Birth control pills seem to be throwing her metabolism off somewhat. She is considering getting her tubes tied so she can drop the birth control pills.
Oral contraceptives contain both a synthetic estrogen and a progesterone.
Both of these hormones are known to increase insulin resistance . Therefore, they may increase insulin requirements when they are taken. To make matters more complex, the progesterone component may change during a 28-day cycle of the pill. Patients with diabetes on the pill have a variable response, in terms of their blood sugars. Some patients clearly show increase in insulin requirements during the 28-day cycle, and some do not.