Hi fellow CGMS users [and diabetics in general :D].
I just had a baby 5 weeks ago. During my pregnancy, and even before it, I was able to maintain the best control I've had in years with A1cs of less than 6, using my CGMS. Though ups and downs were there, i mostly saw sensor data that flatlined during most of the day. I read a post by Kerri Sparling once that mentioned flatlining at 90, and until I had a CGMS, I never thought it possible. Remember the old school... 150 after meals? No longer! :D
But, I have a new doctor since the birth of my daughter. In the three weeks since I've seen him--and have been corresponding with him--my sugars seem to be out of control. He likes how they look. :( He says my average numbers look good and that he wouldn't change a thing. This is week three and I thought FOR SURE he would adjust something in order to work toward that FLATLINE. But again, he says 'don't change anything.' Today I told the nurse I was not happy and that I was surprised he wouldn't change anything. She actually started to talk to me about her experience with Type II. UGH! Like that has anything to do with me, right?
Are my expectations too high? I am ready to go back to self-management. I know three months isn't a long time in the grand scope of things, but I'm worried about waiting until February to get another A1c done. I think it's going to be close to 7. SEVEN! Gosh, i'm getting irritated thinking about it. But I feel like that will be the only proof the doctor will accept that things are not as good as they seem. I like tight control. I would rather skim along the bottom line and manage lows with small snacks throughout the day than deal with correcting highs. Am I wrong to think this approach is okay?
Hi Bethanne. Congratulations on your new addition! I am often discouraged when the doctors say that I expect too tight of control. I was like you. Before my son, I had great control. Then it was a roller coaster for a long while. Some of it was my reaction to the highs and taking too much to bring myself back down. I know that when I nursed my son, it affected my blood sugars tremendously. I would have to drink a juice box and eat a granola bar without bolusing. Could your body still be adjusting frome the pregnancy and birth?
Take care and be careful about skimming along the bottom line. I thought I could do that too, but I ended up having a low that left me incapacitated and I was with my two children. They were 4 and 9 but it has left me with a lot of guilt and scared when I think of all the things that could have gone wrong.
Maybe you could see it through for a few more weeks and then compare your readings to how they are now. If it still bothers you, see if you could fax your logs and have him make some adjustments.
yeah. no doubt, I am still adjusting. It is hard, isn’t it? I am nursing, too and though it’s evened out some, I do find that the nursing has a profound effect on my sugars. Hopefully that is what he is considering. You are probably right, I should give him his due time.
How are you doing now? Do you see your readings as a roller-coaster ride or do you have more level readings? How long did it take to get back to that point?
It’s hard to wait for normal after a pregnancy, and aside from that, can I expect to be level when normal is reached?
Healthy people on a normal diet don’t flatline. Healthy people have ups after carb loaded meals. I have no problem with after meal spikes at 120. Outside feeding time I try to stay below 100.
i would love to see a 120 after meals again.
I also believe that with the pump and the CGMS, we diabetics have the ability to strive for that 120, if not lower. With the combination of bolus and basal insulin rates, hitting 180 after meals shouldn’t be expected. It is not healthy or normal.
I keep thinking about joining them but need to figure out how to post pics, I saw it somewhere but got distracted by something else and wandered off? I usually run pretty level, particularly during the week. I try to aim not to go > 140 after meals but I get a lot of days where I sort of watch my CGM go 122…125…129…whew…127 and stuff like that? I usually get CGM avg of 90-95 and meter average of 100-105. I spend most of the night pretty flat most of the time though and kind of figure that if I ‘bank’ 6-8 hours of 70-80 every night, it adds up?
I wouldn’t listen to a doctor telling you your numbers are ‘fine’ if they are not fine for you? I don’t really discuss ‘tactical’ approaches too much with my doctors, I pretty much get labs, am ‘ok’ and come see them in 6 months. Several of them (we moved last year so I got new ones…) have expressed alarm at the ‘lows all over the place’ but to me a 70 is not a problem if I’m not doing anything much and the line is flat?
