Alterations in glucose metabolism during menstrual cycle in women with IDDM

B. Widom, Michael Peter Diamond, D. C. Simonson

Research output: Contribution to journalArticle

61 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)213-220
Number of pages8
JournalDiabetes Care
Volume15
Issue number2
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Fingerprint

Luteal Phase
Menstrual Cycle
Type 1 Diabetes Mellitus
Glucose
Estradiol
Hormones
Follicular Phase
Androstenedione
Dihydrotestosterone
Corpus Luteum
Luteinizing Hormone
Hyperglycemia
Prolactin
Progesterone
Insulin Resistance
Testosterone
Research Design
Serum

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Alterations in glucose metabolism during menstrual cycle in women with IDDM. / Widom, B.; Diamond, Michael Peter; Simonson, D. C.

In: Diabetes Care, Vol. 15, No. 2, 01.01.1992, p. 213-220.

Research output: Contribution to journalArticle

@article{148159223dc84f36a60d4468d3a5e789,
title = "Alterations in glucose metabolism during menstrual cycle in women with IDDM",
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.",
author = "B. Widom and Diamond, {Michael Peter} and Simonson, {D. C.}",
year = "1992",
month = "1",
day = "1",
doi = "10.2337/diacare.15.2.213",
language = "English (US)",
volume = "15",
pages = "213--220",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "2",

}

TY - JOUR

T1 - Alterations in glucose metabolism during menstrual cycle in women with IDDM

AU - Widom, B.

AU - Diamond, Michael Peter

AU - Simonson, D. C.

PY - 1992/1/1

Y1 - 1992/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0026545922&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026545922&partnerID=8YFLogxK

U2 - 10.2337/diacare.15.2.213

DO - 10.2337/diacare.15.2.213

M3 - Article

C2 - 1547678

AN - SCOPUS:0026545922

VL - 15

SP - 213

EP - 220

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 2

ER -