Hi everyone!
I’m wondering what people’s experience with insulin resistence has been. I’m currently 24 weeks pregnant and have already had some significant increases in my insulin needs. It feels like as soon as I have any control, they start to spike up again. It really concerns me, since they say you should only worry about highs that don’t come back down. Just yesterday I had blood sugars between 170-200 that stayed there for SIX HOURS! Despite giving myself more and more corretive insulin and not eating (except for dinner, snice I also didn’t want to starve the baby)… I have already jumped to about 75 units a day, where before I was around 38-42 units a day. Is this normal?? Its freaking me out, b/c I didn’t think it would jump so high, so quickly. The chart about how your insulin needs change during pregnancy make it look so gradual! I’d love to hear what others have experienced-Thanks!
Sorry I’m not going to be able to offer experience, but I will say that I’m having the same issue and I’m at 18 1/2 weeks. In fact, I was coasting along pretty holding steady numbers for a good three days in a row, and then suddenly I’ve spiked with highs in the 150-160 range that last for two or three hours and longer overnight when no amount of additional isulin seems to bring them down!
Like you, I thought there would be gradual changes, but this is almost an over-night change! Hopefully others who’ve been through it can shed some light for us, but hopefully it helps to know your’e not alone!
Hi Megan,
I am 25 weeks pregnant and this exact same thing just happened to me! I didn’t see a gradual rise like the charts depict… All of a sudden I saw crazy high numbers after eating breakfast - and I eat the same thing almost every day. I jumped from 35 units/day to about 55 units/day (maybe in the end it will look gradual if I eventually get up to 75+ units/day!). It has left me all of a sudden feeling crappy — both from sitting through periods of highs and not knowing exactly how to tackle it!
Yesterday I upped my basal and bolus by more than I thought I would need — I’d rather start off taking a little too much insulin (I test like a crazy mad woman - 20x/day… so I catch lows) and then reduce from there. Maybe not what the docs would say to do, but hey… If anyone else has any other tips or experiences with the trend upward, I’d also love to hear!
I’m at 25 weeks and have had the same. My endo says this is normal though – although the charts make it look gradual, many women have “jumps” instead where your insulin resistance goes up really quickly and then plateaus for a week or two, and then jumps up again. Apparently its not that unusual to be at ratios of 1:1 (insulin:carb) by the end of pregnancy! CRAZY!
Thank god for my pump, so i can just set the ratios, enter my carbs and try not to think about the ridiculous amount of insulin I’m getting.
Also, and I don’t know if this is true for others, but I also have my ratios change 3-4 times a day. Right now my ratios are 1:4 in the morning, 1:10 in the afternoon, 1:5 in the evening and then 1:8 for late night snacks. Navigating the switches during the day have been the hardest part!
Best of luck – you’re totally normal!
We are all different in this, but I don’t think that any of these jumps are abnormal for pregnancy. I had almost no insulin resistance before week 20 and then things started gradually, but now in the last couple weeks (I’m in week 31 now), we have been increasing much more dramatically.
My total daily basal is about twice what it was pre-pregnancy. My boluses are more than double. (My breakfast bolus is 3 times what it would have been before pregnancy.) I don’t think that there is any reason to worry about the amount of insulin you are taking. Just keep increasing gradually to fight off those highs. They are incredibly frustrating, but I don’t know any other way to figure out how to increase without seeing some numbers over 140.
One thing that my endo does is watches for increases. For example, if I am increasing from 80 to 110 in the mornings for a few days, then she will increase my basal in the morning without waiting to see highs there. I am still seeing numbers from 140-160 at least every other day, but we are trying to cut those back.
Our son is measuring big (a few weeks ahead of schedule) – so now we are trying to lower my numbers even more to prevent going above 120. But it’s hard to fight increasing insulin resistance without going about 120!!
Thanks everyone! Its so encouraging to hear other peoples experiences. I think one of my fears is that pre-pregnancy my bolus insulin to carb ratio was 1 to 5, so its good to hear that some people do get to 1 to1 and it isn’t a bad thing. I am really trying to take the “whatever it takes” approach to my blood sugar control, but it is definitely harder than I realized. Kristin- I’m curious about your son being a bit big. I seem to hear different things about this. I feel like stuff I read just said, oh, by the way, the baby may be big, but then I started to hear that it can reach a point where it impacts the child. Has your Dr. said anything to you about this and when this can occur??
My doc told me that the main risk with large babies is that you need to have a c-section or need to be induced / deliver earlier than you would otherwise. (this is assuming your blood sugars aren’t crazily out of control — then there are other problems too) I did some research myself and it also seems like large babies are associated with metabolic syndrome later on in life (increased risk of obesity, hypertension, type 2 diabetes, etc), but the problem with most of these studies is that they are done with people who have gestational diabetes. Having gestational diabetes is associated with increased risk of metabolic syndrome for yourself, which means that you might be passing these genes onto your kid as well. The main take home point is that it is not clear from these GD studies whether or not the same risks (macrosomy relating to higher risk of obesity and Type 2) apply to Type 1 mothers and whether it is from the macrosomy OR from the fact that the GD / Type 2 mother passes on genes that increase risk of metabolic syndrome.
Diabetes is an exercise in letting go… you do the best you can, and then you try not to worry about the things that are difficult or impossible to control. (If only I could follow my own advice!)
My OB-GYN didn’t seem concerned about it yet, but I’m going to ask more when I go in two weeks. At the ultrasound, they made it sound certain that it is because of my diabetes (and really questioned whether my control is good or not).
Then I heard that one of my friends is also measuring big, but since she doesn’t have diabetes no one is worried about it.
