Abstract Body

Individuals with type 1 diabetes (T1D) need to continuously calibrate insulin therapy, to account for time-varying insulin requirements driven by multiple metabolic and psycho-behavioral factors - eg, meals, physical activity, psychological stress. Among these factors, the menstrual cycle has been documented to impact insulin needs and complicate insulin dosing in women with T1D. According to several studies, women with T1D may experience a decrease in insulin sensitivity during the second half of their menstrual cycle (ie, the luteal phase), which is oftentimes accompanied by an increased exposure to hyperglycemia. Also, increased occurrence of hypoglycemia has been documented during the initial days of the menstrual cycle, as women transition from luteal to follicular phase. These patterns are not consistent across women and elevated inter-subject variability has been observed; further, intra-subject variability has also been documented in some studies. During this talk, we will review the physiology of the menstrual cycle and the effect that phases of the menstrual cycle have on insulin requirements and glycemic control in women with T1D. Further, the talk will discuss how technology in the form of open-loop decision support systems or closed-loop automated insulin delivery systems can support women in the management of T1D across the menstrual cycle.