Question about highs

While I am not pregnant, I am hoping to be in the near future. I enjoy reading everyone else’s questions & answers here, it’s a nice resource, even though I am not quite there yet. I have a question is in relation to high sugars:
I know highs are a concern in pregnancy and I know you test, you correct and get on with your life. Everything I have read said it’s not the sporadic highs, but rather continuos highs over a period of time that pose problems. What is this time period? Hours?

I realize days of prolonged highs would be a major issue, but sometimes my body just doesn’t like to react to insulin right away and I have to take another correction 2hrs after the initial one because my sugars haven’t budged or gone higher. I know some can result to higher fat/protein food intake, but other times, there’s not reason for my insulin to not work (I am on a pump, so I use the wizard to avoid stacking). Last night, I had cottage cheese & strawberries; 2 hrs after eating I was 193, took a little insulin, 2 hrs after that, I was 197 - took more insulin and came down shortly after - but I was close to 200 for a couple hours. This is my biggest fear about getting pregnant not being able to come down as fast as I want.
I finally got approved for the sensor and have been wearing it for about a month - but when I am out of 100-140 range, it’s way off what my meter says - last night it said I was 160 and going down.
I have been so diligent over the last 3 months trying to get myself in the best control possible, that it’s painful to see numbers like that - before baby talk, I would be happy just to see a 100 anything.

I know I just need to test often and correct, if that means every hour, so be it - I just would like to feel less freaked out when I don’t see immediate results.


I would assume that most of us are like that when it comes to highs. It usually takes me a few hours to come back into my target range. Don’t let that scare you away!

As to your question about how long is prolonged…I’m not sure anyone has a scientific answer for that. Remember that it’s an issue of risk. Higher numbers over a longer time mean a less healthy environment for the fetus. During the first few weeks of organ formation, those numbers over 140 mg/dL pose more of a risk to tissue development. In the final trimesters, it’s about the baby growing too quickly from increased glucose.

I don’t think that isolated events of high postprandials that you’re treating with correction boluses are going to derail the baby’s development. During my first pregnancy, I had highs over 200 a couple of times a week and highs in the 160-180 range at least once a day after a meal. And my daughter developed perfectly.

The important thing is that you are monitoring. And that monitoring may cause you to make different choices - such as waiting to eat until you’re trending downward, or eating something different if your pre-meal BG is too high.

My experience, for what it’s worth:

When I was trying to get into better control pre-conception, I had to come to grips with how precise I had to be with my food intake and insulin doses. I had been used to estimating amounts of foods and getting pretty good post-prandial blood sugars, but not very predictable ones. I don’t know if you’re like me, but if I’m a few grams off in my carb counting, it can change my blood sugar pretty significantly. Forgive me if you’re already doing this, but for me it really helped to get a book that lists carb counts of everything (I have the Calorie King one) and to be really really vigilant about looking things up and measuring very accurately. I enlisted my husband to help by asking me if I was sure I knew how many carbs I was about to eat before I ate. He has been really helpful and will even jump up from the table to go look something up and get a measuring cup for me.

Like I said, you may already be doing this, and kudos to you if you are. And as MelissaBL said, no matter what you do, you will always have some highs, and they will never come down as quickly as you would like.

One trick for getting a high down more quickly is to take a small correction bolus and then do a bit of exercise, if you can.

Best of luck, and keep the questions coming.

For pregnancy, postprandial readings should be 150 after 1 hr, 120 after 2 hours. You may want to try to experiment with different foods. In the mornings, I know that my body cannot handle cereal or bread, but it can handle fruit well. The rest of the day, I really have to watch out for lows if I eat fruit. I also do not do well with any type of fruit juice because I spike really high, then crash while my body feels really horrible. So, it could just been the food itself rather than the amount of carbs.

Also, if you’re using Humalog, you may want to switch to Novolog. There are some reports of Humalog possibly clogging the tubing. Even if it isn’t clogging, Novolog tends to work more quickly and smoothly. Novolog is actually prefered among pregnant women. I noticed that Novolog worked better, and I used less Novolog than I did Humalog.

Thanks for all the support.
For the last few weeks I have been trying different foods out in the morning, testing 1 & 2 hrs afterwards to see how they affect me - I have tweaked my insulin enough to have a good idea of a few different things I can eat without going over 150 2hrs after. My next issue is trying to add enough protein to those meals so I am not crashing before lunch.
Most of my prolonged highs are around dinner. Counting carbs is one of my main problems and I have gotten a lot better at it, especially eating at home where I control what goes in to my food and the portions. I have an older version of the calorie king, I should invest in a new one. Of course when I actually went to the gym after dinner, my numbers were great - hmmmm, maybe I should get back to doing that.

newtoheaven: I actually just switched to Novolog last week - at first I thought that was why my sugar wasn’t coming down as fast, everything I read says Novolog reacts a bit faster, but, I am not known for being normal and following the rest of the pack. Who knows?

Thanks again for all the advice :slight_smile:

Jen, another thing that helps is taking your meal bolus 10-30min before the meal. If you’re seeing 150 at the 2 hour mark, I strongly suggest pre-bolusing. CGMS technology is teaching us (and our medical teams) that insulin peaks much more slowly than we thought it did. The older insulins (Regular) should have been taken up to an hour or more before a meal and our faster analogs today still need a considerable amount of lead time.

Where do you put your infusion sites? There may be some places where insulin is well-absorbed and some that are not. Make sure to keep track when you change your sites with your logs to see if you notice a pattern.

Exercise has helped A LOT with my glucose control during pregnancy. Keep at it.

I actually send my glucose readings every week to my dr, and she adjusts as needed (been doing that throughout the pregnancy). Provided that you have a supportive medical team behind you, don’t hesitate to ask them for help. Even though I’ve been a pump user for 9 years, I still learn something new every time I get guidance from them.

Bolusing earlier may help prevent crashing later, too. If your insulin is peaking earlier, you may see less of a post-prandial spike, allowing you to reduce your insulin: carb ratio, which will mean you have less insulin on board a few hours later.

This is really interesting, I hadn’t heard that Novolog is better for pregnancy. I’ll have to ask my doc what she thinks. Thanks for the tidbit!

I have been bolusing before breakfast and that has helped a ton. I think because we eat so late, I am starving by the time we get dinner ready, that I bolus and start eating. Usually my pre-dinner numbers are under 100, so I don’t think to bolus and wait.
I am not pregnant yet, so I think have time to continue working out the kinks , but then again, maybe not - only time will tell.

Thanks again!

Just remember too that even if you get things just the way you want them pre-conception, pregnancy is one long journey of “working out the kinks”–just when you think you’ve got things figured out, everything changes! :slight_smile: So do your best to prepare now, but know that things will continue to change and your control will never be perfect. (Well, I hope for your sake that it is, but let’s just say that MY control will never be perfect!) :slight_smile: