08 July 2026
Episode 360 - Highs, Lows, and Hormones: Aging with Type 1 Diabetes with Melissa Slemp
Diabetics Doing Things Podcast
About
Melissa Slemp has lived with type 1 diabetes for 44 years — since she was
diagnosed in 1982, before glucometers, before CGMs, back when insulin came
from vials and syringes and "boiling your needles" was still a recent
memory for a lot of people. In this episode, we trace that whole arc: what
early management actually looked like, the high-risk pregnancy she
navigated in the 90s, and the moment — after more than four decades on
injections — she finally switched to a pump. If you've ever wondered what
it's like to hand over that much control after that much time, this is the
conversation.
But the real heart of this episode is what happens to blood sugar when a
woman with type 1 diabetes hits perimenopause. Melissa walks through her
own experience of watching her basal insulin needs climb for no obvious
reason, the years she spent without an explanation, and what she eventually
learned about estrogen, progesterone, and insulin resistance — knowledge
she says she had to dig up herself, because most endocrinologists and
OBGYNs simply aren't trained in the overlap. That research became the
reason she wrote Highs, Lows, and Hormones, a survival guide for women
navigating diabetes from their monthly cycle through menopause.
Along the way, we get into hormone replacement therapy, why so many women
blame themselves before they ever think to blame their hormones, and the
bigger pattern underneath it all: how much of diabetes research and care
has historically centered men, and what it costs women when it does.
There's also a genuinely great story about how Melissa met her husband, who
also lives with type 1 — on the side of the road, of all places.
This one's for anyone managing type 1 diabetes as a woman, anyone who loves
someone who is, or anyone who's ever felt like their body changed the rules
without telling them why.
Chapters:
00:00 Cold open and introducing Melissa Slemp
01:21 Welcome, and 44 years living with type 1 diabetes
02:24 Diagnosed in 1982, before glucometers existed
04:03 Reframing: the best and hardest time to have diabetes
04:59 Growing up rural with limited access to healthcare
07:09 Early management: injections, mixed insulin, urine strips
07:46 A high-risk pregnancy in the 90s
08:13 Switching to a pump after 40+ years on injections
10:24 How Melissa met her husband, also living with T1D
13:06 Introducing the hormone and diabetes connection
20:14 Rising basal needs and insulin resistance in perimenopause
25:25 Community stories and menopause's hidden career toll
29:44 The gender gap in diabetes research
33:04 Hormones, GLP-1s, and insulin as hormone therapy
36:03 Advocating for yourself with doctors and specialists
Resources:
Melissa’s Book: Highs, Lows, & Hormones: A Survival Guide for Women With
Diabetes From Monthly Cycles to Menopause
The Menopause Society
Type 1 In Midlife Podcast
diagnosed in 1982, before glucometers, before CGMs, back when insulin came
from vials and syringes and "boiling your needles" was still a recent
memory for a lot of people. In this episode, we trace that whole arc: what
early management actually looked like, the high-risk pregnancy she
navigated in the 90s, and the moment — after more than four decades on
injections — she finally switched to a pump. If you've ever wondered what
it's like to hand over that much control after that much time, this is the
conversation.
But the real heart of this episode is what happens to blood sugar when a
woman with type 1 diabetes hits perimenopause. Melissa walks through her
own experience of watching her basal insulin needs climb for no obvious
reason, the years she spent without an explanation, and what she eventually
learned about estrogen, progesterone, and insulin resistance — knowledge
she says she had to dig up herself, because most endocrinologists and
OBGYNs simply aren't trained in the overlap. That research became the
reason she wrote Highs, Lows, and Hormones, a survival guide for women
navigating diabetes from their monthly cycle through menopause.
Along the way, we get into hormone replacement therapy, why so many women
blame themselves before they ever think to blame their hormones, and the
bigger pattern underneath it all: how much of diabetes research and care
has historically centered men, and what it costs women when it does.
There's also a genuinely great story about how Melissa met her husband, who
also lives with type 1 — on the side of the road, of all places.
This one's for anyone managing type 1 diabetes as a woman, anyone who loves
someone who is, or anyone who's ever felt like their body changed the rules
without telling them why.
Chapters:
00:00 Cold open and introducing Melissa Slemp
01:21 Welcome, and 44 years living with type 1 diabetes
02:24 Diagnosed in 1982, before glucometers existed
04:03 Reframing: the best and hardest time to have diabetes
04:59 Growing up rural with limited access to healthcare
07:09 Early management: injections, mixed insulin, urine strips
07:46 A high-risk pregnancy in the 90s
08:13 Switching to a pump after 40+ years on injections
10:24 How Melissa met her husband, also living with T1D
13:06 Introducing the hormone and diabetes connection
20:14 Rising basal needs and insulin resistance in perimenopause
25:25 Community stories and menopause's hidden career toll
29:44 The gender gap in diabetes research
33:04 Hormones, GLP-1s, and insulin as hormone therapy
36:03 Advocating for yourself with doctors and specialists
Resources:
Melissa’s Book: Highs, Lows, & Hormones: A Survival Guide for Women With
Diabetes From Monthly Cycles to Menopause
The Menopause Society
Type 1 In Midlife Podcast