Slight vent - and some questions about 3rd trimester numbers/measurements

[sleepyheadzzz]

I posted a few months ago now about my issues with my pump infusion sets (http://www.diabetes.co.uk/forum/threads/infusion-site-issues.81462/) - oddly it seemed to mostly resolve itself about a week later (I had thought I'd been using the 6mm infusion sets but I've actually been using the 9, so I may try switching still). It's happening a bit again and I had to change my site 5 times yesterday before finding one that worked, but hopefully I can rotate effectively and stay on top of any issues. Yesterday really took it out of me stress wise but today has been much better with most numbers below 8. My site is a bit painful but the numbers are pretty perfect so I can handle a bit of pain until I change it again this evening.

I'm 32.5 weeks and feeling a bit stressed in a similar way at the beginning of the first trimester. Surprisingly, my basal rates haven't really changed too much but my ratios are way up (as expected) - I started at 1:5 and for breakfast I'm at 1:3, lunch is 1:4, late afternoon is 1:5, and evening is 1:3. I've been doing weekly basal testing but they mostly look good with minor increases in the morning. Staying on top of the changes is such a headache but today is my last day of work luckily (using up vacation before mat leave officially begins at week 34), so I can adjust my routine a bit over the next little while.

Anyway, on to questions:

I was just curious what kind of numbers and spikes other T1's were seeing around 32-33 weeks along. I've been hitting 11 or 12 at least once a day lately, usually because of meals, with a couple of 13's, but most of those ended up being a site needing changing. Yesterday I hit 15 twice but that's very unusual and was again from the site issues. I've luckily only had ketones 3 times the whole pregnancy, and all 3 times it was from a site not working overnight and I was back down to normal within 2 hours.

I was also curious if you're baby ended up being larger, when did that start showing up at appointments/scans? So far he's been right on schedule even with my numbers creeping up, and as of today he's in the 55% percentile. My next ultrasound is Tuesday at 33 weeks so we'll see if that holds steady. My doctor will induce between weeks 36-38 depending on where my numbers are and how he's responding so only 4-6 weeks to go!

 

[azure]

I don't remember the exact details, but from around 30+ weeks I found it harder to control my blood sugars. I got some 11s after meals, particularly my evening meal. I had to put the ratio for that up from 1: 10g to 1:3g. I also found there was no leeway for slight inaccuracies in carb counting or portions. I tended to overestimate the carbs a little just to get on top of this. Obviously, I always tested after meals and acted cautiously, but by the end of pregnancy I had a huge amount of insulin resistance (for me).

I started testing earlier after meals - at one hour not just two hours. This allowed me to spot if my blood sugar was on the way up.

My baby stayed around the 50th centile all through pregnancy so I can answer your other question. I think like most things it can vary, but usually begins to be noticeable in the second half of pregnancy. But I'm sure you don't need to worry about that as you sound like you're largely getting good control

 

[sleepyheadzzz]

I don't remember the exact details, but from around 30+ weeks I found it harder to control my blood sugars. I got some 11s after meals, particularly my evening meal. I had to put the ratio for that up from 1: 10g to 1:3g. I also found there was no leeway for slight inaccuracies in carb counting or portions. I tended to overestimate the carbs a little just to get on top of this. Obviously, I always tested after meals and acted cautiously, but by the end of pregnancy I had a huge amount of insulin resistance (for me).

I started testing earlier after meals - at one hour not just two hours. This allowed me to spot if my blood sugar was on the way up.

My baby stayed around the 50th centile all through pregnancy so I can answer your other question. I think like most things it can vary, but usually begins to be noticeable in the second half of pregnancy. But I'm sure you don't need to worry about that as you sound like you're largely getting good control

I'm finding the same thing - no margin of error for miscalculating carbs. I'm also treating my lows with only 8g to start (2 glucose tablets) because often more than that is too much. Oh the fun of diabetes. I'm definitely looking forward to having my sugars only affect me without the extra worry.

Yesterday and today have been a big relief because the numbers have been almost all on target (except around 9pm last night when I hit 11 again). Just woke up at 4.3 - the day is always less stressful when it at least starts out right.

I guess we'll see if he starts to creep up in size over the next couple of weeks. My co-worker had gestational and measured right on schedule until week 32 and then she said they jumped weeks ahead. Her first was 10lb and second was 9lb so I'm feeling pretty good that he's still in the 55th at just over 32 weeks. But even if he does get bigger that just means we'll be meeting a little earlier.

 

[azure]

I think Gestational Diabetes is a different kettle of fish and in some ways not so easy to control. At least with Type 1 you're used to insulin and blood sugars.

I don't think the highs you've had will hurt My consultant told me that as long as they were short lived that things should be fine. My basal did increase a lot in pregnancy, but that was more in the middle of it, not really so much towards the end. The last few weeks were more dealing with meals and ratios.

If you haven't already done it, now's a good time to check you've got your pre-pregnancy basal rate on your pump, ready to swap back to right after delivery. Be prepared for lows too after delivery.. I had a few, and even more so with the breastfeeding. For quite a number of days it was almost like being cured : D I ate giant carby meals in hospital with tiny boluses and still went low : o

Keep us updated and enjoy the last few weeks of your pregnancy