Breakfast: Greek yogurt and toast with peanut butter or english muffin with peanut butter
Lunch: Sandwiches on light bread, salads, 1 serving of fruit and 1 veggie and then a snack like a granola bar or chips or whatever
Dinner: Soups, salads, steak with veggies and 1 starch side, pretty much anything including pizza (all be it only 1-2 slices a meal).
Up your basal 120%. That should help. Then spread your bonus out to cover your insulin resistance until you can get to your endo and ask for one that handles pregnant women. Carbs are not bad but they are hard. Iām doing ivf and the progesterone teaks havoc on your blood sugars.
My doctor told me if you get high itās ok, just donāt stay high. You want to stay between 80-140.
Iād use a food counter like myfitnesspal, does it seem a bit light on protein?. 75-80g P is a good target, sugar/starch carbs to what works for you and gets decent BG levelsā¦lots of low carb veg and salad, add real fats for energy, up to the calories you need
Congratulations Olivia! I am a T1 & 19 weeks pregnant myself. This is my 2nd pregnancy. 1st went fine, 2nd okay thus far, though blood sugars a little harder to manage this time. Besides T1, have several other medical complications, and the 1st still went fine & 2nd okay thus far. So try not too worry too much.
My advice is talk to your endo and CDE asap & hopefully they can work with you and all your data 1 to 2 times a week. They will help you keep the blood sugars under control as your insulin needs shift around, sometimes from week to week. And they will help you manage any new carb needs prescribed by your MFMS or OB. And honestly the MFMS and OB cannot do much for you now. (If you are taking any meds, though, you can check in with any primary dror OB to make sure nothing needs to be stopped or switched because it could harm fetal development. This might include some of the newer insulins out there.) I think I didnāt end up seeing a MFMS for the 1st pregancy until the end of the 1st trimester. Waiting that long made me nervous too but It didnāt matter.
At this point your baby does not need extra calories: lots of women end up practically starving unintentionally due to so called morning sickness happening all day & night. If you have had tight control with what youāve been doing up to this point with low carb, I say stick with that until you have endo/CDE help you take on more carbs if drs insist on more carbs later.
But I say call your endo folks right away & get their close guidance. Early pregamcy hormones can lead to lower insulin needs, so things start changing diabetically pretty quickly. Things have gone smoother for me with expert diabetes support.
Thank you so much for all the feedback and advice! I was able to get in today to see my doctor who will manage my blood sugar while Iām pregnant. She told me normal, non-diabetic women have fasting numbers in the 60s! I was floored. The only thing I found really frustrating is she wants me to do finger pricks 2 hours after meals and record and submit them. Iām so used to taking a more dynamic approach to my management - I use a Dexcom and pump and Iām afraid all the timing and reporting is going to give me diabetes burnout. I wish I could submit my Dexcom daily graphs instead.
Can you try to negotiate that? If you are consistent about pre-blousing (or blousing and then eating right away), then it should be easy enough to look at your data downloads and see what your post-meal bgs were.
I am waiting for any of my many doctors to start requesting weekly data, but Iām going to try to stick to sharing my uploaded data rather than filling out one of those charts. My endo is fine with it, as is the CDE. Iām concerned about the MFM.
Maybe take a look at your own CGM reports and see if you can consistently find your 2-hour post-prandial bgs. Then, you can point them out to the doctor to see how easy it isā¦
Good luck!
I think you will find the Dr is wrong, for the average nondiabetics
On average, fasting blood glucose (FBG) was 70.9 Ā± 8 mg/dL (n = 195) (Table 2). The weighted mean pattern of glycemia (including FBG, 1- and 2-h PP, and 24-h mean glucose) is shown in Fig. 1B.
I should have specified - she said ānormalā pregnant fasting blood sugars are in the 60s. I havenāt been able to find any data on it, though.
The articles referenced above in fact report ānormalā (i.e., non-diabetic) pregnant womenās BG levels. The average fasting BG seems to be closer to 70.
Whoops! I should have looked closer. Thanks for finding thatā¦itās very interesting!
My MFM and endo just wanted my fasting BG to be below 95. 60 seemsā¦ crazy.
Iām T2, so my experience is undoubtably different - but I wasnāt required to submit finger pricks. I just worked with my endo on BG management, and I saw her pretty frequently throughout the pregnancy (maybe every 2-3 weeks). I tested a lot, but then again, I donāt have a Dexcom or pump. I just did MDI and finger pricks. As for carbs, well - I got a bit out of hand, I think. I was using NPH and Humalog, and I found that I needed a LOT of carbs at night or else I would crash into the 40s overnight. It was not ideal ā but then again, you have the tools to make more accurate adjustments than I had!
The MFM mostly just focused on extra scans (particularly growth scans), and then at the end of the pregnancy I had to go in twice a week for NSTs. The endo and the MFM office coordinated, so the endo would just send over notes and records. If you are working with an endo, the MFM should not be giving conflicting advice - you may want to see if thereās an MFM that can work with your endo.
Hereās the only real advice Iāll give you, advice that helped me tremendously. The occasional high BG happens. Donāt beat yourself up about it. Of course you want to maintain as tight control as possible, but donāt think that if you have an off number that youāre hurting your baby. It will be harder to control as things go along, because the placenta starts doing double duty. I went from 5.2 A1C to 5.6 by the end of my pregnancy. Everything changed again, right away, after he was born! Someone here (donāt remember who!) mentioned a mantra they had, and I found myself saying it and getting a lot of relief: Dear baby, please take the nutrition you need, and leave the rest for me!
Thank you so much for all the information! And I love the mantra.
Yes! I ate between 30-80g per day during my pregnancy.
I donāt want to eat more than 100 or so carbs per day (and some of those might be ācheatingā - for example, I eat chis seeds for breakfast - although they technically have 15 grams of carbs, they also have 15 grams of fiber). Was your doctor supportive? I will eat PLENTY of calories (I could eat a jar of peanut butter with a spoon), but thereās no way I can eat the recommended amount of carbs and keep my blood sugar within the levels theyāre recommending.
Agreed. I have a PhD in molecular and cell bio and read a lot about low carb during pregnancy. Yes, my Endo was very smart and very supportive. My MFM never asked what I ate. My A1C was normal (low 5%) throughout and I delivered a healthy 6lb 11oz baby at 39+5. Here is a good article by a CDE which is easy to read but also has a list of references if you want to dig in: Guest Blog Post: Is It Safe to Go Low Carb During Pregnancy? - Low Carb Dietitian