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The menstrual cycle affects half of people with type 1 diabetes, yet it's nearly invisible in clinical guidelines, research, and technology design. Dr. Cecilia Nobili — a pediatric diabetology resident and researcher living with T1D — bridges the gap between lived experience and clinical evidence.
In this episode, Dr. Nobili shares findings from her observational study of 170 women, revealing how different insulin delivery systems handle monthly hormonal shifts, which phases create the biggest burden, and why this represents a genuine gender gap in diabetes care.
Full show notes: https://theglucoseneverlies.com/menstrual-cycle-t1d/
KEY TOPICS:
• Why 60% of women on MDI experience ≥5% drop in time in range during luteal phase
• How AID systems cut glucose deterioration in half — but aren't perfect
• Why hypoglycemia when bleeding starts is often more burdensome than luteal phase highs
• Practical strategies for each AID system (780G, Omnipod 5, Control-IQ, CamAPS FX) and MDI
• The progesterone effect: why insulin resistance peaks before your period
• How to anticipate changes and adjust proactively rather than reactively
• Why this should be built into algorithms (but isn't)
WHAT YOU'LL LEARN:
✓ The five phases of the menstrual cycle and their glucose impact
✓ Which AID systems show the most stability across cycle phases
✓ Target adjustments, boost functions, and profile switches that actually work
✓ Why pre-bolusing matters more during the luteal phase
✓ How to prevent the hypoglycemia tsunami when bleeding starts
✓ Why one bad day per month is not catastrophic
Dr. Nobili's research is funded by a grant and represents the first multi-center study specifically examining menstrual cycle glucose patterns across insulin delivery modalities.
This episode provides the structured guidance that should exist in every diabetes clinic — but doesn't.
GUEST: Dr. Cecilia Nobili
Pediatric Diabetology Resident, Turin, Italy
Living with T1D
Multi-center researcher on menstrual cycles and glucose control
Full show notes, practical checklists, and related episodes: https://theglucoseneverlies.com/menstrual-cycle-t1d/
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Disclaimer
This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.
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Enquiries
Collaboration: John Pemberton — john@theglucoseneverlies.com
Creatives: Anjanee Kohli — anj@theglucoseneverlies.com
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Disclaimer
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