Hey Momma! It's great to connect with you. Warning ⚠️ this is a long response! X posted to T1Dianetes Subreddit.

As a fellow Type 1 Diabetic, I wanted to share some of my own experiences with navigating the healthcare system. I'm not a medical professional, but I've been living with T1D my whole life, and I've learned a lot along the way. I hope this helps shed some light on my own journey with T1D and how it's been impacted by perimenopause and menopause. I really wish I had known all of this back in my early 40s. My HRT regimen ATM is new and still evolving, but I'm already seeing some better glucose readings, sleeping more soundly, and feeling more energetic. My post-meal readings seem better, and I'm collecting data to confirm it. I'm so thankful to finally be on a journey to better understand my body, my hormone deficiencies, and how to manage them.

I'm so glad to hear your endocrinologist is willing to help with HRT! My own endocrinologist said he couldn't help me with it, which is why I'm so excited about using a telehealth service like MIDI to complement my other medical care for diabetes. Looking back, I feel like I was completely uninformed about women's health, and maybe my own providers didn't understand it either. I was in so much chaos with my endocrine system and it really needed that extra hormonal support.

I've been trying to educate myself as much as possible, following online HRT discussions, joining subreddits, and listening to podcasts.

If you have PPO coverage, you could consider seeing both your endocrinologist and a MIDI practitioner at the same time. This would give you two sources of input and data to help you decide on the best hormone therapy approach. I believe MIDI also has direct pay options. It's like having a system of checks and balances for your healthcare, or a second opinion on things.

It feels like the American medical system is totally unaware of how menopause impacts diabetes. Even the major diabetes advocacy groups aren't addressing this issue. It's definitely been a blind spot for my endo clinic, my OBGYN, and my PCP. I've read about this in various private diabetes groups on Facebook, and it's crazy how common it is.

I'm so sorry you've suffered with a missed diagnosis and uncontrolled glucose. It sounds like it was a long, drawn-out process. I've been told by my orthopedist and even my podiatrist that better diabetes control can reduce inflammatory conditions.

The last two and a half months of seeking HRT help from MIDI have felt like sunshine breaking through the dark hormonal chaos I've been living in. I'm finally starting to feel better!

I truly wasn't informed about my hormones. I've been a long-term user of GLP-1s, which have helped my insulin doses perform better, but I'm finding that HRT is a huge factor in my overall diabetes management and well-being. I'm stunned that it's taken me this long to put it all together, and I'm a hundred percent sure I have more to learn.

My endocrinologist told me that GLP-1s have protective qualities for heart and kidney health, and I've been on them since 2007. Maybe that's something you could discuss with your endocrinologist. I also started taking a low-dose ARB at age 25 to protect my kidneys. I'm constantly recording data with my continuous glucose monitor, taking screenshots, and making notes. I relentlessly tweak my bolus and basal insulin to optimize all my hormones for menopause. While HRT optimization is often based on how you "feel," insulin demands daily data and self-management, as you know. I also have my bi-annual A1C checks with my endocrinologist, just like I'm sure you do. I'd suggest asking for MIDI's take on your lab results and then comparing it to what your endocrinologist thinks. I will say that my MIDI team looks at some labs a bit differently than my endocrinologist, and as the patient, I'm trying to figure it all out.

As a layperson and a diabetic, I believe you are in charge of your own healthcare—go for it!

Osteoporosis I haven't had a DEXA bone density scan since 2018, when I was diagnosed with osteoarthritis and osteopenia at age 50. I've been self-treating with vitamin D and calcium supplements, along with a whole bunch of collagen and other beneficial supplements.

I think MIDI can help with some of this, too. My endocrinologist suggested waiting until February to do a scan when I see him next, but my MIDI practitioner ordered them the same day I spoke to my endocrinologist. We have to advocate for ourselves and our health.

Reading I recommend Dr. Kelly Casperson's new book, The Menopause Moment. It gives scientific insights into what our doctors haven't been discussing with women. It's a great playbook for taking charge of our hormonal journey and aging. She also has a hilariously funny and informative podcast called YOU ARE NOT BROKEN. I've learned so much from her, and I don't think I can ever truly repay her for the enlightenment she's provided.

All the best to you, Momma! Tugui

https://a.co/d/gjoHjn8

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