Crazy dawn phenomenon and breakfast blood sugars? possible pregnancy?

Hi all-
My husband and I just started trying to conceive after I have been in the pregnancy clinic for over half a year. This past week my morning blood sugars just have been going crazy (high), but I can get them to settle down before lunch. It seems like I am developing a new norm for the dawn phenomenon and my breakfast insulin to carb is no longer relevant. I should add that I have been eating the same thing for breakfast for over a month and until this have had no issues like these blood sugars. Yesterday I aggressively changed my early am basal rates and then after another breakfast high (from one piece of toast that was more than generously bolused for), I adjusted my I:C ratio hoping tomorrow will be better. The fact that it is occurring in the morning when hormones are surging makes me wonder if I am pregnant.

And just to complicate everything, I got a UTI (treated very quickly) and have had a cold. I was accrediting my blood sugars to those, but I got the UTI treated very quickly and the cold is about gone, but the am blood sugars still running high.

Has anyone else had these crazy mornings really, really early (like a week) on in pregnancy? From what I have read it seems like a lot of people get lows? But then I have been reading some get highs too. I don’t know if I am pregnant yet, it is too early to tell with a home test.

Just FYI, on insulin pump and CGM, Type 1 for 30 years, I’m 38 years old. This is the first time I have attempted to become pregnant.

thanks!!

With my now 5 yo, I started getting highs within 24 hours of conception. This was within 24 hours of IUI being done.

Yes, some people get highs, some get lows.

Treat yourself as if you are pregnant for now.

Correct aggressively and monitor very frequently. Good thing that you have a CGM. I didn’t during my pregnancies. And that is the only thing that I would have loved to have.

When I was pregnant I became severely insulin resistant in the mornings. My standard breakfast became eggs (Ie. no carbs)… I was able to eat a bit more carbs / vegetables later in the day.

Wishing you well and hoping that you will find yourself pregnant.

I knew (/highly suspected) I was pregnant right away because of dramatic shifts in bg trends. Did my best to adjust to get them back to normal while I waited it out a few days to take the HPT. Got a positive result and called the doctor who got me in to take the blood test the next day, I believe. I did get the lows, but that was a few weeks later. Good luck!

thanks all! I got to my DR next week and will get the tested so I actually know. I am pretending I am pregnant and my big basal adjustments seem to have worked, I woke up with a normal blood sugar this morning. I think I suspect because in the past when I have had to make adjustments to my basals, they are more tweaks, this was more than that.

Good to know about the am carbs, I am going to avoid them first thing in the morning until I get everything figured out, or until I get those lows!

thanks!

Not pregnant, guess the highs were just PMS.

My a1c was in target, but I feel pretty down about my visit to my Endo. For some reason my blood sugars aren’t all getting entered into my CGM, and I swear I’m entering them. I still get about 3 a day entered, but I don’t understand why the others aren’t going in. I feel like I must be losing my mind!

I also had a few random blood sugars spike into 300. One I can explain (scone :unamused:), the others not so much. Any tips?

Annnd one more thing! I’m wondering how the heck I keep my post meal blood sugars (1hr) from 90- 129 if I do get pregnant, won’t I go low so thereafter? I already pre-bolus 10 mins before eating.

Any tips would be great, I’m feeling a bit overwhelmed!

Thanks!

I haven’t paid as much attention to this recently, but I know at one point I felt that quite a few of my bgs weren’t registering in my pump records, even though I was entering the numbers. I have a t:slim and try to make sure I run through all the screens (as in, enter the bg and keep clicking through to see if it recommends a correction or not and complete that series…rather than entering the bg and hitting the back button to get to the main screen). Worst case scenario, can your meter data be downloaded? Mine can, I just don’t do it that often.

You may want to pre-bolus for a longer period of time. I try for at least 15 minutes (I only actually do this successfully about 20% of the time) and if it’s something I feel is likely to spike me, then I try to wait a full 30 minutes.

To avoid crazy spikes and higher bgs, I found that low carb helps a lot. Hopefully someone who’s not low carb can weigh in on their techniques, because I know there are folks out there who manage to do it well.

Hang in there. It’s a lot of work and will feel overwhelming throughout, but I’m coming to believe that the doctors are overly cautious and if you’re in pretty decent control, the situation is not nearly as dire as it’s made out to be.

Thanks, I really do appreciate the encouragement. I keep wondering if I should keep going given my age and the betes, or if I should adopt? Which I am not sure if that is an option either (I just haven’t looked into it much).

