Tighter guidelines for BG control while pregnant?

When I was pregnant, the targets that were standard for my health region were below 5.3 fasting, and between 5-7 mmols two hours after a meal. I think that translates to 95 and 90-126. I was told to take a glucose tab if I ever went under 4 mmols (72) I followed that guideline and I had no complications.

Honestly, I don’t know much about it. I think that the conversation came up when I commented that I don’t feel my lows anymore until I am below 60. Then she told me not to worry about that.

I still treat 60 as a low. I still treat 65 as a low, but I don’t treat the lows very agressively unless I am below 55. I try to just raise to 80.

But I agree with you and Melissa that you can’t push this too far without risking bad lows.

I don’t know about the effects on the baby, especially after reading Mel’s comment that the baby has about 80% lower blood sugar. I found this article (only a two sentence summary and it’s from 1974). Surely there must be some more recent research about this…

I would be curious if anyone know anything more about this…

im pregnant now and i had a similar shock, but not to the extreme that you did. The ob and her partner endo wanted me to get my a1c down to 5 which i will not do. They want my readings at 90 before meals and an hour after. They werent concerned about low blood sugars because they dont affect the baby however high readings could. That is what i do not agree with as the lows can be dangerous to you, and trust me there are a LOT of them

I would ask her again. I treat anything under 70 otherwise i end up at 30, i still wake up everynight sometimes twice being low

Hi all,
I’m 4 weeks pregnant and still trying to get used to the strict guidelines… have not met with my OB yet, but my nutritionist (in the high risk pregnancy department) has advised me to be under 100 fasting and under 130 one-hour post meal… like others have said, I am not to treat a low in the 60s which is taking quite a bit of getting used to since I feel shaky when in the 60s but I have been told that I will get used to this. I’ll be honest, I’m having a pretty hard time with my post meal number and have started taking 3x the amount of insulin I was taking pre-pregnancy… still cannot even get my head around the increased need! Anyone else having a hard time with this?

All this being said, I cannot believe there is a hospital advising a fasting of 50-55! Sounds like a wise decision to seek care elsewhere!!

Take care :slight_smile:


Congratulations on your pregnancy!

I’ve heard that during the first trimester, most women actually find that they need LESS insulin, not more (lows are common). Usually, the increased resistance doesn’t come until the third trimester when the pancreas secretes an anti-insulin hormone.

Either way, keep a close eye on your numbers - you might find yourself crashing faster than you expected.

How do you time your insulin dose before the meal? I found that it’s much easier to stay within the target range if I give the bolus a 20min headstart. It will curb the postprandial spike. Even then, we have to realize that, even in a non-diabetic body, the blood sugar will rise as much as 50 mg/dL after a meal (they’re just discovering this, thanks to CGMS). So if you start out at 110 and rise to 165, that’s not unreasonable. I’ve reminded myself of that often throughout this pregnancy. If you’re already up to that much extra insulin, you should try playing with both the timing of the dose AND the frequency/carb quantity at meals. If you could eat more often, but less carbs at a time, that might help. Insulin handles 30g of carb a lot better than 60g.

Some women get the frequent lows throughout the first trimester. I didn’t. I had fairly normal blood sugars (except for spikes in weeks 6/7 and then, after week 20, began the gradual increase to four times my normal TDD of insulin to account for placental hormones. I’m currently taking as much insulin when I sit down for dinner as I used to take in a day. I actually programmed a 40 unit bolus the other day and couldn’t believe it was real!

Hi! I am sorry to hear the trouble you are having in Steamboat! I live fairly close to you actually in Laramie, Wyoming and am struggling with the same thing. I work as a Labor and Delivery nurse and have all of our OB’s at my fingertips. I am hoping to start a family within the next year or so but have not found a doctor who has any experience with diabetes. Our doctors still use NPH and Regular! HAHA. Sounds like your doctor is misinformed. Good luck to you in finding another one!

Thanks Steph! I’m sure I’ll get through it with the OB’s–somehow. I do have to say I LOVE my diabetes educator here in stmbt and my new Endocrinologist in Denver too, so that makes up for some of the frustrations :slight_smile: Best of luck to you!!!

I see an Endo in Fort Collins and am hoping to get some suggestions from her regarding OBs in Fort Collins. I do not mind the drive! Are there any neighboring places you could try?

I’m seen at a high-risk practice here in Phoenix. Once I told them I was pregnant, I was told to have my fasting BS between 70-80 and post-meal BS at 140 an hour after eatting and back under 120 2 hours after eatting. I had several lows a day through my 1st trimester. Now that I’m in my second, things are evening out. Because I was having so many lows I asked if that would hurt my baby, they said no. The baby seems to tolerate lows much better than it tolerates highs. They ask at each appointment when I start to feel low blood sugar symptoms. They want to make sure that I can respond early enough to treat an oncoming low and also make sure that I’m not feeling miserable longer than I need to.
I agree with Melissa that eatting smaller amounts of carbs throughout the day has made it easier for me to manage the swings. I finally got breakfast figured out and now I have to work on the nighttime snack. It’s tough but it is going to be worth it.

The only neighboring place i have not tried (haven’t found any docs there yet) would be Vail. It’s closer to me than Denver or Ft. Collins. That said, if I have to go in Denver etc for an OB, no big deal, I’ll just coordinate with the Endo when I can, and when I can’t, then I will just make the drive! Well, make my husband go with me, so he can do the driving :slight_smile: haha