Ok, so I’m working the slowly climbing basal rates…even when they’re not so slowly climbing! 
Have others of you found that you need to adjust your carb ratios dramatically during the last trimester? I feel like my carb counting can’t be THAT off, but I spike after meals and take hours to come back under 150. Any thoughts/suggestions would be awesome.
Hi Tziporah-
My insulin needs totally sky rocketed at the end of my second trimester into my last trimester. I went from being on a 1 to 15 carb ratio for instance at breakfast to being on a 1 to 5 ratio! It took a couple days to get everything tweaked out and I had the same problem where it was difficult to get my numbers to drop after meals when the old ratio no longer sufficed. But the doctors worked it out and I’ve been good ever since (aside from feeling like I am taking a boat load of insulin everyday)… If it is any consultation I think my needs changed around 27 weeks and I havent needed adjusting since (I am now 31 weeks). I get the feeling I may need to change my nighttime basals soon, but havent had any major trends yet.
Good Luck! The doctor says that the highs around this time are totally normal and most women need adjustments around the 3rd trimester
I found my last trimester to be one of the hardest with blood sugar control. To quote my OB and my Endo “Don’t beat yourself up over your blood sugars … insulin resistance is going to make it very difficult for you …” Needless to say, my HA1c that was done 3 weeks after giving birth came back at a 6.7. I was disappointed when I saw that, but remembered how hard it was for me to keep up with the changes.
Perhaps eating less carbs is the best solution, if you can control the cravings and need to eat all the time!!! Easier said than done. 
I was down to 1:3 breakfast, 1:4 the rest of the day. My CDE said she had seen women with 1:2 ratios, so it could be worse. After I delivered, I was back up to 1:15. No placenta, no problem.
Human placental lactogen is the reason for the lovely insulin resistance. My perinatalogist reminded me that it’s a sign that your placenta is NORMAL. (Nice to hear that something works in our bodies, right?) The placenta doesn’t know you don’t need its help with insulin resistance and is so obliging to step in there and produce anti-insulin hormones for you. In a non-diabetic woman, it helps keep the baby from becoming malnourished. For us…ugh.
whoa…well, these replies are both relieving, and kind of a bummer. I see that the basal tweaks are not doing as much, and figured something else needed to change. I can’t believe how much more insulin I am already using, but then hearing your experiences makes me think this is really only the beginning.
I wonder why my endo’s office is still focusing so much on the basals and not on the carb ratios… IMHO, that seems to be a prime culprit.
thank you so much for the replies, and the reassurance. seriously appreciated!
Tziporah
After giving birth, I had a wild ride with my insulin adjustment for 2 weeks or so. Maybe 3 … I dropped all my weight so fast that I think it was making the insulin changes more difficult, too. I thought it was the breast feeding that did it, but perhaps all diabetics go through it?
My correction factor was as tight as 1:13 toward the end, and not pregnant is between 1:35 and 1:45. And my basals were all high during the last couple months, too. So I would say that everything will go up. My non-pregnant TDD was in the 30s, but my third trimester TDD was over 120 units.
Melissa, did you ever have to change your active insulin time? I’ve had another rough couple of days with BGs and am trying to figure out what (else) might need changing. I am continuing to dial up my carb ratios (now 1:6 and climbing, for most of the day) and also my basals. My correction factor just changed, too. Maybe that’s it? Oy, this amount of insulin is alarming…
In the 3rd trimester, I recall my insulin levels being at least 3x what they were prior to pregnancy, and with the case of my 2nd and 3rd pregnancies, 4x. But immediately after delivery, back to close to pre-pregnancy.
Try a square wave bolus with your meals. I recall that helping with meals during pregnancy, not to spike as high.
Good luck!!
I’ve been out of commission lately. Sorry for the late reply. No, I never changed my active insulin time.
Im 31 weeks now and my bolus is at 1/6 in am and 1/5 throughout the rest of the day for lunch/dinner…