I went off birth control at the end of September after getting my endo’s ok to try for a baby. I’ve been working hard to get my A1C down and my last one was 5.9, but since I went off birth control my sugar has been terrible in the morning–even the highest fiber, lowest carb breakfast causes spikes and it takes a while to get back in range.
I’m disappointed because I was ready to try to get pregnant and now I think I should wait until I get this issue sorted out. I’m a worrier and the info about diabetes and pregnancy has scared me.
I’m not sure if I want advice or understanding right now. Anyone else dealt with something similar?
Hi there! I am T2 and was in a similar position (though going through fertility treatment, and very closely monitored). I ended up adding glipizide before bed, and this has brought my fasting number into an acceptable range. My endo also told me that I will probably have to add insulin when pregnant (many pregnant women, even those without D, get gestational diabetes. meaning, blood sugar is an issue for most pregnant women). It’s worth talking to your endo more about this - they may have solutions for you!
I’m sorry you’re so disappointed - it’s really hard to think, “ok I’m ready now!” but have to delay. I was diagnosed with D because of my infertility troubles - we started trying a year ago, and are finally in treatment. It’s rough.
Good advice and an important question to start with. I’m post menopausal, 9 years post oophorectomy and still having terrible hot flashes which drive my #s crazy.
I’m just piping in to underscore that our hormonal fluctuations wreak havoc with our diabetes throughout our lives and getting used to paying attention to those fluctuations early on is a very excellent idea. So Brava, Ladies. Keep it up…Blessings on getting pregnant! Be safe!..Judith
I think you should already adjust your bedtime insulin dose / increase it. One thing I have learned is that hormones make a huge difference in how blood sugar behaves. Also don’t hesitate to do corrections when needed using fast acting insulin, even while you are working out the change in your basal rates - this will mean that even if you have ‘highs’ they will not last for long. For breakfast, increase your short acting insulin and give it a bit longer between when you inject and when you eat (so the peak of the insulin can match the high). You can make this adjustment fairly quickly (you are going to need to be comfortable with adjusting your own insulin as things will change rapidly during pregnancy. Adjusting insulin is safe so long as you combine it with frequent testing. During pregnancy it really felt like my insulin was not working!
The other thing, if you ovulated already, could you be pregnant already. In my experience immediately post conception my blood sugars go haywire… Even before you can get a positive test. I have read that this happens for some women, but not for others.
I am suspecting early pregnancy (today is 5 days post ovulation; we did IUI) and my insulin requirements are already nearly doubled. Yesterday I ended up using 70 units of insulin (10 unit increase on basal and about 15 units increase of fast acting - mainly for corrections to try to get my sugars down - vs my normal < 40 units)… and I still never got below 91 (normally I can range from 70 - 90 for fasting and pre-eating). Today I will do a further 10 unit increase in basal (normal 15am + 20pm units increased to 25am +30 pm = 55 units), I also just did my 3rd x 2 unit correction for the day and it is only 9:30 am here (and I haven’t eaten and I have exercised). If I am pregnant, and this one makes it, it will be my third diabetic pregnancy. So I guess I am super experienced with this.
Regarding breakfasts. I typically have no carbs for breakfast or < 5 g of carbs. During pregnancy I found I just could not handle carbs in the morning at all. Even protein needed lots of insulin @ 2 units of insulin / egg. Outside of pregnancy I don’t usually dose for protein.
I actually went and had a blood pregnancy test done yesterday at the advice of my mom, after I read that persistent, wacky highs could be an early, early pregnancy symptom. Waiting for a call back on the results. I’ll think that I’m pregnant for an hour and then think I’m not the next. We’ll see!
I’ve been making almost daily adjustments to my mealtime insulin, but I hadn’t considered bolusing for protein. I think that will help a lot–I’ve switched to a nearly carbless breakfast of cottage cheese and eggs, but seems like my body needs as much insulin to cover that as it used to need for oatmeal!
How long until your period is due? The almost daily adjustments to mealtime insulin sounds very positive.
Regarding the blood test, if it is negative, you could still possibly be pregnant. Crazy blood sugars can begin immediately after conception, and positives on a blood test only show up 10 - 14 days after conception (5 - 6 days after implantation)… so it is still possible to get a negative blood test if you are very early.
Are you on an insulin pump? If so, maybe it’s as simple as changing your hourly rate? Seems as though you’re not getting enough insulin at night causing you to run high in the morning. It may be something as simple as your going through a lot of stress thinking about getting pregnant. Have you contacted your doctor about this?
I just got the results back from the blood test–it came back negative. My period is due next week, although before birth control my cycles were generally around 32 days long so it’s probably more accurate to say that it’s due in two weeks.
With some changes to meal time insulin and some basal tweaks, I’ve gotten my average blood sugars down. Still having those post breakfast spikes, though, despite aggressive changes. I keep tweaking my breakfast carb ratio–I’m now at 1:6, when two weeks ago it was 1:12! I’m catching the spikes earlier, though, and I’m getting back in range fairly quickly.
@Jessica_Strickland88 Yes, I am on a pump. The issue isn’t my overnight basal though: I wake up in range and my sugar stays great if I don’t eat breakfast. I’d just give up breakfast, but I need food.
Are you taking your insulin 10 minutes before you eat your breakfast? What kinds of foods are you eatin gfor breakfast? I can’t give much advice on breakfast spikes because I have them too. Sometimes I’ll take more insulin than I need and if I happen to fall low then I will just correct with juice or food.
I don’t know how long you have been off birth control, but my numbers go stupid in the week or so before my period is due. I think birth control masks it?
I’m wondering if it is breakfast or getting up that is spiking you? My bg used to go up when i got up - regardless of the time, it was the act of becoming vertical that kicked it off - even after a nap in the afternoon. I found that injecting a unit or two as soon as i hit the floor really helped. (My doc even calls it “getting up insulin”) That seems to have stopped now however, thank goodness.
I also switched to de-caf coffee, and bolused for protein.
If i eat breakfast, i bolus at least 15 min before. Sometimes, it helps too if i stop eating, do something else, then come back to eating - so i worked my morning routine around that - starting my breakfast in a bathrobe and finishing it completely dressed/ hair done etc. And not spilling coffee on myself too much.
Stopping the breakfast spike is really hard - i can do it, but i find it easier just not to eat breakfast. Not viable if you’re pregnant though… good luck!
