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24 weeks pregnant

Discussion in 'Pregnancy' started by Julie.reid1906, Feb 9, 2017.

  1. Julie.reid1906

    Julie.reid1906 Type 1 · Active Member

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    I am 24 weeks pregnant now and this week my insulin requirements have increased significantly. I am really stressing out because my blood sugar is sitting about 8mmol/l most of the day. I am on a pump and have a dexcom CGM so I can see exactly what's happening all the time which is stressing me out even more. I keep increasing my basal rates but it doesn't seem to make any difference. How much should I be increasing by? I have been trying to reduce my carbs to make is easier but with little joy. This morning my bm was 5.9 when I got up. I had 0 carbs for breakfast but 2 hours later my bm was 8. My basal was 0.4, I have upped it to 0.6 for tomorrow, will this be enough? Thanks in advance for any advice
     
  2. himtoo

    himtoo Type 1 · Well-Known Member
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    Hi @Julie.reid1906
    I am tagging the lovely mum @azure she should be able to offer you some support.

    try not to stress too much ( I know it must be hard )
    have you spoken to your DSN recently ? she may be able to offer some advice too !!
     
  3. Julie.reid1906

    Julie.reid1906 Type 1 · Active Member

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    Saw her on Monday when she told me that my blood sugars were too high even the ones that I thought were ok. Since then it's like she pushed a button that made everything spiral out of control
     
  4. himtoo

    himtoo Type 1 · Well-Known Member
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    don't know anything much about pregnancy -- sorry -- but I do think you are allowing yourself to get stressed -- which will raise BG's

    there are some fab ladies on here that should be along to support soon hopefully -- @1Sarah1 . @tigger , @-Artemis-
     
  5. azure

    azure Type 1 · Expert

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    Hi @Julie.reid1906 Just logged in here. First of all, don't panic - the insulin resistance is increasing at a very common time. My insulin needs went up around then too.

    I personally wouldn't cut carbs unless you're eating excessive quantities. It's not the carbs' fault, it's just your hormones, and carbs are important in pregnancy.

    First thing I'd do is change your insulin so you know that's fresh and effective. Then look at increasing your basal gradually, choosing one segment of the day at a time. I can't remember what increments I used, but I did it in stages not one big increase.

    You may also need to look at your ratios.
     
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  6. Julie.reid1906

    Julie.reid1906 Type 1 · Active Member

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    I have already increased my ratios but not having much luck with that either. I am trying to sort out my mornings cause that's when it's the worst. I thought if I had 0 carbs for my breakfast I would be able to see if it's my basal or my ratio that is the main problem. It seems to be my basal as my bm went up despite no carbs. I just hate that you have to do it a little bit at a time because every day that my blood sugars are too high they are causing damage to my baby ☹️
     
  7. azure

    azure Type 1 · Expert

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    By the end of pregnancy, my basal had almost tripled, and my ratios had increased a lot eg my evening meal went from 1:11g to 1:4g, and I still had to correct sometimes then.

    Overall, my TDD tripled.

    i can't give you dosage advice, but if that was me I'd eat a normal carb breakfast with an advance bolus at the right time (I had to bolus earlier in pregnancy), and eat that breakfast pretty soon after getting up to stop any waking rise.
     
  8. azure

    azure Type 1 · Expert

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    Although 8 is above target, it's not a bad BS and could be higher so you're doing ok. Remember stress will put your BS up too, so stay calm. You can sort this :) We all went through some higher sugars and had to make adjustments over a few days, and our babies are ok :)

    Dont worry too much about whether you should up your basal by X amount or your ratios by Z amount. It doesn't matterif you're upping a ratio when you should have tweaked a few hours of basal. As long as you're safe and your BS is in range, that's all that matters.

    You'll be making lots of changes anyway, so just focus on keeping to your targets, however you do that. I often upped both basal and ratio a small amount.
     
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  9. Julie.reid1906

    Julie.reid1906 Type 1 · Active Member

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    Thanks for the advice. Think I'll call my dsn tomorrow see what she thinks. I've done the advanced bolus and I've also tried super bolus but it still goes high. At least if I'm eating less carbs it doesn't go quite as high.
     
