), whereas this rise was not observed in group 2 (334 ± 156 vs. 423 ± 74 pM, NS). Changes in other reproductive hormones (progesterone, testosterone, dihydrotestosterone, androstenedione, luteinizing hormone, follicular-stimulating hormone, or prolactin) were not related to the differences in glucose uptake in the two groups.

Conclusions — 1) Marked heterogeneity in glucose metabolism is seen throughout the menstrual cycle in women with IDDM, 2) a subgroup of patients exhibits worsening premenstrual hyperglycemia and a decline in insulin sensitivity during the luteal phase, and 3) the deterioration in glucose uptake in this subgroup was associated with a greater increment in estradiol levels from the follicular to the luteal phase.

  • Received April 30, 1991.
  • Accepted September 25, 1991.
  • Copyright © 1992 by the American Diabetes Association

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February 1992, 15(2)
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Alterations in Glucose Metabolism During Menstrual Cycle in Women With IDDM
Barbara Widom, Michael P Diamond, Donald C Simonson
Diabetes Care Feb 1992, 15 (2) 213-220; DOI: 10.2337/diacare.15.2.213

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Alterations in Glucose Metabolism During Menstrual Cycle in Women With IDDM
Barbara Widom, Michael P Diamond, Donald C Simonson
Diabetes Care Feb 1992, 15 (2) 213-220; DOI: 10.2337/diacare.15.2.213
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