Sugars are running high in first trimester

Hi everyone,
I just found out I was pregnant yesterday and I'm a type 1 on a pump. It figures, we have been trying since April, and over Christmas I was not being careful. I figured it wasn't going to happen since since we were told by fertility specialist it was less than 10%. So I ate poorly, drank a little and figured I would be good again in January. But then my sugars have been all over the place. Really unexpected highs, then lows. I'm having an issue staying low. I'm 5 weeks and I'm not feeling well, which i am hoping is a good normal sign. But I'm afraid I am going to loose it since I have been high? I also on metformin, but I don't think it works. I went to bed at 109 and woke up at 229. So I'm feeling really out of control. I thought you were supposed to be low in the first trimester. My endo wants me no higher than 140, but I am chasing my sugars constantly with bolus after bolus and i am eating normally.
Suggestions? Is it a bad sign i am high? Do i give up carbs?


First off, congratulations!!!!

Second don't freak!! I was about 5 weeks when I found out too. Not planned, totally a shocker and my A1C was not ideal. I had trouble with highs and lows, and heck I still do to be honest but they are much better.

My biggest issue my first trimester was low blood sugar, which as you said, is fairly common. Your dosing may need to increase since you are running higher and this may simply be because of the hormones.

I think having sugar levels all over the place is something you can control, but also know that it is a bit expected considering all of the changes taking place in your body.

I wouldn't give up carbs, but maybe eat different types of carbs or cut back just a bit. I wouldn't say being high is a bad sign, I would just say it is a sign of pregnancy and body changes, and just work with your doc to try to correct them as much as possible. Something as simple as a 20 minute walk can make a huge difference for me.

I am 15 weeks now and I wish you the best! Please reach out if you have any questions.
I am on MDI and was diagnosed in 2005.


Thanks Nicole. Yes I would love to keep chatting. My brother is also a Type 1 and suggested I try and get my heart rate up every time my blood sugar goes up, so i think the walking will help.
I dont think i can give up carbs, but i can try and make some changes. This morning i was in the 200s and then kept bolusing and then got to 52. so i am on the rollercoaster. The month before i got pregnant i was pretty consistant and was always under 180. My A1c was 7.1, not great but decent. Today, I am crazy emotional. Please tell me this gets easier, lol.

Hi Stephanie!

I may not be much of a help, as I had the opposite problem and had such struggles with lows the whole first trimester, but I would have your doctor make some adjustments on your pump. I would send in a log of your numbers to your endo and see if they can adjust some of your basal rates for different times throughout the day that you are noticing higher numbers. The pump is absolutely great for making minor adjustments at a variety of times within 24 hours. And this way, you may not feel like you are constantly making corrections. I use a Medtronic pump and making the basal rate adjustments or changing the carb to insulin ratio is very simple. I agree with the comment above, if you feel well enough to get some light exercise in I would do that as well.

The best thing to do is check often, especially two hours post-meal. This will help determine if you need an adjustment in your carb to insulin ratio or a basal rate increase, etc.

Wishing you the best of luck! I am currently at week 20 and have found this site to be a great resource thus far. Don't beat yourself up too much either! I think the first trimester in general is very tricky when it comes to managing blood sugar, high or low. Congratulations!

Congratulations! I'm at almost 36 weeks of an unexpected pregnancy and thought I'd pass on how I can relate to higher sugars in very early pregnancy because for me, a couple of unexplained highs were part of what made me slow down and realize something was up with my body (and that my period was late and I was actually pregnant)! I had a quick look back at the numbers from the early weeks in my pregnancy and it was in week 5 that I had 5 or so sugars well over the 8.0 mark which leveled out to only 2 over in week 6 and after that a real challenge with running low for the rest of the first trimester and into the second (and not so many more highs). As for suggestions from my experience, as I became more and more insulin resistant later in pregnancy, bolusing well before eating carbs became a big thing. Pre-pregnancy I would very often begin eating immediately after bolusing and I can't imagine doing that now. I use Humalog and I take my shot a full 15 minutes before the meal (sometimes even earlier than that) because I find it takes that long for the insulin to get in my system to do something useful with the carbs I eat. I keep very active (minimum 60 mins a day of walking or other activity) -- but I'm really lucky to have a schedule that allows for that. Over the holidays, when eating low GI and really being careful with measuring carb counts was more of a challenge, splitting the walk to be 20 min after each meal really helped avoid post-meal spikes, but they do happen sometimes. Also, I'm aggressive with the bolus for the meal and just test, test, test afterwards and count on snacking on 10-15g of carbs 2 hours after a meal when I'd start to drop low. Super frustrating moments along the way (insulin resistance later in pregnancy would have me change my dosing drastically from day to day) but then settle out to be steady for weeks and blood glucose numbers would do that as well so it's not been all roller coaster all the time for me! I think there are lots of different strategies for keeping the tighter control throughout pregnancy - I've found my endo and the nurses at the pregnancy clinic I go to invaluable support. Take a deep breath, and good luck to you!

Mine was 7.1 too!! Not ideal, but still pretty good.
I definitely did experience some crazy emotional times, and recently had a breakdown over the weekend too.
It does get easier though and with support from your docs and even this community, you will be just fine (:

Try to embrace it & enjoy it!

I had a miscarriage this morning. Went to the dr and they couldn’t find it. My levels dropped. Hardest walk of my life was walking out of the office through the waiting room full of pregnant women. I knew something was wrong. I feel like this is my fault.

I am so, so sorry to hear this. I can't imagine how you must be feeling, but please do not blame it on yourself.

So many things can happen out of our control. Remind yourself of that.

