What's up?

Food Nutrition
1

Hi everyone!

My latest A1C is 5.3 (increased again from 5.1 2 months ago and 4.6 4 months ago). I am not happy at all about this and really feeling down about it.

According to Dr. B's calculation, this is equivalent to an average blood sugar of about 112 = (35.6 x 5.3)-77.3.

According to his recommendations a pregnant woman should try to get her blood sugar below his average 83 and he recommended 65 as an average target during his last telecast, if I could get there without feeling shakey (I feel shakey below 60)... so I guess it is realistic.

I am on MDI with Humalin-N and Humalog and I do not have CGM and there is no way I can get one OR afford one. But most of my readings are below 100. I generally measure 2 hours after eating and before eating.

It seems I have been having readings up to 140 probably once every 2 days and I always adjust with humalog to get it down as quickly as possible and usually would get it down within 2 hours of detecting it.

Fasting ranges from 65 to 98, but is usually in the low 80s. Not as low as it should be, obviously.

How can my A1C (and average BS) be so high when I'm apparently not having high numbers? Or maybe the once every 2 days is skewing everything...... As far as I can tell I don't go high at night and the humalin-N nicely blocks the dawn phenomenon.

I am low carbing, but obviously not enough!

I am also 33 weeks pregnant this week and feel like I am harming the baby by having these numbers.

My Obe is telling me the baby is measuring big and I am feeling very pressured and 'at fault' about this. I am also getting a lot of encouragement from my Obe not to gain more weight as I've already hit the 15 lbs total weight gain that she says is suitable from someone with Diabetes and who started off with higher than optimal BMI.

My endo doesn't give any advice at all. He just monitors once a month and then tells me I'm doing fine and he wishes all his patients were like me....

Any recommendations. I am scared to eat and scared not to eat and then I get hungry and eat something I shouldn't (hence the 140 or so every few days)....

And I know that anyone but you guys here would think I'm making a mountain out of a molehill with the numbers that I'm having - but really they are not good enough and I am so scared of what damage I am doing to this baby.

My A1C now is worse than it was with my daughter 3 years ago. I had an A1C of 4.7 when she was born (but to be fair the diabetes was new at that stage and was much easier to manage than it is now).

I have only 6 weeks or so left and I CAN'T let baby get too big and I MUST get these numbers further down.

And yes, I am getting obsessed with this! :(

2

The A1c calculator I use shows a 106 BG average. One answer to the disparity between your meter readings & A1c is that meters have a margin of error of plus/minus 20%, not that I want to add to your concerns. Also, more recent BG weighs more heavily on A1c results than those from a month or two ago. It's not truly an average of 90 days, but the best we've got. Also, some people's RBC's who live longer or shorter than average.

CGMS is rather inaccurate & requires testing to verify anyway, so you're not missing anything there.

Ok, lots of deep breathing because you're doing fabulously! Even given Dr. B's recommendations, I can't imagine there's harm to your baby with a slight high here or there. They're not prolonged spikes. Give yourself & the baby a big hug. You have to eat when hungry being pregnant. Know how you feel because when I have high fasting, I don't want to eat either. So, eat what you should at the first hunger pang instead of courting highs. Also what's needed is a slight insulin adjustment. Just a tiny increase.

3

Sally
of course your baby comes first, so you must keep to a highly nutritious diet. There are a few possibilities for why your A1c is up a bit. I won't even guess, but will point you to Dr. Lois Jovanovic. Research her writing. she specialises in care of diabetic mothers and you might find the answer there.
Nevertheless, Not many diabetics hit A1c of 5.3%
Don't worry too much about your baby being a bit big.
My cousin's second son [now a father of 3 himself] was born weighing 12 pounds because of her gestational diabetes, which eventually came back as T1. Martin grew up in normal health and has a University degree, so is obviously unimpaired.
As a Grandmother, I understand your concern about your baby.
Try a Food/exercise diary for a week and see if you can find a clue.
Good luck with your baby
Hana

4

Hello Sally, congratulations on your soon to be new addition! And congratulations on your Amazing A1C's all of them!!! I am type 1 and I can remember with my first pregnancy the doctor kept telling me my sugars are a bit high, but it never went further. 3 years later I was diagnosed. That was 17 years ago. My daughter was born healthy at 6 lbs. even. With my second pregnancy and being totally diabetic by then my A1c's were all in the high 7 ranges. I didn't even know who DR. Bernstein was then. My daughter was born bigger at 8.9 LBS. And because of her being larger she was born 2 weeks early as my then obgyn thought it was better. She was healthy and totally fine. That was in 2000.

I would say pregnancy, stress, etc. can be the cause of your A1C numbers being higher. Continue doing what you normally do and try not to stress, as this will only make everything worse on your numbers.

I wish my control of my diabetes was as good as your is. To me your an inspiration!