Type 1 Diabetes Management in the Female Population: Evaluation of the Impact of Sex on Glycemic Control and the Perceived Performance of Diabetes Technology Across the Menstrual Cycle

OBJECTIVE We aimed to explore sex differences in type 1 diabetes management and investigate the perceived need for improved diabetes technology to mitigate the effect of the menstrual cycle on glycemic control in females with type 1 diabetes. RESEARCH DESIGN AND METHODS A REDCap survey was designed to ask adults with type 1 diabetes about demographics, medical history, diabetes management, and, when applicable, the impact of the menstrual cycle on glycemic control and the extent to which currently available diabetes technology is successful at regulating blood glucose levels across cycle phases. RESULTS A total of 299 respondents completed the survey. Of these, 218 (72.9%) reported being female. No significant sex differences were detected in reported A1C, glycemic time in range, or diabetes technology used (χ 2 tests, all P >0.3). One hundred and thirty-six female respondents reported actively menstruating. Of these, 97 (71.3%) indicated the luteal phase of the menstrual cycle to be the cycle phase that most affected their glycemic control, and 102 (75.0%) reported increased exposure to hyperglycemia during this phase. When asked about technology satisfaction, 68 respondents (50.0%) reported that their diabetes technology was not successful at regulating blood glucose levels across the menstrual cycle, and 88 (64.7%) indicated that the technology they used could be better at mitigating cycle-related metabolic variability. CONCLUSION Most investigated type 1 diabetes management outcomes showed no significant sex differences. Importantly, 65% of female respondents who were actively menstruating indicated the need for improved diabetes technology to stabilize glycemic control across the menstrual cycle.