P-29: Food cravings, carb intake, and glucose/insulin levels during the menstrual cycle in young women with type 1 diabetes using AID

Introduction

T1D is a challenging condition, especially for women, who may have difficulties managing glucose levels during the luteal phase of the menstrual cycle. The association of food craving, carb intake, and glucose levels in AID users remains unknown.

Objectives

To evaluate food cravings, carb intake, glucose, and insulin levels in the luteal compared to the follicular phase in young women with T1D using an AID.

Methods

Women using AID non-users of hormonal contraception (n=19, 13-34 years, MiniMed™ 780G) were prospectively followed. The Spanish Food Craving Inventory (FCI-SP), assessing 28 foods across 3 categories (simple sugars/trans fats, complex carbs/proteins, and fast food), was applied during follicular (days 2 to 4) and luteal (days -3 to -1) phases. Simultaneously, glucose endpoints, insulin outcomes, and daily carbohydrate intake were downloaded from Carelink™. The association of food cravings with other variables were analyzed using fitted linear mixed models that included menstrual cycle phase as fixed effects. Insulin and glucose in the different menstrual phases were compared using t-tests.

Results

Simple sugars were the most craved items throughout, but food cravings were not associated with insulin/glucose metrics or carb intake. Higher mean glucose (143±16 vs 135±12mg/dL, p=0.005) and lower TIR (77.2% vs 81.0%, p=0.02) were observed in the luteal compared to the follicular phase. Insulin metrics remained stable. Despite luteal fluctuations, TIR remained >70% in both phases.

Conclusions

Food cravings are not a significant factor affecting glucose and insulin metrics during the menstrual phases in users of an AID system. A mild increase in glucose levels was observed during the luteal phase, but these levels remained within the accepted glucose treatment targets.

*Antibody negative for GAD/IA2/ZnT8