Ep 178 - Perimenopause with Type 1 Diabetes: When It Feels Like You're Starting Over

What happens when the diabetes management you've relied on for years suddenly stops working the way it used to?

For many women with type 1 diabetes, perimenopause can feel a little like being diagnosed all over again.

In this episode, I'm joined by Erika Forsyth, LMFT, a Licensed Marriage and Family Therapist who specializes in supporting children, adolescents, adults, and caregivers living with diabetes. Erika has lived with type 1 diabetes since 1990 and brings both her professional expertise and lived experience to the emotional, social, and behavioral side of diabetes.

She's also a strong advocate in our diabetes community, serving on the American Diabetes Association's Mental Health Advisory Group and Safe at School Working Group, the Touched by Type 1 Medical Oversight Committee, and the board of You're Just My Type. She's also a frequent contributor to the Juicebox Podcast Mental Health Series and a speaker at diabetes conferences around the country.

And now, Erika is navigating perimenopause herself—which makes this conversation especially personal.

We talk about the unpredictability of perimenopause, changing insulin needs, sleep disruption, brain fog, emotional overwhelm, diabetes distress, and something Erika describes so powerfully as body grief: grieving the body and patterns you once understood while still having to care for that changing body every single day.

Erika was also an advanced reader of Highs, Lows & Hormones, and in this conversation she shares how she's using pieces of the book—particularly the Symptom-Hormone Matching Guide—to better understand what she's experiencing, connect the dots between hormones and blood sugar, and prepare herself for conversations about hormone therapy.

We also talk about:

Why perimenopause is about much more than insulin resistance The emotional weight of adding hormones to an already complicated diabetes equation Why unpredictability does not mean you're failing at diabetes Diabetes burn out, distress, anxiety and isolation How hormone changes can affect relationships and communication Why HRT conversations can feel overwhelming—and why you don't have to figure everything out at once Learning to experiment rather than expecting yourself to immediately "fix" your blood sugar How to recognize when it may be time to seek additional emotional support Advocating for yourself when your endocrinologist or OB/GYN doesn't have the answers Giving yourself permission to learn your body again One of my fa