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  10. azure

    azure Type 1 · Expert

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    @Julie.reid1906 Then it does sound like maybe your basal needs upping too. I haven't got records of what mine was at that stage, but I do remember that some parts of the day increased by approx 30% pretty early on, and that some stubborn times doubled around the time you're talking about.

    For advance boluses, when I used Humalog I had to bolus approx 50 mins to an hour in advance for breakfast by the last stages of pregnancy whereas I'd normally bolus 30 mins in advance when not pregnant. That was a huge change but it was totally necessary.

    Good luck in sorting it out - I'm sure you will :) It took me a while to get my head round just how much my insulin needs changed in pregnancy, but once I got going in the second half of pregnancy and felt more confident about increasing insulin, I felt a lot more relaxed about it.
     
  11. tigger

    tigger Type 1 · Well-Known Member

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    Well done on the 5.9 waking reading. That's really good! Now take a deep breath make yourself a nice cup of tea/decaf coffee and try and do something else which will make you feel good. Above all do not look at the dexcom until lunch. Looking at something not moving will stress you which will in turn contribute to keeping your levels above where you want them. It's an unfortunate vicious circle.

    Then write today off as a bad one and focus on looking at the patterns before you make changes.

    Is your basal right? Your needs will start to increase at this point and you might want to experiment with some temp basals to see how much you need to increase by.

    Is your carb ratio right? Your resistance will also start to be increasing at this point so you may need to make alterations there. @azure 's advice is to eat the same thing 3 days in a row to check if it is correct. I'm afraid I tend to get bored but do stick to something I can very easily measure when checking my carb ratios.

    Are there parts of the day where you're more insulin resistant than others? Mine has always been the morning.

    How long are you pre-bolusing before a meal? Have a look at the dexcom and work out where the trend starts to come down and then you can calculate how long this should be.

    Split bolusing? I find this helps with some meals even if there's only 30 mins in between. It's essential for me for big meals.

    Are there are other external factors which could be affecting your readings? A cold (even a slight one), or other infection, stress at work or from other factors, sudden changes in temperature, a canula sited on a capillary (I find this really delays absorption).

    I tend to low carb when everything is out of sync and do it more when I'm pregnant as I get much less of a spike with it. However, you have to remember that not all low carb food works the same way and supposedly 0 carb may not be treated by your body as such particularly if you low carb a lot.

    Also you mentioned that your DSN said your readings are not in range when you thought they were. Why is that? I was told by my consultant last time that even if I might be getting slightly higher readings in the permitted range, the fact that I was centring them over a smaller range and avoiding bad hypos was far better.

    You will get there. It takes time and effort but you can do it.
     
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  12. 1Sarah1

    1Sarah1 Type 1 · Well-Known Member

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    Hi there -my requirements also tripled in both my pregnancies. I tested a lot - including at least twice through the night.
    Don't get stressed as will make it worse @tigger and @azure given good advice.
    I was told to follow low GI diet (porridge for breakfast etc) and I kept to roughly same carbs at same time for consistency. I used to test half hour after meals to make sure I was on track and possibly give more insulin or have a few more carbs depending on where I was.

    My dd was diagnosed just after my twins were born (age2) so been trying to understand her levels now too it's not easy. Don't panic if you get the odd high just try get it down a bit.

    It will be worth it in long run.
    x
     
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  13. Julie.reid1906

    Julie.reid1906 Type 1 · Active Member

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    Thanks for all the advice and encouragement. I've had a much better day today, just being a bit braver with upping my basal. Seems to have done the trick, hopefully I can get some stability now.
     
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  14. M80

    M80 Type 1 · Well-Known Member

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    Good, remember this will continue and you will need to do it again (upping the basal) until the last stage of the pregnancy then it will stop and flatten out, you will need to decrease it again.;):cat:
     
  15. mist

    mist · Guest

    Congratulations! :)
     
  16. azure

    azure Type 1 · Expert

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    How are things going with your basal change now?

    Well, I hope :)
     
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