I don’t really know what to make of it yet. I think that the main risks are with the labor (not being able to deliver vaginally or going into labor early), but I’m not sure. I’ll let you know if I know more. I also started a discussion about it hereto see what other women’s experiences were!
You are right Laura and I wish that I could follow your advice too 
I have decided not to be stressed about it and have mostly managed to keep to that. I had some tears after the first ultrasound when they said that he was measuring big and then decided to just let it go and wait and see. I just feel that the outside world judges me for producing a big baby. I just want him to be healthy and not to experience any negative effects from my diabetes!
I do my own dosage increases/ decreases.
27 Weeks
I’m taking 60 units of Levemir in the morning, 70 units of Levemir at night. I’m taking between 20-30 units of Apidra PER MEAL. My carb ratios are 1 unit for 2 carbs in the AM and 1 unit for 4 carbs the rest of the day. I’m also taking one pill of Metformin in the AM and one pill of Metformin in PM to help my insulin resistance.
Before Pregnancy:
10-15 units Apidra per meal, 30 units Levemir AM, 40 units Levemir PM, no Metformin (except for 3 months last year) Carb ratio was 1 to 5.
I’m on 20+ MDI and my thighs (my main injection site) are so bruised! I’ve got the only stretch marks on my body so far are on the FRONT of my thighs!
A friend of mine delivered a 12 lb baby vaginally. haha. I think you will be okay!
My older brother was 9 lbs 13 oz at birth and my mom didn’t have GD. No one in my family has any form of D besides my grandfather with Type 2.
Please try not to stress. And if the docs give you a hard time about your control, tell them where to stick their advice! Pregnancy is hard enough. Top that off with 24/7 disease. Add to that the fact that we have to be so careful about what we put into our mouths when EATING is WHAT PREGNANT WOMEN DO. So, I know you’ve tried really hard to be on target with your numbers. Don’t let some idiot doctor make you feel badly about it when I’m pretty sure you’ve done all that you can to keep your boy healthy.
You are almost done. You are almost ready to meet him! Relax. You have done so well!
“letting go” is the advice I’ve followed this entire pregnancy. After our miscarriage last Fall, I learned to just do what I can and to be satisfied with that. If anyone tries to make me feel badly about my diabetes life and control (which I’ve done EVERYTHING I can to monitor and control), then I tell them to F themselves and don’t speak to them again.
Maybe I’m an a**hole, but I don’t care. I know me. And I know that I’m doing the best that I can do. Not only that, but I got Type 1 and no one in the entire bloodline has it, so it’s not all based on genes. Some things just… happen. No use in getting worried about it.
Wow! I knew it was possible, but that is impressive! I do want to try a vaginal birth. The ligaments in my pelvis have all relaxed and caused this tailbone pain, but it’s all because my body is preparing for a vaginal birth, which I think is pretty amazing!
I really, really, really can’t wait to meet him!
I had gestational diabetes with my first pregnancy 5 years ago and was told my little boy was measuring over 9 lbs about 3 weeks before my due date and that I may be scheduled for a c-section. I begged them to induce instead and was induced 2 weeks early they were WRONG he was only 7lbs 15ozs!
They are letting you take MEtformin for the insulin resistance in pregnancy!? I have wondered about this! How is it going? Thanks for sharing!
I would not worry about the amount of insulin you have to take just take whatever amount is needed for the baby and just remember this soon shall pass and you will be back to your normal insulin ratios after you deliver that beautiful baby! Congrats on your pregnancy! Oh and I too have read about women needing 1:1 ratios by the end of pregnancy and from what I have read your insulin needs may drop around week 36 and will drop very dramatically after delivery. Some women need NO insulin the 2 days after delivering.
Some Endos will let you, others won’t. My OB said it won’t help the insulin resistance because the hormones are stronger than the drug. But, my Endo prescribed it to me last year at my request and re-filled it for me last month. I’ve looked at other sites and read reports done by Endos with type 1 and pregnancy and Metformin seems to be a really healthy drug to use during pregnancy. But many Endos won’t do Metformin with Type 1s. And if they do it with Type 1s, they will take you off of it after the first trimester because your homrones will likely out-do the pill’s efforts. But, so far so good! I mean I’m still increasing my insulin dosages and the resistance is still going up, but I had really bad resistance BEFORE pregnancy. I see it helping a lot. My numbers have been pretty dynamite for this pregnancy.
hello! in my experience things were not that steady and gradual as depicted in the chart. Yes, my insulin needs increased throughout the pregnancy, but there were definitely weeks where things increased quite dramatically, and then followed by a week where it was a slower increase. I would have 1 week where I needed to adjust both really aggressively, and another week where it was just minor basal tweaks. there were lots of times where i’d correct multiple times before i could come down from a 180 because my basals needed to be boosted.
It sounds like you’re doing great - the best thing you can do is make corrections until you can figure out the right bolus/basal adjustment, and don’t stress too much. stress makes by sugars go higher, and by 24 weeks all the important development of the organs is done (yes, it’s still important to have good control, but after the first 13 weeks a few days here and there where things go out of whack won’t cause harm). highs will happen - especially when you get into the third trimester, but the danger comes from highs that are sustained for days, not a few hours. when I was pregnant i would get really worried about highs like the one you described, but in the end everything turned out ok (at 38 weeks i was at 98 units a day), my daughter was born full term and perfectly healthy at 5lb 15 oz.
good luck!
omg what a perfectly sized baby! Did you have to be induced? Were you able to deliver naturally? I’m at my 28th week now (I think? I’m starting to lose track) and they are talking about inducing at 37 weeks if her lungs are fully developed. I’m trying to deliver with no meds and no induction, but not sure if I’m going to be allowed to.