I recently found out that I am pregnant (about 7 weeks) with my second child on the way! I am a fairly controlled diabetic (my A1C during my first pregnancy was a 5.6 and currently sits at a 6.4 as of last month) but just within the last two weeks I have been having an incredibly hard time controlling my blood sugars! I feel like I can’t eat anything without a spike in blood sugar; I’ve hit 200 every day for the past week and a half and it’s really starting to stress me out despite all of my efforts to bolus 30-45 minutes early and even reduce carbs. I have a CGM too, so I try to be as proactive as possible to correct upward trends, but this usually results in horrible crashes later and then this vicious cycle of highs and lows ensues. I basically eat once per day and skip all other meals simply because, no matter what steps I take, it always results in a high reading and I know the risk it can have on the baby.
If that weren’t bad enough, I’ve had zero support from my endocrinologist and OBGYN. They both know I’m pregnant (I called them both a little over two weeks ago), and neither has expressed any urgency to help me manage my diabetes during pregnancy. My OBGYN refuses to see me until I am 9 weeks pregnant and my endo FINALLY made time for me to see them this Friday. I even called a high risk OBGYN consultant but they wont see me without a referral first from my OBGYN.
I’m SO frustrated and worried that I’ve hurt my baby. I’m really trying my best. Any suggestions? I’m desperate at this point.
I understand how upset and worried you must be, but don’t let the stress of all of this make things even worse. It’s great that you have a cgm! Reaching out to your doctors was the right thing to do and I am shocked that your doctors are being unresponsive and suggest you put them on the spot and directly ask them if you can count on them to be responsive going forward. Also probably start looking for new doctors. In the meantime, it’s important for you to keep eating, one meal a day isn’t adequate (In my opinion). Here are some strategies that I would suggest to improve your blood sugars: (1) try going for a brisk walk after you eat. This gets your circulation going and can increase speed of insulin significantly. (2) I know you eat low carb already but try to eat even lower carb meals. If you have to eat carbs, eat something high fiber and eat it at the end of the meal. (3) make sure you are drinking enough water throughout the day. Even mild dehydration can impact how insulin works. (4) look at this problem as a puzzle that needs to be solved: your body is acting different because of the pregnancy, but the solution is out there you just have to find it. One strategy you could try is a “process of elimination” approach: try to eat the same thing every day for a few days (I know, so boring) and try different approaches with insulin and exercise to see if you can figure out what works. You could even try a full day without carbs to see what happens. Also make sure to cross check the cgm value with a finger stick test every now and then too. (5) last but not least, if you don’t already have one, consider getting a pump at least for your pregnancy.
