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Managing menopause and type 1 diabetes: Sarah Gatward

Sarah has been living with type 1 diabetes for almost 50 years. Here, Sarah talks about how her experiences of perimenopause impacted her daily life with type 1.

Sarah in her kitchen sat smiling at camera

Sarah Gatward was diagnosed with type 1 diabetes in March 1972, a few months after her seventh birthday. Sarah is currently in the process of writing a series of blogs every four weeks as she approaches her 50 year diagnosis of living with type 1. The idea behind these is to show why Sarah feels it is such an achievement to reach her 50 year diaversary.

Sarah is very content with what she has achieved in life so far but feels it is important to say that although she has not let type 1 stop her from doing what she wants to do, it has and can still get in the way and has to be factored into all decisions.

One of Sarah’s specialist subjects includes managing type 1 diabetes and the menopause.


About ten years ago, I was talking to my parents over an early morning coffee. I was 43, had already been living with type 1 for 35 years and was used to just getting on with it all. However, it was getting harder and harder. Having successfully navigated two pregnancies and breastfeeding two babies, family life had settled into a reasonable routine and blood glucose levels were generally okay. But… this was all changing.

My frustrations

I was caught unaware. It seems ridiculous now but it was not on my radar. I went through a winter convinced I was fighting off the flu. I kept having these episodes where I would come over all hot & clammy but it didn’t ever develop into anything more. Arguably this is a problem that all women face when approaching the menopause. It is an area that I have found is not talked about much by my peer group, unless they have type 1. Then, it crops up regularly because of the realisation of how ill-informed we all feel.

So what has changed for me?

I started to notice changes in my early to mid 40s. The length of my cycles began to reduce, initially to 26 days and then averaging at around 22 to 24 days in length. They were still very regular but just significantly shorter. From the age of 50, my cycle lengths began to increase slightly again, returning to the 26 to 28 day length.

The specific problems of managing type 1 through these changes

My basal insulin requirements are reducing. Not in a predictable constant way. The general trend is downwards but there are a lot of bumpy up and down movements

Although I have still experienced a regular cycle, albeit often shorter in length, there has been far less certainty over how blood glucose readings are likely to behave throughout my cycle. There has definitely been a less predictable pattern of ovulation.

I am no longer certain of the dawn phenomenon response that has been a regular companion to my mornings. Instead, mornings can now be split into three or four different patterns – dawn phenomenon; foot to floor rise when getting out of bed; or foot to floor drop when getting out of bed which could eventually turn into a delayed foot to floor rise, almost an hour after getting up.

Night sweats and hot flushes have led to quite rapid increases in blood glucose and they are impossible to predict.

Exercise of any description has become more of a challenge, regardless of the level of intensity.

The burden of managing all of this mentally has been huge.

To read more from Sarah and her thoughts and experiences of living with type 1 for nearly 50 years you can visit her blog.

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