I don’t know why my blood sugars aren’t registering, but I felt like a crazy person today trying to tell my endo, “yes I do register them” and then they aren’t there. The only thing I can think of is that when I try to register them, the pump is giving me insulin. I have noticed that when I hear the little noise of administering insulin, any button I press at the same time does not work. I have to wait the second or two after for the button to be operational again. I’ll have to see if that is happening for the calibrations.

I can download from my meter, but honestly for me it doesn’t really change much. I think it was more that I was initially told I need to test more (then my meter was downloaded and the number of tests revealed), and then I need to enter them more. I have been making a HUGE effort to test a lot, and enter those numbers. My coworkers have been awesome, when I take a few to take care of all this. I guess that is why I got upset (I cried) when I was told I need to test more, etc… I’ve been testing before and after every meal, if I get a weird reading on my CGM, if I feel weird… A lot of testing. I have a seasonally physical job, so I have been trying to juggle the change in activity with all this too (winter is pretty sedate).

I am curious about the low carb, I currently do about 95/ day and got fussed at when I visited a nutritionist for having too much protein and too little carbs (I had been doing a lot of weight training). What are the low carb #'s? I generally eat lo GI carbs, brown rice, quinoa, jasmine rice (I think that is more moderate GI), squashes, if I have bread it is the Ezekiel sprouted whole grain, and never more than one piece at a time. I do eat some fruit at lunch, and juice when low. I do have a wicked sweet tooth though which is usually fixed by a Greek yogurt popsicle.

How did you deal with cravings?

And thanks all for letting me vent :slight_smile:

I agree with the overly cautious, though it is a scary thing. I try and think of my mom’s friend who now at 70 was one of the first Joslin babies (her mom was diabetic). The treatment was so rudimentary then, and she (my mom’s friend) had no complications.

I find that doing a lot of research on my own helps, so that I can be a little more assertive and push back with some of my team. It helps that in my case, my endo is supportive of low carb, she knows me, and she’s very reasonable and open-minded when it comes to “non-traditional” treatment. If someone (usually the MFM or OB) raises an eyebrow at a spike, I reiterate that my average bg for the last three months was in the 90s and the spike only lasted for two hours. The OB tried to tell me that a bg in the 50s would harm the baby, and I pressed her for specifics on how exactly that would happen (all the research says the only risk is if you pass out or trip and physically impact the baby in some way). I stress to both the OB and MFM that my endo manages my diabetes and make sure to mention my 5.1 A1C. I’ve had multiple people try to tell me that low carb would harm the baby and similarly, pressed them for specifics and asked for the studies that support that argument. I’ve learned that many of the medical professionals have archaic and incorrect beliefs, so I am cautious about just buying into anything they tell me. That’s why I think it’s critical to have at least one person on your team that you feel super comfortable with, so that s/he can be your voice of reason.

With the low carb, I think it might actually be better to frame the discussion by saying that you’re making sure to eat as healthy as possible, with whole foods. So lots of fresh vegetables, fruits, little to know processed foods, etc. Had I done that, I may have been able to avoid some of the reactions from the MFM (who is, frankly, kind of intimidating and doom and gloom, but I’ve learned to take her in stride and chuckle about whatever she tells me as soon as I leave the appointment). When I started low carb, I followed Dr. Bernstein’s Diabetes Solution plan very closely. It calls for 6 carbs at breakfast, 12 at lunch, and 12 at dinner, so 30 for the full day. You can basically eat all the fats you want and I find that keeps me from having any kind of cravings. These days, I eat more carbs than that, as I’ve re-introduced things like beans, quinoa, sweet potatoes, high fiber English Muffins, and some fruits. Carb counting is not my specialty, but I’d guess I’m at about 50-60 per day.

When I started low carb and asked my endo about going to a nutritionist to make sure I was doing it correctly and getting all the necessary nutrients, she recommended I not do that. She said the nutritionist was only going to tell me to eat more carbs. So, I found groups online, like this one, and Grit Pregnancies on Facebook, where I can ask questions of people who are living this and read about their experiences.

So as an aside to all of this, as just one example of one of my doctors having questionable methods and beliefs, I asked my MFM why my records say I am “showing signs of pre-gestational diabetes” when I have been T1D for nearly 30 years. She said they know I’m T1D but they only indicate pre-gestational or gestational for their patients. Why they picked “pre” for me, no clue. It’s just odd. Fortunately, I feel like she has a handle on evaluating how my baby is doing, so I can deal with the rest.