When my numbers get out of whack, I am not shy about adjusting rates. Recently I’ve been a bit goofy b/c I did a lot of bicycling over the summer and am back at running w/ the cooler weather so my BG has been running lower, probably until I get used to it? I’m adjusting the carb ratio to one less at the 3 different levels and will probably make a similar small adjustment to basal if that doesn’t quite do it? The overall numbers are ok but when I am lower all the time or fending off lows all day, I figure I can adjust it a smidgen without bothering the doctor? I would think that trying a very small adjustment and seeing how it works for a couple of days would be a more reasonable approach than what the doctor is doing?
Good luck and congratulations on junior!
If you need a couple of rounds but get your BG locked in then you can pwn him at your next appointment. “I told you not to adjust your rates!” “5.8 thpffffft, neener neener”
Great advice, acidrock. Usually I don’t bother the doctor too much, but with a nurse for a mom, I still get twinges of guilt about it. With a new doctor, too. The twinges are a bit worse. I need to get over them, though and get some control back.
I dunno if 80 G of carbs would be enough if you are eating for two though? I think that the ‘software’ will beat up the mom to protect the kid except that’s not good for the mom? One of my friends was type G w/ both her sons but I have not done a huge amount of research.
I restrict myself to 172G of carbs/ day and my meal spikes rarely reach 140 either? I sort of cheat @ night pretty regularly though, and bolus for 20-25 extra G of carbs and then ‘catch up’ w/ beer and junk food, neither of which are probably good for moms either?
probably not. haha
I have no idea what my average carb intake is…I will have to look at that next time I’m on Carelink.
Thinking over a day, it’s probably anywhere from 100-150 g. Hmm. I know lowering those carbs will help with the spikes. The baptism cake over the weekend didn’t help… Ack!
Does your pump have a ‘utilities’ option? That’s where I get my daily totals from. I also check my daily average ‘score’ every couple of days b/c I am OCDiabetic and figure if it goes up a couple points, I can pay better attention to what I’m doing?
oh yeah!!!
My god, I was way off.
In 14 days my carb average is 240.
Jiminy Cricket, maybe that’s why I feel so out of control.
I think tomorrow I am going to start keeping an eating journal.
A few days of that should help me get motivated. eyeroll
Theres a lot of carbs we eat and dont notice realize. When I started recording the nutritional value of the food I ate daily (although now about once weekly), I was shocked. What I thought was 150 was closer to 250 like you.
Plus that doesnt take into account and LBS carbs or just bump carbs you may intake.
I eat a low carb diet, HERE is a link to the nutritional value of how I was eating about 3 months back durring the beginning of my new diet.
Oh, and congratulations on the new addition to your family!
thanks for the link. since the baby was born. My diet is pretty atrocious.
I think part of that is feeling some freedom after nine months of such strict… well, everything.
My wife was gestational and got a taste of the fun life. =^)
You have to keep up your energy for nursing as well (as others have said), which Im sure can be tough. Take it slow and steady - youll be back on track in no time.
Your right. It was hard to wait until normal returned, but I had to realize my normal was now different than before. Now, my levels are pretty good. I can still have my days where they are up and down, but for the most part it’s doing better. But like I said it a different normal. My activity level is/was more because I went from one child to two. Then for at least 8 months to a year you are constantly carrying around another little one, plus all of the junk that goes with you everywhere. Normal just seems to change and I have learned to be a little more patient with it…although I fall short now and then.
There is another comment here saying that you could change your meds yourself, and I have to say, that I do that sometimes, but I make gradual adjustments and check often. There is a great book that I read that I had seen many people here talk about highly. Its called Think Like a Pancreas. Great book and really helped me fine tune adjustments.
I wish I could answer your last question, but for me, My body changed after my pregnancy with my son and some things returned to the same as before and others changed. We are all so different that no one could tell you with certainty how your body will change and respond.
Hopefully that is what he is considering. You are probably right, I should give him his due time.
