one for the women- insulin resistance and PMS

[RLK]

How do you deal with insulin resistance during PMS? I have successfully increased my basal rates to compensate, but cannot seem to get my post-prandial numbers right. I have terrible 2-hour post-prandial BGs (250-300)during PMS, even though my 4-hour BGs are typically fine. My basal rates are correct (confirmed through fasting tests).

I had an endo appointment yesterday, and the NP gave me some Symlin to try, but I'm very very reluctant to use it because my cycles are not very predictable in length or timing. One cycle may be 35 days and the next only 28. I may have hormone-related insulin resistance beginning on day 12 one month and day 20 the next. And the resistance isn't consistant from one meal to the next, so how do I decide when to take the Symlin? I'm terrified of going too low and I hate the idea of another medication.... (And darn it, I'm really tired of doctors who don't take the time to listen or talk through a problem, but just fling another medication at me!)

I have thought about trying to take extra bolus insulin (above my normal insulin:carb ratio) and then reducing my basal rates later to avoid lows at 3-4 hours, but haven't yet because of not being sure when I need to do this and being afraid of going low. However, if I run the same risk of hypos with the Symlin, why not try it, right?

Do any women use Symlin just during PMS? Has anyone on the pump tried bolusing extra up front and then decreasing or suspending the basal after the meal? How else do you guys cope with PMS-related BG issues?

Thanks in advance for your help!

[princesslinda]

Hi RLK:
I'm type II, so I really can't answer your question, but you have validated something that my internist said was unlikely.

Around the week before my period, my BS levels raise. I asked the internist about it and his response was "that's very unlikely that it would have any effect on your glucose levels." Any other type II's out there have higher blood levels at time of menses? I'm relatively new to diabetes, but have noticed this trend.

[belyro]

I'm type 1 and my bloodsugar levels drop a LOT during "that time of the month".

[grace girl]

I know EXACTLY what you are talking about...I go through the exact same thing every month....and the time it lasts is unpredictable, and really even during a single 24 hour period it's unpredictable. I, too, have started raising my basal during this time, and it helps, but not completely. I tried adjusting my carb ratio, but didn't find much help there. I'm going to try it a different way this month, I'm going to adjust my correction factor from 50 to 40 and see what it will do. I know what you mean about the lows...the unpredictable nature of this puts you in the situation where you never know what's coming next, and it's very frustrating. I'm just going to test a lot and always be prepared to deal with a low.
I have a female endo, and she's even really reluctant to listen to me where this is concerned, even though this very thing has caused me to have high numbers for two weeks of the month, while I'm normal the other two weeks.

I haven't tried symilin, and I'm so stubborn about new meds I probably wouldn't just because I feel like my hands are full enough with what I'm currently doing! However, if you try it and it works, post and let us know. I've been working hard the last few months trying to fix this thing on my own, it just seems to take a lot of time to find the answer because you're only dealing with it for a week or two out of every month.

[RLK]

I know EXACTLY what you are talking about...

Yay- I'm not alone!!! That alone makes me feel better already....
Tweaking your correction factor should help- mine goes from 75 point drop/unit to about 40-50 point drop/unit during PMS. I feel like you do about adding the Symlin....just one more med and one more variable. If I ever get over my own stubborness and try it, I'll definitely let you know how it goes. For now, I'm inclined to tweak the bolus timing and dose before adding another variable.

[grace girl]

Yay- I'm not alone!!! That alone makes me feel better already....

That! Seeing your post made me feel like I'm not all alone! As if I'm not frustrated enough during that time, all of the b/s issues makes me want to pull my hair out some days! Then to have your endo look at you like you're making excuses for having high b/s....well, the last time I was there I was experiencing some raging pms already...and I really considered just choking her there on the spot and being done with it! Horrid, I know, but true!!!!!!

[RLK]

well, the last time I was there I was experiencing some raging pms already...and I really considered just choking her there on the spot and being done with it! Horrid, I know, but true!!!!!!

Nothing horrid about it- I've been dreaming about the nasty letter that I would love to write to my endo's practice after yesterday's appointment. :-
I broke down in tears yesterday...something I never do...and the NP asked me if I was PMS'ing. My response was, "I don't know! If I could predict this stuff, we wouldn't be having this conversation in the first place!"
This is why these forums are so important....for the support that they provide. Even if I never figure out how to deal with this, at least I know that others are dealing with it too....