Finally, regarding adoption: if you choose this route, which is an admirable one, I don’t think there are that many factors that rule you out, depending on what kind of adoption you’re interested in. From one end of the spectrum to the other is adopting a white American baby to a foster-adoption of a kid with special needs. Personally, I’ve always wanted (and still want to pursue this) to do foster adoption for either teenagers or a sibling set; both groups are among the hardest to place. Age and marital status are minor issues compared to having a safe home and a stable lifestyle.

Anyways, sorry for the super long post. In summary, do your best to learn what you can so that you can push back and advocate for yourself.

No apologies for the long post, it was very helpful! I appreciate the insight and advice, especially from experience.

I just ordered Dr. Bernstein’s book, I think it is worth giving the low carb a try. I watched one of his videos, and while I don’t know that I agree with everything, he had some very valid points. The one that sticks out in my mind the most is trying to line up the two spikes, the carbs and the insulin, and him pointing out that it is very difficult. I’m in a good position right now to try something and experiment a little, so here it goes!

I had already been thinking of at least doing low carb for breakfast (did it last week and it worked out really well), and lunch as well. I don’t think under my current management I can achieve an A1C lower than what I have now (6.6), so I am willing to give it a try!

That being said, any suggestions for recipe sources? Assistance with meal planning/ shopping?

Thanks again- I really appreciate the input and thoughtfulness.

I definitely don’t agree with everything of Bernstein’s, but the foundation is good. The most impactful idea for me was that diabetics are carb intolerant. I tried to follow his 6-12-12 until I felt I had the hang of it, and then I started to modify.

These are the two sites that I get the most recipes from, when I’m searching for ideas:


http://alldayidreamaboutfood.com/

I like variety, but I also don’t mind eating the same meal for multiple days in a row. Here’s my list of basics:

Butter, olive oil, coconut oil
Cheese, heavy cream, full fat Greek yogurt (Fage Total)
Eggs
Nuts
Meats
Salad stuff, broccoli, spinach and other leafy greens, asparagus
Da Vinci Sugar Free syrup
Enlightened ice cream bars
Low carb tortillas
High protein low sugar granola (bulk foods @ Whole Foods)
Blackberries, green apples, bananas with hints of green in skin
Kosher salt

Breakfast is either Greek yogurt + DaVinci + granola or an omelet (egg + cheese + some veg)
Lunch and dinner are usually meats on top of salad or next to vegs.

Cheesecake is amazing (I make one, cut it into slices, and then freeze the individual slices). I’ve tried all the low carb ice creams and Enlightened is my favorite - it barely impacts my bg and has a good, creamy texture.

Salt is on the list because if you’re removing processed foods, you need to make sure you have an adequate sodium intake. Plus, it makes everything taste better.

I’m a coffee drinker but weaned myself down to one cup per day. A month or so ago, I switched to “half-caf” so I could have two cups per day instead. :slight_smile:

I hope this helps!

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Yes this is great!

I just checked out the sites, it looks like there are a lot of good recipes, though I have trouble with some dairy. I can do aged cheeses, yogurt, but no creams, and cheese blankets over food (you know when the top of an entree is completely covered by a thick layer of melty cheese). I have found that some vegan cookbooks have good cream substitutes by using soaked nuts and blending them, so that seems like it would be a good replacement for me.

I also am a big coffee drinker but have limited myself to 1 a day and no other caffeine, which stinks right now with allergy season! I like the half-caf idea!

thanks again!

Avocado and (canned) coconut milk are other good options for fats if you can’t do dairy. There are a number of recipes out there (try googling LCHF or keto) that are dairy free.

I love both of those!

Soooo, just out of curiosity, last night I took a pregnancy test. A cheapo one that I ordered in bulk from Amazon. It came out, faintly pregnant, which I thought was weird since I came out negative at the doctor on Friday. I also, thought maybe it was just the way the test worked? It was one of those double line tests (cliniguard or something like that). Today after work I picked up a clear blue digital, and it said pregnant. Uhhh?

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Sounds like you’re pregnant, girl! Congratulations. The test in the drs office may have been too early.

Congratulations! What kind of test did the doctor do? After I got a positive HPT my doctor sent me to get blood work drawn. They do the test once then again two days later to check for changing/increasing levels of…something.

Thanks all, kinda freaked out now!

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Hugs! You’ll be ok. You can do this. Kind of a big thing thinking of little bean growing, isn’t it.

Keep on top of the blood sugars. Test heaps, correct as required.

My children are the best things that have every happened to me.

Low carb helps a lot with keeping blood sugars from spiking. As does prebolus, frequent testing, and careful corrections (not over correction) of lows using sugar/glucose (more accurate) instead of food.