One of the things I’ve come to understand through my Type 1 experience and my guests on The Long View – Living with Type 1 Diabetes podcast is that the condition doesn’t stay the same.
It evolves.
Not just with age, technology, or experience – but with life itself. And for women, one of the biggest and most complex influences is hormones.
In this episode, I talk to Melissa Slemp, who has been living with Type 1 diabetes for more than 40 years. Her story is both relatable and important, particularly for women.
Because the impact of perimenopause and menopause on Type 1 Diabetes just isn’t talked about enough:
Growing up with Type 1 without understanding it
Melissa was diagnosed as a teenager in the early 1980s, at a time when information about diabetes was limited and often incomplete.
Like many of us diagnosed years ago, she describes an experience where diabetes was minimised rather than explained:
- little understanding of how the body works
- very basic monitoring methods
- a focus on “avoiding sugar” rather than understanding patterns
It meant she spent many years simply “getting on with it”. But as we often see, that lack of understanding can catch up later.
When the long-term impact becomes clear
For Melissa, that moment came about 10 years after diagnosis, when she was diagnosed with diabetic eye disease.
It was a shock. And a turning point for her.
Like many people, she moved from just getting on with it, to the opposite extreme: trying to tightly control everything.
But as she shared in our conversation, that comes with its own challenges.
– more hypos
– more fear
– more pressure
It’s a reminder that managing Type 1 diabetes is never just about numbers, it’s about finding a sustainable balance.
Then come the hormones
For many women, just as that balance begins to feel possible, everything changes again.
Perimenopause and menopause bring:
- fluctuating hormone levels
- sleep disruption
- changes in energy and mood
- and, crucially, unpredictable blood glucose patterns
And yet, as Melissa points out, this stage of life is still often under-discussed, even in healthcare settings.
Women are left wondering:
- why their usual approach no longer works
- why blood sugars feel harder to manage
- and why they suddenly feel “different”
All while still managing the daily demands of Type 1.
Why Type 1 diabetes and menopause are harder together
Hormones already affect blood sugar and most women with Type 1 will notice changes throughout their monthly cycle.
But during perimenopause and menopause, those shifts become less predictable.
This can mean:
- insulin needs constantly changing
- more frequent highs and lows
- difficulty maintaining routine
- increased mental and emotional strain
And perhaps most importantly a feeling of losing control over something you’ve worked hard to understand.
For many women, this can be one of the most challenging periods of living with Type 1 diabetes.
“Just get on with it”? Or ask for more?
One of the strongest themes in this episode is how often women are still expected to simply “get on with it.”
That approach may come from:
- how we were taught to manage diabetes as children
- a lack of awareness among healthcare professionals
- or simply not knowing that support exists
But Melissa’s message is clear: You don’t have to accept feeling unwell as the new normal
Support is available, but it often requires self‑advocacy.
Advocating for yourself
Advocating doesn’t necessarily mean having all the answers.
It can start much more simply:
- noticing patterns and tracking symptoms
- recognising that something has changed
- asking questions
- finding specialists or communities
Melissa emphasises the importance of:
- understanding your own body
- being curious rather than dismissive
- and connecting with others going through the same experience
Because, as she says, no one should have to deal with this alone.
The power of community
This is where stories and conversations and like my podcast really matter.
For many women, hearing that others are experiencing the same challenges can be incredibly reassuring.
It moves the feeling from: “Is something wrong with me?” to “this is something we’re going through”
That shared understanding is one of the reasons listeners often describe The Long View as one of the best Type 1 diabetes podcastsm because it brings together real, relatable experiences.
There is more support now than ever before
Perhaps the most encouraging part of this conversation is that things are changing.
More women are:
- speaking openly about menopause
- sharing their experiences
- seeking treatment options such as HRT
- and building communities of support
Information is more accessible than ever.
But awareness still needs to catch up, particularly in how Type 1 diabetes and hormones intersect.
A final thought
If there’s one message to take from this episode, it’s this:
You don’t have to just “get on with it.”
Whether you’re newly navigating hormonal changes or have been struggling for some time:
- what you’re experiencing is valid
- there is a reason for it
- and there is support available
Because living with Type 1 diabetes is already complex and when hormones enter the picture, understanding and support become even more important.
Melissa’s website is here: Abundant Health with Melissa | Coaching for Women with Type 1 Diabetes in Midlife
Her podcast is on Apple and Spotify, and also here on her website: Podcast | Melissa Slemp Type 1 In Midlife
And you can buy her new book on Amazon here: Highs, Lows, & Hormones: A Survival Guide for Women With Diabetes From Monthly Cycles to Menopause: Amazon.co.uk: Slemp, Melissa: 9798995412526: Books
You can listen to the full episode of The Long View – Living with Type 1 Diabetes here on Spotify: Ep 12: Melissa Slemp – Hormones, midlife and living with Type 1 Diabetes – The Long View – Living with Type 1 Diabetes | Podcast on Spotify
And here on Apple: Ep 12: Melissa Slemp – Hormone…–The Long View – Living with Type 1 Diabetes – Apple Podcasts
If you’re looking for honest conversations about managing Type 1 diabetes through real life, this episode and others in the series are here to help you feel less alone.
And if you have your own experience of Type 1 diabetes, I’d love to hear from you. Email me at thelongviewt1@gmail.com.