I will keep you in my thoughts/prayers and I wish you strength.

Stephanie, I'm sorry to hear about your loss. Many of us experience highs in the first weeks (before lows set in). For many women this is the first symptom that they are pregnant. Most likely your miscarriage had nothing to do with diabetes.

I hope that you can get pregnant again soon! Keep us posted on how you are doing!

HI everyone, Just an update, but I went in to see the doctor a couple weeks later and my A1C was 6.6. So they dont think my miscarraige was due to high blood sugars, but just nature's way of something not right. Anyway, it made me feel better and more confident that if i get pregnant again, I will know something is off when my sugars spike up again. We waited a month and we are trying again, so we will see. I'm day 15 in my cycle this month and my sugars are high again. I cant figure out why. The only thing i did differently was have a massage yesterday and i started probiotics on sunday to help my tummy issues. Can a massage give you highs? I called the endo to let them know, so we will see. Last time i tried to fix my highs on my own and i ended up being pregnant.

I’m pregnant for the third time. The first time I miscarried, second was and ectoptic and now my sugars are running high again. So to say that I am freaked out is an understatement. My first sign of pregnancy is high blood sugars. Blood sugars that take a LOT of insulin to get them down. This time, I was on it faster and I did temp basals until could get a hold of my endo. I started out with 110% temp basal and I ended up at 120% temp basal and now we have figured that out as a pretty good starting point to adjust for early pregnancy ( I’m about 4 weeks). According to my endo, weeks 3 to 8 can be really high blood sugars and weeks 8 to 12 you can be insulin sensitive. Since I have a history of ectopic, I have to go in every two days to do and HCG test to make sure its developing correctly until they can see it in an ultrasound and make sure its in the correct place. I was just wishing I could have a normal pregnancy and not have so many fears. I’m wondering when I can relax or if my whole pregnancy will be this stressful for me. I keep expecting to get my period. Fingers crossed that my HCG test will show normal growth and development.

Hi Stephanie,
Congratulations! Think of the last 2 attempts as your trial run and practice. Now this one is going to be a sticker and you are going to do fine (with lots of hard work Lol!).

I’ve been through 2 diabetic pregnancies. It aint no walk in the park (as you already know), but the end result is so very worth it.

My biggest advice, I guess, is to eat low carb (i absolutely couldn’t control my blood sugars within target range if I didn’t), test frequently (Very frequently), and don’t be afraid to use as much insulin as you need to get things down (as long as you are also testing very frequently). If you have or can get a CGM this will absolutely help.

Hey Stephanie- I’m sorry to hear about your experiences- I am now on my fourth pregnancy after three miscarriages, and I also went ridiculously high at the start of this one- in fact my basal rate doubled, I’m still waiting to get through the first trimester and I would just like to give you a virtual hug as this waiting game really frays your nerves, and it’s something that no one understands- like a constant tension that won’t go away…

Having said that- we’re still ticking along with a lovely heartbeat at 9 weeks! I have found that I had to drop my carb intake massively- faster carbs like white bread, potato and fruit have just had to go.
But I figure it will be worth it- and I am seriously looking forward to having a huge Italian meal once this is all over! Fingers crossed for you.

Thanks @Kokos and @JustLookin , I’m 6 weeks along and tomorrow I go back in for another ultrasound. At 5 weeks we could only see the sac. So I’m hoping everything will be ok and we see it tomorrow.
My basal settings are high, but I can do fruit and I’m trying lower carb. I’m doing ok except feeling so tired. I’m just wondering when I can relax not worry with this waiting game.

Hi. Hope your next scan is good. When can you stop worrying? Maybe 20 years. :slight_smile: the early and of pregnancy are more stressful. Keep controlling your blood sugar and it will all be worth it.

Keep increasing your insulin, under supervision, to maintain target blood sugars

I asked a friend of mine who also had trouble staying pregnant whether she could finally stop worrying after the first trimester was over - she said yes - but then the baby is born, and the worrying REALLY starts :smile:

The last two nights I’m dropping low even though I’m dropping my basal by 1 point each night - so now of course i’m worried that ‘means something’.
I’m going to be a total nut case by the time this is over!

Went today’s appointment and we didn’t see the heartbeat but everything looks right on track for me at 6 weeks. I’m so relieved. I know I still have 6 more weeks for the first trimester, but I’m so glad we could see changes and the yolk sac. Why do I keep reasing horror stories? I go in for my big endo appointment on Monday but they have been happy so far. My biggest issue is fighting lows because I take my insulin then I feel sick or not hungry after my bolus.

So glad to hear that everything is still ok! I have the same feeling about the sad stories - I guess the people who successfully go on to have kids don’t have time to post a lot! My next appt is on Wednesday - I’m dancing on hot coals till then.
Good luck with the food - I had some problems with what I could eat and what not-I found keeping some fruit chopped up in the fridge really helpful, for a while that and Greek yogurt was all I could deal with. Also I found a recipe for crackers that really helped - Toys and Bacon: Low-Carb Bread of Perpetual Crispiness - you don’t really need to bolus for them, and they also help to settle the stomach enough to eat properly.
Keeping fingers crossed for you!!

Congratulations Stephanie!!

I am a little over 16 weeks now and had similar issues with higher blood sugars shortly after I found out at 5 weeks. I increased my basal rates which seemed to help a lot, and then maybe around week 8 or 9 I started getting more of the traditional “lows” associated with first trimester. Unfortunately my endo is not helpful at all, so I feel a little bit on my own trying to figure out where to go from here. I have a CGM which helps a lot, but it would still be nice to have more support from a doctor. Hope everything continues to go well for you!!