Just wanted to get some advice from those who have been here before. My appointment with my endo is not for another 3 weeks and I’m desperate for some perspective.
I’m 10 weeks pregnant and in the last two weeks I’ve been suffering from severe and unexpected lows whenever I do ANY physical activity with insulin in my system. I’m scared to go high, but then if I don’t go high, I can’t even go for a five minute walk without crashing. Its super scary! Today was the worst: I ate toast and drank some milk to get my blood sugar up without taking any extra insulin, waited till it had risen to 170 (then I started getting worried I was hurting the baby!), then went for a walk with my husband. Less than 15 minutes later my BS was 52, and my husband had to run back to get the car and come pick me up as it was clear I could go any further.
On top of this, I have back pain and extreme fatigue so need to get some physical activity in…
What do I do? Turn my basal WAY down? (I’m scared to risk going high though and hurting the baby) I feel like a disabled person as I can barely move without my BS crashing.
How long do the early pregnancies lows last? My morning sickness was over in week 8… I was terrified of third trimester insulin resistance, but now I’m almost looking forward to it!
First of all, congrats on your pregnancy! We will be going through this rollercoaster together I’m currently 16 weeks pregnant.
I’m sorry to hear about this experience. I had days with 4-5 lows around week 10 and I still haven’t seen ANY insulin resistance. The way to stop them is to adjust your basals. You may have many weeks ahead where you will be insulin sensitive – so it is important to make those basal adjustments. Are you pumping? I assumed you were from your post, but let me know if not.
Do you have any system with your endo to check in BETWEEN appointments. Can you fax your numbers in to make basal adjustments?
IF not, you will need to feel comfortable changing your basals because it is VERY likely that you will need to change them more often than monthly.
I live in Hungary and here I visit my endo weekly (yes, it’s a lot). Since week 9, we have been lowering and tweaking my basals bit by bit and lowered my boluses (increased my insulin to carb ratio) at dinner and evening snack. I’m taking around 70-75% of my pre-pregnancy basals. For boluses – we have found that it varies a lot. I do have MAJOR insulin resistance. Before pregnancy, I was taking one unit of insulin for 11-13g of carb (insulin to carb ratio). My currently insulin to carb ratios are:
Breakfast - 5
10am snack - 13
Lunch - 8
4pm snack- 13
Dinner - 14
10pm snack - 20
With these rates, my numbers have been great (staying mostly under 140 with a low every 1-2 days), but it took a lot of tweaking to get rid of those terrible lows that you are now experiencing. My point is – things seemed to change A LOT for me during pregnancy and sometimes in weird ways (insulin sensitivity most of the time, but MAJOR insulin resistance in the morning). So log your numbers, then you and/or your doctor can make changes. Don’t be afraid to change your basals and boluses. So many things are changing in your body now and those will likely need to change too. The best is to make small adjustments (we only move my basals up or down by 0.1 units at a time) and wait a week to see if we should change more. Feel free to post your numbers here, as I know that we have many women who made lots of adjustments to their insulin during pregnancy.
If you can’t see your endo more often, maybe there is a diabetes educator (CDE) that you can meet more often to make adjustments??
Whenever I do physical activity (and yes, I also find walking counts), my doctor wants me to use a temporary basal of 80-90%. I don’t always do it because I find that it makes me high later. I usually try to just eat 10g of fast acting carbs during my walk. The most intensive exercise that I do it walking and cleaning.
Hope that you can get the settings right to avoid these lows!
Congrats on your pregnancy! I am also pregnant for the 1st time - currently 20 weeks. Yes, my reply is similar to Krsin’s, below - Going low in the beginning of pregnancy is totally normal and you’ll need to change your basal often throughout the pregnancy.
Someone on this site recommended a good book that I’ve been reading, “Balancing Pregnancy with Pre-Existing Diabetes Health Mon, Healthy Baby” by Cheryl Alkon. The book shows a graph of the typical (changing) insulin requirements throughout pregnancy. (I attached a picture of it).
Basically, until ~ week 11 you’ll need less insulin than pre-pregnancy. Then throughout the pregnancy after that, it will continue to increase to far more than you needed pre-pregnancy, then it drops way down again once you have the kid. I attached the graph. So far, my blood sugars/ insulin requirements have pretty much followed this trend.
Congrats on the pregnancy Laura! I am going through the same thing…14 weeks pregnant and so many severe lows I cannot do ANY amount of physical activity or exercise (even with a temporary basal rate on my pump of 70%) without immediately dropping into the 40s and 30s. This is SO frustrating. Prior to pregnancy I removed my insulin pump while exercising (I know now that this is a huge no-no, especially during pregnancy).
I have also noticed that it takes a LOT more carbs to get my sugars back up to the normal range…I treat with 15 exactly then wait 15 minutes before testing again. Normally this works the first time, but with pregnancy I will treat sometime 4-5 times before coming back up into the 80s.
I fax my blood sugar logs (including time, meter reading, carb intake, and any insulin-bolus for food or correction, and exercise) to my doctor once a week at a minimum. I also fax in if I am having any specific concerns—which seems like daily! The doctor is fairly conservative and only adjusts basal rates a little at a time…I feel that more could be done more often—carb to insulin ratio??
Have just started the Dexcom CGM today and praying that the adjustment period for getting used to it will be quick so I can feel more in control. I am just frustrated because I feel like by the time I have a handle on things my baby will be ready to deliver.
I find myself worrying that everything I am doing is having an negative effect on my baby…I know the risks of high blood glucose for any extended period of time, but does anyone have any information about the risks of lows to the baby besides the obvious risks to the mother?
Sorry I dont have more advice for you, but DEFINITELY feel your frustration. I just more than anything want to get back to my exercise routine! Anyone out there know how long this will last? Suggestions? Thanks in advance to anyone who can shed any sort of advice.
I was told by my doctors (endo and OB) all 12 times that I asked, that the only time lows were a danger to the baby is if I went low enough to have a seizure. I am still dubious, but I’ve been assured that normal lows – even the really unpleasant ones – pose no risk to the baby.
I’ve noticed the same thing about corrections not working as well – and yet my insulin:carb ratio has not changed at all. SUPER confusing.
Anyway, take care and here’s hoping for a little insulin resistance in the coming weeks!
That graph is really helpful… thanks! I wish my doctor had shown me something similar so that I could know what was coming. Great info though, I appreciate it!
And anyone else: I’d be so thankful if you spread the word about my book if you know other women with diabetes considering pregnancy. It sells on Amazon and elsewhere, and I sell autographed copies via Paypal.
Thanks for posting that graph! I’ve been wondering why my BS were dipping when I thought they were supposed to be starting to rise. I’m 12 weeks, and the week has been tough keeping the numbers up. My specialist even lowered my basal some on Tuesday, and it seems like it’s dipping more. I’m instructed to send in my BS levels next week, so I’m guess they will be lowered a little more but not too much since they are aware that my BS could rise any moment.
My experience has been the exact opposite. My first pregnancy symptom was a doubling of my insulin requirements. Yes, double. If I sit down and count it back, I can probably chart the day of conception just from the suddenly insanely high blood sugars.
I am now at 8 weeks and a bit and still needing double the amount of insulin. 1:5 before pregnancy, 1:2.5 for the past 8 weeks. So if the trajectory on that graph holds true, I can look forward to something totally insane like 1:0.5 towards the end? Oh joy!
I’m currently 16 weeks pregnant.