28 weeks, carb to insulin ratio

[Donnalouise]

Hi

I'm 28 weeks and 5 days. Prior to pregnancy my control wasn't great, I started to get it under control when planning to get pregnant. Hba1c has been roughly 34 throughout which I've been very happy with.
The last week however has been awful. I can't seem to meet the 7.5 or under target an hour after carbs set by the diabetes team. My carb ratio has shot up over the past week, I'm now on nearly 3 units for ten grams of carbs! Tonight an hour after food I was 9.2, despite a correction of 2 units an hour later I was 11.
Does anyone else have any experience of this? I am starting to feel like I can't get this right and am worrying about the effects.

Donna

 

[noblehead]

Welcome @Donnalouise

I'll tag @azure into your thread as she always gives excellent advice on pregnancy matters. Best wishes.

 

[azure]

Hi

I'm 28 weeks and 5 days. Prior to pregnancy my control wasn't great, I started to get it under control when planning to get pregnant. Hba1c has been roughly 34 throughout which I've been very happy with.
The last week however has been awful. I can't seem to meet the 7.5 or under target an hour after carbs set by the diabetes team. My carb ratio has shot up over the past week, I'm now on nearly 3 units for ten grams of carbs! Tonight an hour after food I was 9.2, despite a correction of 2 units an hour later I was 11.
Does anyone else have any experience of this? I am starting to feel like I can't get this right and am worrying about the effects.

Donna

Are you on a pump? Could it be your basal that needs upping too?

My insulin needs shot up around a similar stage of pregnancy and things seemed to change quite suddenly.

I recommend sticking to 'safe' meals - ones you know the carbs of - and get your ratios right that way.

By the end of pregnancy my basal had almost tripled and my evening meal ratio had gone from 1:11g to 1:4g - so again, almost tripled.

Try sorting your basal first, leave it a few days to assess how it works, then look at the meals, is my advice.

Your increased needs seem very normal to me : )

 

[Donnalouise]

I'm on a pump, also been given a Dexcom cgm which I started last week. I'm pretty certain it's my carb ratio which is the main issue but planning on starting some fasting tests tomorrow just to double check.

In terms of carbs I have been sticking to the same things and weigh everything out as realised my pre pregnancy estimations were completely wrong.

Thank you for the reassurance. Nice to know this is a fairly normal part of pregnancy and T1.

 

[azure]

I'm on a pump, also been given a Dexcom cgm which I started last week. I'm pretty certain it's my carb ratio which is the main issue but planning on starting some fasting tests tomorrow just to double check.

In terms of carbs I have been sticking to the same things and weigh everything out as realised my pre pregnancy estimations were completely wrong.

Thank you for the reassurance. Nice to know this is a fairly normal part of pregnancy and T1.

@Donnalouise I don't recommend fasting tests during pregnancy. I adjusted my basal by instinct and adjusted it very slowly over a few days I did this while still eating regularly. Basically, in pregnancy your insulin needs are changing so much that it doesn't matter if you adjust basal slightly when you should have adjusted your ratio, as long as your safe and you're in range.

If you're sure your basal is ok, then just adjust the ratios. I found this easiest to do by eating the same meal for 3 days in a row.

I'd also point out that in pregnancy, I had to bolus further in advance eg for breakfast, my most resistant time, I had to bolus approx 45 mins in adavance in the later stages of pregnancy. Bear this in mind too, as it can help reduce spikes.