Am 4 weeks pregnant today, and hoping this one will go ok.
Last week I was having highs. Then it seemed to be stable, and then last night I woke up at 3:45 am and tested (I don’t usually test, but I was feeling particularly shakey) and it was 61. Drank a small box of juice (24 g of carb) and went back to sleep. Woke up at 6 and tested and am only 70! Have never been this low in the mornings. Am about to go for a jog, so i’m drinking another box of juice now.
Is this normal? Wierd? I’m gonna have to test a lot more often now.
Should I reduce my basal? I take 12 units of Humulin at night. Took no humalog last night for dinner (it was low carb dinner - fish and green beans). Think I’ll try 10 units tomorrow.
Oh dear, I think I’m in for quite a ride!
The good part is that baby to be is having a big impact already, which makes me hope that all can be ok with him.
I would suggest asking your endocrinologist or CDE if you can start carb counting for your insulin doses rather than doing a set dosage. Your insulin needs are going to change so drastically throughout the pregnancy and having that kind of precision will be helpful. For instance, with a low carb dinner of, say, 20g, you’d take one amount of insulin (example: 2u), and for a carb count of 40g, you’d take twice as much fast-acting insulin (example: 4u).
It’s great that you tested and verified the number before treating. That’s particularly critical to do during pregnancy. With fatigue, hormones, increased or decreased hunger, it’s a lot harder to know where your numbers are. It’s normal to test 10 or more times per day during pregnancy. I think my max was 14. I would test before each meal or snack, when I woke, before I went to bed, in the middle of the night, before exercise, an hour after every meal, and any time I felt weird.
Please Sally, do not be scared to eat. You must eat in order to ensure that baby gets all the proper nutrients. While I admit I do not have a true answer for your concerns, I would recommend you figure out (maybe thru us on here, maybe thru an actual professional) how to determine your insulin:carb ratios and then fiddle around with them throughtout the day. Almost as if you were on an insulin pump. It is doable, I just am not really the right one to be giving such advise (I don’t think).
You can do this! You’re a smart woman and you’re in the right place for support & ideas. Keep us posted.
Are you still in your first trimester? If so watch out for the lows as they keep coming until about 16-18 weeks. I had to stop working out in my first trimester because I would have nasty lows (30’s) and huge rebounds (300’s). You will have to test more frequently as it will help your Endo when they have to adjust but be prepared to decrease insulin doses. I’m at 21 weeks and was starting to increase mine recently but since the heat wave this week has caused me to tweak my basal a little bit to keep the lows to a minimum.
My CDE and perinatalogist both stress that low carb is not good for the baby. They recommend 180-200g per day, though I’m sure you could get by on less. The standard pregnancy/diabetes diet suggests six small meals a day or three meals and three snacks. It makes it easier to manage the spikes. There were meals toward the end where I was tempted to eat less just because I was afraid to take large meal boluses (25-30 units), but my perinatalogist told me to feed the baby and take the larger doses.
Sounds like they are treating you as a gestational diabetic and you really need to be treated as a pre-existing diabetic. My insulin:carb ratios varied frequently through my first pregnancy. By the last trimester, I was taking 1 unit for every 3 grams of carb! My CDE said the highest she’s ever seen is 1 unit to 1 gram. If I so much as ate 1 chip, I needed a whole unit of insulin. Trying to manage these changes on your own is going to be really challenging. Can you meet with a nutritionist or CDE?
5 units to treat a 162 is pretty massive considering your insulin:carb is more like 1:10. Do you treat highs on a sliding scale (1 unit for every x mg/dL over a certain target number)? I wouldn’t freak out about a 162 90min after a meal (though by 120min, you should be closer to 120). You’ve got meal insulin on board for a good 3-6 hours, depending on your insulin action time and the kind you’re taking. Did you end up going low?
You should reduce your basal by about 1-2 units every 3 days until you are no longer seeing these lows, and decrease your insulin to carb ratio for the time being until you are not having highs after meals.Your insulin needs will start to go back up around 12-15 weeks.
Just watch the highs after eating, sometimes they come down at the 3hr mark instead of 2hr mark. Hormones make our bodies do weird things with the insulin. I know that in the morning, my sugar gradually rises after I eat breakfast and slowly comes back to normal range 3 hrs later. I’ve been waiting 12-20 minutes after bolusing but a few time waited too long and had a drop. All the tweaking we have to do is enough to make you nutty!! Only 16 to 18 more weeks to go for me…
