Hormones

Many type-1 diabetic women of childbearing age experience that their blood sugar fluctuates in a characteristic way during each cycle. This is due to the sex hormones that influence insulin resistance. Their concentration rises sharply in the second half of the cycle, which promotes insulin resistance; women need more insulin to achieve good blood sugar levels. With the onset of the period, the oestrogen and progesterone levels drop abruptly. So, while the second half of the cycle is characterised by hyperglycaemia, unless the insulin dose is increased accordingly, there is a risk of hypoglycaemia after the start of the period if the amount of insulin is not reduced again. Women with type 1 diabetes should track their values well in order to find out which insulin dose ensures good blood sugar in which cycle phase.

The second hormonal hurdle that affects blood sugar is pregnancy. Initially, the insulin requirement of the pregnant woman decreases here until about the 14th week of pregnancy. Then, however, from about the middle of pregnancy, the expectant mother needs considerably more insulin. This additional need drops off abruptly after birth. Type-1 diabetics and women with gestational diabetes have to check their blood sugar frequently every day and do everything they can to keep the values within the normal range. High blood glucose levels can be dangerous for the child. First of all, in the womb - miscarriages and heart defects are more common, and these children often become very heavy, which can cause problems at birth. But there is also a threat of trouble after birth, because the baby's pancreas has helped to lower the mother's high blood sugar levels as much as possible in the womb. The baby's pancreas therefore runs at full speed and ensures that the baby's own blood glucose levels drop sharply after birth and the child becomes hypoglycaemic. All these risks can be prevented as far as possible with the best possible blood sugar control.

Sometime between the ages of 45 and 55, often earlier for diabetics, the last hormonal roller coaster ride in a woman's life begins, caused by the menopause. For type-1 and also type-2 diabetic women, this means that a phase of restlessness awaits them once again. Many factors come together: The calorie requirement decreases, and with the same amount of food, women therefore gain weight, which promotes insulin resistance. Since visceral fat in particular grows and the vascular protective oestrogen says goodbye at the same time, the risk of heart attacks and strokes increases significantly for diabetic women who are already at risk. The hormonal fluctuations associated with the menopause cause an alternation of very high values from time to time and a tendency to severe hypoglycaemia. Because menopausal symptoms with hot flushes can manifest themselves in a similar way with hypoglycaemia, women can easily confuse the causes. For diabetics with pronounced menopausal symptoms, hormone preparations, preferably in the form of patches or gels, bring more calm to the blood sugar.

Young people with type 1 diabetes have a harder time than healthy teenagers. Simply partying all night, drinking lots of alcohol, enjoying the dolce vita, doing sports to the hilt - with all this, the diabetics among the young people always have to pay very close attention to their diabetes, and often enough they don't feel like it at all. Sometimes they get into a phase in which they ignore their diabetes, they don't care how high their values are. Eating disorders, which often occur during adolescence, are also more common among diabetics than among the average healthy teenager. The constant pressure to watch what they eat and the possibility of easily losing weight by skipping insulin injections at the cost of high levels encourage various eating disorders. More than usual, teenagers with diabetes are therefore dependent on at least one diabetes-experienced adult. In addition to the diabetology practice, this can also be an experienced PTA or a pharmacist.

PTAs and pharmacists have many talking points with diabetics. They should use them, but not interfere therapeutically. This boundary between pharmaceutical knowledge and medical action must also be observed in the case of the chronic mass disease diabetes.