Confused!

[Joeypritch]

I'm not sure there's many with gestational diabetes on these forums but any advice greatly appreciated. I recently (week and half) started taking 2 units of fiasp with my evening meal so that I could eat carbs, dietician made a point of saying I must eat a decent amount of carbs after taking it so that I dont end up having hypo. But 2 units doesn't seem to be doing much, unless I'm just clueless with food, tonight for example I had some sweet potato fries (oven) with bolognaise (home made) and had an 8.1 at an hour (need to be 7.8 or below) and then it continued to rise after the hour. Can anyone help me with what I should be eating? Perhaps I'm better off keeping it super super simple and not having flavour?? Or is it normal that the fiasp would stop doing much after a week and a bit?

 

[Guzzler]

Sweet potato is quite carby and especially when it is baked.

 

[Diakat]

Insulin won’t stop a rise in blood sugar unless you exactly match the amount of insulin to the carb amount and the timing to the carb profile - which is a lot to ask!

 

[Jaylee]

Hi @Joeypritch ,

I don't do Fiasp. But I'll tag in someone I believe does.. @MeiChanski . (Hopefully she can tag other Fiasp users for thoughts.)
Without further info on what your BG numbers are over a 4/5 hour period, it's hard to work out if you may have under bolused?

It's all about balancing the insulin you take with what you eat. Not as your dietician seems to suggest, 'tuther way round...?

 

[Joeypritch]

Thanks guys, maybe I will do a bit more research and try find out what I can expect two units to be able to allow me to eat! I've been told to keep it at two units for now but given no clue as to how much that should have meant I could eat! Perhaps I need to carb count a little more strictly also xxx

 

[EllieM]

Thanks guys, maybe I will do a bit more research and try find out what I can expect two units to be able to allow me to eat!

Certainly as a T1, 2 units can allow one T1` to have 5g of carb and another to eat 50g, so the amount is liable to depend on you as an individual rather than something you can look up on google. And your team probably know that, they'll be looking at your food diary and readings to calculate your amounts. But of course that isn't helped by the fact that your insulin to carb ratios will be changing all the time due to pregnancy, and you're still producing insulin anyway, just not enough to cover what you're eating.

I guess the good news is you only have to do this for a few more months/weeks. . Good luck.

 

[MeiChanski]

Thanks for the tag @Jaylee

I'm not sure there's many with gestational diabetes on these forums but any advice greatly appreciated. I recently (week and half) started taking 2 units of fiasp with my evening meal so that I could eat carbs, dietician made a point of saying I must eat a decent amount of carbs after taking it so that I dont end up having hypo. But 2 units doesn't seem to be doing much, unless I'm just clueless with food, tonight for example I had some sweet potato fries (oven) with bolognaise (home made) and had an 8.1 at an hour (need to be 7.8 or below) and then it continued to rise after the hour. Can anyone help me with what I should be eating? Perhaps I'm better off keeping it super super simple and not having flavour?? Or is it normal that the fiasp would stop doing much after a week and a bit?

I think your best best would be speak to your dietitian and your nurse again to discuss different carb ratios, correction units and insulin profiles. It is difficult to say because 2 units of fiasp varies on everyone so it is very personal because some are insulin sensitive and some are not. As @Jaylee pointed out that it is difficult to comment because fiasp has a 4 hour window and you tested at 1 hour, which for anyone eating carbs they would be high as well. We usually say give fiasp a chance to work and test again at 4 hours. So I don't know if you retested again. If you were high by the end of 4 hours, you'd need a correction. So again I'd advise speaking to your team again to teach you how to adjust your fiasp for meals because not all carbs needs 2 units of fiasp, some need more, some need less and some carbs containing high amount of fats need a split dose.
Also it might be a good experiment, so weigh your carbs and use your 2 units of insulin and test. Then you can note down what is suitable for 2 units of fiasp. However no two days are the same, sometimes you need more.

 

[Cocosilk]

I had gestational diabetes but only ended up using insulin before bed to try to keep my morning fasting down. I had a few hiccups after meals and got 10mmol twice, once after a meat pie of all things.
I ended up eating fairly low carb to avoid bigger spikes but still saw 8 mmols a few times too.
In my experience, as the pregnancy went on I became more glucose intolerant so what you can get away with at 30 weeks pregnant might not be the same at 35 weeks pregnant.
My nightly insulin started at 2 units and was increased every few days till I was finally on 22 units for the last few weeks! And I was eating fairly low carb too!

Can't help you much with how much insulin to take with meals but I would stick to 1/4 of a plate of carbs rather than large servings, you know, no more than a half cup of cooked pasta or rice, a small slice of bread, 1 small white potato, or couple of slices of sweet potato. Make the rest of the plate meats / good fats and non-starchy vegetables. If you want fruit, have half a cup of berries. I only had small bites of things like banana. Most fruits are too sugary.
I've stayed low carb / keto in the postpartum period. Dehydration while breastfeeding has been a bit of an issue but my supply has been almost surplus! And you can lose the baby weight (fluid) fast if you stick to very low carb too.

You don't really need to eat that many carbs while pregnant but I understand it's tricky when most caregivers tell us we have to eat carbs.. It's a shame there is not more support for low carb eating while pregnant.

Check out what Lily Nichols suggests about eating while pregnant.

 

[Joeypritch]

Thanks very much for the advice cocosilk, I am pretty much doing what you suggested already, I think that's why I am so frustrated! I'm taking Metformin twice daily and insulin for fasting at night, I'm on 22 units at 28 weeks! I haven't touched fruit since finding out at 16 weeks, I was at the point where if I even looked at a tiny new potato my sugars rose which is why they decided to give me meal time insulin with dinner, other meals tend to be ok, and I was pretty happy to just cut out carbs but docs seem concerned that I was loosing weight, but I have some extra pounds so I wasn't too concerned about that, but when the team looked at my food diary they made a real fuss about how fewer carbs I was eating and made me feel like I was starving my baby - despite eating meat cheese and nuts like no body's business!! But even with this evening Insulin, half a small roast potato puts me in the 8s.

I will def look into the lady you mentioned as I have been trying to find research/case studies of keto in pregnancy and not finding much other than don't do it :-/ and now of course because I'm taking the insulin I'm worried about hypos if I don't eat the carbs.... My team only work two days a week but I am hoping to speak to them on Wednesday. I never really know what to say though, they just look at me sympathically and tell me to eat more

Thanks all for your replies