Modeling the variability of insulin sensitivity during the menstrual cycle in women with type 1 diabetes to adjust open-loop insulin therapy.

Abstract

Women with type 1 diabetes (T1D) typically experience a decrease in insulin sensitivity (SI) during the second half of their menstrual cycle (or the luteal phase (LP)), which oftentimes is not properly addressed by insulin therapy, therefore leading to increased exposure to hyperglycemia. This study proposes a suitable way to model SI variability due to the menstrual cycle in the FDA-accepted University of Virginia (UVA)/Padova T1D Simulator, to determine to what extent the inclusion of menstrual cycle information to fine-tune insulin therapy could help improve glycemic control in the LP of the menstrual cycle. In-silico tests were performed considering different simulation scenarios, and the obtained results show that hyperglycemic excursions can be largely reduced when SI variability is taken into account for planning insulin therapy, without a relevant increase in hypoglycemic events.