Menstrual phase variations in glycemic control and insulin requirements in females with type 1 diabetes: A systematic review and meta-analysis
Authors' conclusion
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.
Study context
- Population
- Adolescent girls and women with type 1 diabetes mellitus (T1DM); studies comparing follicular and luteal phase glycemic outcomesstudies identified, with 16 contributing to overall pooled estimates
- Participants
- 18 studies
- Comparison
- Follicular and luteal phase glycemic outcomes in females with T1DM
- Outcome
- Time in range (TIR)
Methodological detailsPRISMA-compliant, PROSPERO-registered, random-effects models
- PRISMA-compliant
- PROSPERO-registered
- Random-effects models
Pooled result
As reported in the abstract
- The luteal phase was associated with reduced time in range (TIR)
Further pooled results
Time above range (TAR 180-250 and >250 mg/dL)
- Increased time above range (TAR 180-250 and >250 mg/dL) in the luteal phase
Mean sensor glucose
- Higher mean sensor glucose in the luteal phase
Hypoglycemia (TBR) and glycemic variability
- Hypoglycemia (TBR) and glycemic variability remained unchanged
Total daily insulin and bolus percentages
- Did not differ significantly between phases
Basal insulin proportions
- Overall basal insulin proportions remained stable
Insulin adaptation by insulin modality
- Adaptation patterns differed between automated insulin delivery (AID) and conventional therapies
- Subgroup analysis
Original publication
Menstrual phase variations in glycemic control and insulin requirements in females with type 1 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. Published 12 November 2026. doi:10.
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