Help!

[Celiarose]

I’m quite new to this forum. Hi everyone!
I’m type 1, 34 years old and 5 weeks pregnant. I’m really struggling with the targets given to me by my DSN, especially the one hour post meal target of less than 7.8. As a result I am currently having at least 2 hypos a day, often more, even tho still having a few spikes at 11/12 as well. I really struggle to understand how you are supposed to achieve that one hour target when you still have around another three hours of active insulin in your system. I use a pump and a Dexcom CGM. Just wondered really if anyone had any suggestions. Perhaps I need to completely change how I eat, eat less and higher GI index?? I am trying to bolus about 20 mins before every meal but that’s not always practical especially when at work. I’m already worried about how this is affecting baby’s development.
Many thanks in advance for any suggestions
C x

 

[himtoo]

hi there lovely @Celiarose
welcome to the forum !!

sorry i can't help with the pregnancy stuff---

I am tagging
a few friends to come along and say hello and hopefully offer some support
@claire1991 , @Juicyj , @AmandaD ,

I really hope you are coping and i am sending all my best wishes for you , and your baby and your family
[[hugs]]
himtoo
x

 

[leahkian]

You need to sit down with your DNS and tell how worried you are, have they not gave you a chart of foods and how much insulin you need to take for each meal? All so being worried can effect your BS so if they have gave you a some thing to test your BS if they have, then right down everything that you have ate, how much insulin you have taken and a record of all your BS incuding hypos to see if you are having them at the same time.you will have spikes now and again but 11/12 is not bad but like i said try to stay calm, i know is easy saying it than doing it. Hope your DNS can help you

 

[claire1991]

I’m quite new to this forum. Hi everyone!
I’m type 1, 34 years old and 5 weeks pregnant. I’m really struggling with the targets given to me by my DSN, especially the one hour post meal target of less than 7.8. As a result I am currently having at least 2 hypos a day, often more, even tho still having a few spikes at 11/12 as well. I really struggle to understand how you are supposed to achieve that one hour target when you still have around another three hours of active insulin in your system. I use a pump and a Dexcom CGM. Just wondered really if anyone had any suggestions. Perhaps I need to completely change how I eat, eat less and higher GI index?? I am trying to bolus about 20 mins before every meal but that’s not always practical especially when at work. I’m already worried about how this is affecting baby’s development.
Many thanks in advance for any suggestions
C x

Congratulations on your pregnancy!

Are you certain it’s 1 hour after eating? I’ve always been told it’s 2 hours after eating, one hour seems ludicrous to me!

Are you seeing a diabetic pregnancy clinic as well as your DSN?

You may find that during the first trimester you will hypo a lot. It’s very daunting at first and is tough but it does pass. I spent most of my first trimester hypo but it was better in the second.

I would definitely book another appointment with your DSN to talk about how you’re feeling and your concerns, they should be able to put your mind at ease over a few of these things. Even if it’s just a phone call to them.

Hope it gets better soon xx

 

[catapillar]

Are you certain it’s 1 hour after eating? I’ve always been told it’s 2 hours after eating, one hour seems ludicrous to me!

Here are the NICE guidelines for targets during pregnancy:

• >5.3 fasting
• >7.8 1hr after eating
• >6.4 2hrs after eating

https://www.nice.org.uk/guidance/ng3/ifp/chapter/your-blood-glucose-levels-during-pregnancy

@Celiarose what advice have you had from DSNs re diet and bolusing? You might find lower GI could help or adding fat could slow down the rise from carbs, or things like "super bolusing" are apparently popular management techniques for pumpers in pregnancy: this is where you turn basal off/down for a couple of hours and give the insulin lost from the basal on top of any meal time bolus, so it gets working faster to avoid the post prandial rise but avoids subsequent hypos because you've knocked the basal down.

 

[Celiarose]

Thanks- that’s really helpful. Will have a go at super bolus. I’m seeing diabetes team next week as well as obstetrics so hopefully will get some help then.
Following week I am working nights so anticipating more problems (sorry for sounding so negative!) but will have a chat to them about that next week too.
Thanks again x

 

[AmandaD]

ah the joy of the targets in pregnancy... it is doable but so hard... try the different boluses on your pump, square and dual and really try and steer clear of the high gi foods...add more fat and protein to try and lesson the rise after eating. I was pretty much hypo for most of both my pregnancies HbA1c got down to 5.1% first trimester was the hardest as well as the last three to four weeks. Try reading sugar surfing it really involves getting to grips with ur cgm data and watching exactly how each food is affecting ur blood sugar. I found I couldn't eat bread, cereal potatoes anything like that. Everything had to be very low gi food. My carb ratios were also changed on a weekly basis as were my basal rates. I ended up on a 1:1 ratio at the end of my first pregnancy 15 units for a small banana!!! Pregnancy and type 1 is tough but its doable and the end result is totally worth the insane lows and constantly checking!! Wishing you a healthy and happy pregnancy xx

 

[AmandaD]

oh its an hr after eating when pregnant and then at 2 hrs you have to be back to what you were before tis a nightmare