Samantha Markovitz, NBC-HWC
On the long list of factors that affect blood glucose, perhaps the least frequently considered is the impact of hormone imbalance and diabetes. Hormone changes of all types are reflected in blood glucose levels, which present unique challenges to diabetes management in different seasons of life.
If you live with diabetes, it's important to understand how to approach these changes and plan for other fluctuations. Here's what you need to know!
Understanding diabetes and hormones
Insulin is a hormone that people living with Type 1 diabetes (T1D) are keenly familiar with, as they spend a decent amount of time calculating insulin doses, administering insulin, and thinking about the next steps necessary to keep their blood sugar balanced. Acting as the key that allows glucose to enter cells and provide energy, insulin is frequently acknowledged as the most important hormone involved in diabetes.
However, the absence of functioning beta cells affects other hormones as well.
People with T1D no longer make the hormones insulin and amylin. As a result, GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) — which are also hormones — are unable to assist in mealtime blood glucose regulation. The University of California, San Francisco (UCSF) detailed that counter-regulatory hormones (including glucagon, epinephrine, cortisol, and growth hormone) function differently in people with T1D.
Hormonal changes and blood glucose fluctuations
For people living with T1D, hormonal changes can cause a ripple effect across their diabetes management. Hormones may cause unexpected hyperglycemia (high blood sugar) and/or hypoglycemia (low blood sugar). Insulin resistance can also be a side effect of some types of hormonal imbalance, which may lead to weight gain or other concerns that affect diabetes management. For those reasons, the delicate balance of hormonal fluctuations and blood glucose levels requires close attention.
Here are the three most prominent hormones that affect blood glucose levels throughout different stages of life:
1. Growth hormone
Teens and young adults experience a surge in growth hormone as they grow up, fill out, and get stronger. At the same time, though, teens and young adults are likely to experience variations in sex hormones and stress hormones as they journey through puberty. This can be a challenging time for diabetes management due to the many frequent changes in the body.
2. Sex hormones
Women experience changes in levels of estrogen and progesterone throughout their menstrual cycle. According to the Mayo Clinic, estrogen may increase sensitivity to insulin, while progesterone may cause insulin resistance. This can also vary based on the individual. As women go through the hormonal fluctuations associated with pregnancy, perimenopause, and menopause, they will require more frequent fine-tuning of diabetes management techniques.
Testosterone levels affect blood glucose levels in men. A study published in the Journal of Clinical Endocrinology and Metabolism found that testosterone deficiency is common in men with diabetes and that there is a relationship between testosterone levels and insulin resistance.
3. Stress hormones
The UCSF explained that the body's stress response involves the release of cortisol and epinephrine, which may cause a combination of low and high blood sugar levels over an extended period of time. Surges in these stress hormones make blood sugar more difficult to manage.
Staying alert, staying healthy
If you're in tune with your body, you're more likely to notice if you're having unexplained swings that could be related to hormone imbalance and diabetes. Some hormone changes may be more predictable due to patterns over time, allowing you to make plans to meet the challenge, while other changes may come out of the blue and require agility!
Staying comfortable with a flexible approach to managing blood sugar in case of a hormone-induced surprise swing can help make these shifts easier. Making adjustments to your ratios, switching up your schedule, or even getting more sleep can be mitigating factors for these hormonally influenced fluctuations. Consult with your doctor for guidance on what hormone fluctuation management strategies will be safe and helpful for your diabetes.
Wondering how hormonal birth control can affect blood glucose levels? Visit the Edgepark HealthInsights blog to read this article about birth control options and T1D.