T1, honeymoon, Pregnant, potential RH, off insulin....where to begin...?!

[AndBreathe]

I think I might try meditation/relaxation @Robinredbreast , at least to ease the anxiety.

@1Sarah1 , I did try bolusing half an hour before breakfast, but even with only 5 units (which reduced the spike), I could still hypo anytime between mid morning and bedtime. As this was the only insulin I was injecting, it was decided that I should reduce my dose and then get rid of it completely. I'm still fairly new to Diabetes, and tbh, the idea of an insulin pump scares me a bit. I've heard lots of people rave about them (and understand how great they are, especially for young children like your daughter), but I'm not sure about being attached to a machine all the time. Although in saying that, I might bring it up at my next pregnancy diabetes clinic and see what my team think about it!

@azure, I am not a fan of the low GI and small portions at all, I'm feeling hungry and grumpy for most of the day. I've decided that as of tomorrow, I'm going to re-introduce my breakfast insulin (slow to start), to conquer this spike. And then hopefully even if I do fancy a non-GI food or treat, I at least won't beat myself up for it.

Thanks @Brunneria, and apologies if I came across as assumptious - as I very well know, when it comes to the quirks of the pancreas, we are all very different lol.

It's funny @jade88, when my DSN saw my food/bg diary, and could see that I was testing and sometimes eating to get to 5 before driving, she told me I didn't need to test at all, as I had no additional insulin in my system. I argued that there was NO way I was in a fit state to drive when having these hypo's (ironically, one of which happened in a car park lol), but she said it was fine. I've taken her advice with a pinch of salt and still test before getting into my car - it doesn't do any harm, and I don't want to be responsible for hurting myself, my baby or someone else if I'm too low behind the wheel.

X x

Erin - Have you heard of and/or looked at the Abbott Freestyle Libre device? It is a constant monitor of interstitial fluids which indicate blood readings. It could be useful in gaining some further insight into what's going on for you - with the highs and lows.

Unfortunately, it isn't available on the NHS prescription, bit if you can afford it, it could be worth considering.

I'm T2, now running in non-diabetic ranges, but I learned so, so much from the Libre I would never have discovered doing even organised finger prick testing.

 

[1Sarah1]

Hi @Erin85 -just to second what @Mrsass said about the pump. I injected for 30years before going on a pump - I resisted for a while as like you I didn't fancy the idea of something big and being attached but it was definitely the best decision to sort out control especially for pregnancy. I was reluctant for my two year old too as she is so little but so far it's better than injections for her. Yes it can be a little annoying sometimes but I normally just clip it on my bra or waistband and it's fine. I would find it really hard to go back to injections now. Just thought I would share x

 

[ArtemisBow]

Just to say I'm now 26 weeks and my doses are still super low with the exception of the evenings when I seem to get a big insulin resistance increase - but that only started around week 24. So although in theory your needs come up during second trimester that's not the case for everybody. I'm two years in to my honeymoon and pancreas still working if erratically, not quite to your extremes but some days I swear I'm not diabetic anymore. If low GI meals aren't working for you, try something else - no point in making yourself miserable if it's not even helping control your BG levels.

I will also say having a pump has massively helped me - able to give much more precise doses. They are still wrong sometimes due to the random nature of my pancreas working, but at least I'm not set to using whole and half units - if I need 0.05, I can take it.

 

[Erin85]

Thank you everyone for your ideas and support, has made me feel so much better about everything, wish I'd posted earlier!!

Due to everything that's been going on, with so many unknowns, my diabetic team gave me the Freestyle Libre for a week's trial, after which I am allowed to keep it. I had looked into it before, but thought it was too costly to buy and maintain, so my husband and I are so grateful that I am able to keep it and just pay for the sensors. I've had it for just over a week and the data I have gotten from it is unbelievable. Some days, my levels can look ok (pre and post prandial), but I've actually been experiencing highs and lows in between, so even when I would have thought that I was doing well (had I been just finger pricking), I'm actually high for a lot longer than expected. Over the last 7 days, I have been over target (7 mmol/l) for 53% and only within target (3.9 - 7) for 39% of the time. This makes me very anxious, but I have spoken to a different nurse this week who explained it all in a different way to me and has given me a different perspective on it all.

