Type 2, Newly Pregnant, High-ish BG


#1

Hi, I’m type 2, 5 weeks pregnant. I started Levemir a little over a year ago, in order to get my 7.2 A1C down for IVF treatment. I had been well-controlled with Metformin until about a year before that when I was laid off and gained a bunch of weight (diagnosed in 2010). Since getting up to a stable dose of Levemir a year ago (100 units split between bedtime and morning), my fasting blood sugar has been in the 95-110 range most days, with the occasional weird blip up to ~120. (My post-meal numbers have often ranged around 160, depending on what I ate/time of day.)

The day that babe likely implanted (I got a positive pregnancy test a couple days later), my blood sugar went totally wonky–144 fasting, with a pre-lunch low of 126 and all my other tests that day in line with my fasting (1, 2, and 4 hours after a pretty normal lunch all in the 150s–usually by 4 hours later I’m down to ~100). The next day, I went up to 120 units of Levemir and my numbers have been better (fasting 115-120), but still higher than they should be–I’m continuing to up this number slowly until either I get the fasting numbers I want or my bg starts to go low (I usually don’t get lows, but I know that 1st trimester can be a time for them). And my post-meal numbers are too high, and I know that I probably need to go seriously low-carb to control them, but I’m starting to feel some morning sickness and all the foods that are supposed to be good for morning sickness are terrible for diabetes. I’m wondering if maybe I should be starting meal-time insulin to control post-meal spikes, but, honestly, my primary care doctor just gave me the Levemir Rx, told me to titrate up slowly, and gives me refills when I ask for them (it was my idea to start insulin). I know that my ob/gyn or an MFM will likely have BG goals for me and may want to see my logs, etc., but I’m not expecting my fertility clinic to refer me to an ob/gyn until 8weeks, and I’m not sure if I should be worried about what effects this will all have on the baby, if I wait until then to talk to a doctor about this stuff.


#2

Although your BG’s are a tiny bit high and you probably do need meal time insulin I think it is safe to keep doing what you are doing for a couple of weeks and maybe push to get that referral sooner rather than later. How high are your post meal numbers? How many hours are you testing after meals? By all means go lower carb if you can tolerate it with your morning sickness.


#3

Just out of curiosity (this situation sounds tricky) - What happens if you take insulin and then throw up the meal or cant hold food? This sounds really tough. Can they prescribe something for nausea?