During the late follicular phase oestradiol peaks, and that means that women are more insulin sensitive, and that can also increase their vulnerability to hypoglycaemia. My name is Lia Bally. I'm an endocrinologist and Professor in Nutrition and Metabolism working at the University Hospital of Bern and University of Bern. One of my research focus centres on the investigation of sex hormones and their impact on glucose metabolism and energy homeostasis. For example, in one translational project I investigate how menopause influences pre-diabetes with a specific focus on GLP-1. And in parallel, I also study menstrual-cycle-driven hormonal fluctuations in type 1 diabetes with novel hormonal sensing technologies. This is a timely and very critical topic, because women with diabetes face unique physiological challenges across their lives, for example pregnancy, hormonal fluctuations during the menstrual cycle, menopause, or also when they have breast cancer and undergo endocrine cancer therapy. It is critical to understand how these hormonal fluctuations impact glucose control. it enhances insulin secretion, it most likely also potentiates the effect of GLP-1, it increases fat oxidation, energy expenditure. But it's also important to note that much of the evidence derives from pre-clinical research, and we need more human research looking into that. During the menstrual cycle, oestradiol as a hormone that increases insulin sensitivity fluctuates. So we have two peaks, one in the pre-ovulatory phase, and a second peak alongside with progesterone in the late luteal period. And this is important to know and to understand, because, for example, during the late follicular phase oestradiol peaks and that means that women are more insulin sensitive, and that can also increase their vulnerability to hypoglycaemia. So it's really important they are aware, and that maybe in the context of exercise which also increases insulin sensitivity, that they know that their insulin sensitivity is additionally influenced, because they have these menstrual cycle-related hormonal fluctuations. We need to be aware that we have currently a lot of knowledge gaps. That's why we are not at the stage to deliver very tailored recommendations. Currently, female-specific research mainly focused on pregnancy, the period during pregnancy. But now there is an increasing research interest also in menopause, how menopause affects glucose regulation and metabolic outcomes, how menopausal hormonal treatment interacts with glucose metabolism. And there are other female-specific topics of relevance, for example, endocrine breast cancer therapies where you block the oestradiol production or the action, that has implication on the diabetes risk, but also on diabetes management if women already have diabetes. And this is certainly also a field where we need more research. Every clinician and every researcher can contribute to filling that knowledge gap by being more aware, recognising sex hormones as a key metabolic variable and not just background noise. For example, also document the age of menopause or whether women are on menopausal hormonal treatment or not. And if we work together by conducting more research in the field, we lay an important foundation for more sex and gender-inclusive precision diabetes care in the future.