I'm brand new here, and don't have all the incredible experience of many of the other ladies here, but am in a similar place as you, so thought I'd leave a note. I'm 20 weeks pregnant with my first, and can definitely relate to where you are. I never really experienced or struggled with any highs until a few weeks ago (the control I had earlier on was very good, partly a gift from pregnancy hormones I guess?). Before, if I ever peaked at 150-160 after a meal, I would always come down very quickly afterwards. But lately I've been having some very stubborn BGs, a few close to 200. It's sooo stressful, I can relate. Obviously we know that insulin needs can start to increase sometime in the 2nd trimester, so I feel like I've been watching and waiting for that. Only thing is that I don't see a consistent pattern yet, where some days I have these highs, and some days I don't. My endo said your insulin needs can go up and down at this stage, before they consistently go up. Great - that makes it super easy, huh?
Anyway, what I've been doing the last week or so is doing a temp basal of +20%, so I can easily turn it off if I start to run on the lower side for a few hours. It's not a perfect fix, but it has helped. Every day is definitely a new challenge. Not sure about you, but if I were sick, I'd easily be in the 200's, so don't underestimate that either.
Like I said, I have no more experience at this than you do (only by 2 weeks I guess!), but it sounds like you've had amazing control, and it seems that everyone here keeps saying that all you can do is your very, very best, and then you have to just keep moving forward. SO much easier said than done, as I've had PLENTY of stressful moments and days, but we can try to follow their advice.
Obviously, talk to your endo too, as I'm sure they'll have some good ideas for you. BTW, looks like you're in NYC? Out of curiosity, who do you see there? I live in Montclair, NJ, but used to go to Dr. Sobel at NYP/Cornell.
Anyway, best of luck to you, and I hope you feel better.