I had said that I was scared to have correction doses, as I had been waking up hypo after a night of highs. She explained that my own pancreas would be recognising the high bg levels, and basically spewing insulin to lower these, and that if I injected insulin, my levels would be lower, my pancreas would be less eager to produce so much insulin, and I wouldn't go hypo. This was a completely new concept for me that no one had explained before, so I have been experimenting this week and slowly re-introducing my insulin. Now up to 4.5u for breakfast, 0-2u for lunch and 3-5u for dinner. I am still experiencing post-prandial spikes, but I have regained my confidence in correcting high levels and feel more in control of the situation.

There's still a long way to go to get back to where I want to be, but I'm trying not to be too hard on myself, and have been reminding myself that I'm still experimenting and moving in the right direction for myself and baby. I have a diabetic pregnancy clinic appt on Tues afternoon and am looking forward to seeing my team to discuss the last few weeks and get their opinion on my spikes (and how dangerous they have been for my baby), and advise on if any more tweaks have to be made, including introducing a background dose again. Will also be asking about the benefits of the pump. I'm still not keen, but have taken on board all you ladies' advice, and if it will help get my levels in range, I am more than willing to go for it for baby. I also didn't realise you could set such low insulin doses, which would be really useful for me.

I just wanted to update you all on how we've been doing, and thank you all again. Just for being here. This site really has been invaluable for me x x x

 

[Brunneria]

Glad things are improving! And glad the Libre is helping. I LOVE it, and like you and @AndBreathe have learned SO MUCH. it is invaluable - and to be able to keep using it for the rest of your pregnancy will be a great help to you.

So pleased for you.

Oh - and going back to your query about RH? You will be able to spot it easily if you have it, using the Libre.
RH post meal curves are often double bumps (like a camel with 2 humps) and if when you eat carbs, your bg always dips a little lower after the meal than before you ate, then you are showing signs of RH.

But many people do. It is only a problem if it is a problem for you. Huge numbers of people experience RH regularly (something like a third of women experience it several times a month) with no issues or ill effects (they probably just thing 'gosh, I need a snack!').

I am telling you this to set your mind at rest, I hope. The odds are pretty slim that you are showing that pattern in your bg, and even if you do, all you need to do is have a teensy snack before the bg dips, and it halts the hypo immediately - but then, you already knew that.

 

[Mrsass]

Glad you're feeling more positive @Erin85

Sorry to harp on again about a pump but when you say about the highs you didn't realise you were getting in between testing a pump could iron that out as you say with such small doses that are possible you can have constantly changing basal rates and bolus settings/carb ratios which would help keep levels a bit more flat. But again, that's just me cos I'm such a pump fan and mdi just couldn't do that for me, others will no doubt say different as we aren't all the same.

How amazing you get to keep the libre!! Very jealous!

Let us know what happens at your appointment xx

 

[Erin85]

Hi ladies (and gents)! Just a quick note to let you know all went well at my appt. I'm a bit higher than expected during the night and still experiencing a huge spike after breakfast. The weirdest thing is that I'm now injecting for each meal and having no hypos! On a 1:10 ratio for breakfast and dinner and 1:20 for lunch. The libre is amazing. I really love being able to see what my patterns are without constantly testing and my wee fingers aren't as sore! My time in target has also increased to 51% and time above target gone down to 42% in the last 7 days, so all in the right direction!! I have my 20week scan on Wed, so excited but nervous for that. Thanks again for all your support, hope you're all well x x x

 

[azure]

@Erin85 I always have to bolus a good time in advance for ny breakfast normally anyway, but by the end of pregnancy, I had to bolus approximately 50 mins in advance! Obviously I built up to that gradually, but moving your bolus earlier might help the spike after breakfast. Something to consider

Glad your appointment went well

 

[Erin85]

Thanks @azure ☺ I have 2 alarms set in the morning - the first to test and inject and the second half an hr later to test and make breakfast. I have slept a bit longer after the second alarm on a few occasions, and gotten away with it if I was 6-7 to start with, or end up hypo after I finish eating. It's all trial and error, hey? X x

 

[Mrsass]

Glad things are going well @Erin85