Menstrual phase variations in glycemic control and insulin requirements in females with type 1 diabetes: A systematic review and meta-analysis.

Authors

Lydia Despoina Tsiaple, Athina Stamati, Georgia Sotiriou, Athanasios Christoforidis

Published in

Diabetes research and clinical practice. Pages 113654. Nov 12, 2026. Epub Nov 12, 2026.

Abstract

To systematically evaluate the impact of menstrual cycle phases on continuous glucose monitoring (CGM)-derived glycemic metrics and insulin requirements in adolescent girls and women with type 1 diabetes mellitus (T1DM).
This PRISMA-compliant, PROSPERO-registered meta-analysis searched MEDLINE, Embase, Scopus, Web of Science, CENTRAL, and ClinicalTrials.gov up to 1st August 2026 for studies comparing follicular and luteal phase glycemic outcomes in females with T1DM. Random-effects models evaluated CGM metrics and insulin parameters. Subgroup/sensitivity analyses assessed the impact of insulin modality, cycle definition, and study quality.
Among the 18 studies identified (with 16 contributing to overall pooled estimates), the luteal phase was associated with reduced time in range (TIR), increased time above range (TAR 180-250 and >250 mg/dL), and higher mean sensor glucose. Hypoglycemia (TBR) and glycemic variability remained unchanged. Total daily insulin and bolus percentages did not differ significantly between phases, indicating that compensatory insulin adaptations to luteal-phase dysglycemia are highly variable and individualized. Overall basal insulin proportions remained stable, though adaptation patterns differed between automated insulin delivery (AID) and conventional therapies.
The luteal phase is associated with a modest but consistent worsening of glycemic control, while compensatory insulin adaptations remain highly heterogeneous. Differences observed between insulin-delivery subgroups are exploratory and do not establish a protective effect of AID; the findings support further evaluation of personalized, cycle-aware management strategies.

PMID:
43020281
Bibliographic data and abstract were imported from PubMed on 13 Nov 2026.

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