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High morning readings!

BAZ-ANDREWS

Member
Messages
9
Hi Guys,

I wasn't sure where to post this question as there are so many threads, but i'm sure one of you lovely lot will be able to help me or nudge me in the right direction!
I've recently found out i'm pregnant with my first baby (yay!) im very excited, however i've been waking up in the mornings with really high readings around 14 (!!?) but i've been going to sleep (around 9/10pm and taking my 24u Lantus) with readings between 5-7 and it's left me totally baffled!
I eat 3 good meals a day but I try not to eat anything after my dinner at around 7pm, should I maybe try and introduce a snack just before bed as i've heard this can really help?
I understand insulin needs can lessen or increase when pregnant which i've been fine with altering during the day as I can test regularly, however it scares me to wake up with such high readings after being asleep for hours. I'm only 5 weeks pregnant so i'm very cautious of the effects that high sugars can have, any help or advice is really appreciated!

Thanks! x
 
Hi! Congratulations!
I used Lantus throughout my first pregnancy. I'm currently 26 weeks with baby#2.
What are your daytime readings like, mainly before meals and 2 hours after?
Are you experiencing any hypos currently?
What is your most recent HBA1c?
My issue with Lantus was that I had hypos if I took enough insulin to avoid the highs.
Xx
 

Hi, thank you!

I’m not finding the day time too tricky to stay in range, after meals it varies from 7-5 depending on if I do it one hour after eating or two. Before eating usually 4/5’s.
I’m definitely experiencing more hypos than I normally would, I guess from all the additional insulin my body is needing sometimes I don’t get it spot on. I also like to exercise which is proving a bit trickier with the extra insulin in my system.
Most recent hba1c was 7.3 so not the best it could be but I’ve had tighter control since then. My next is in two weeks so hopefully I’ll see a nicer number!
If you don’t mind me asking how did/does your insulin needs change with your pregnancy? And do you have and tips/advice?
I’m so excited but it’s so daunting too!

Thanks
 
Hi!
So my thinking would be if you are in range during the day then adjusting the time you take the Lantus so that it peaks at your time of highest insulin resistance (probably 1-3am?)
Alternative to that is splitting the dose so you have peaks where you need them.
Obviously this is just what I was told to do in my last pregnancy and you should definitely speak to your diabetes team to see what they would think is the best idea. A different insulin like Tresiba might suit you better. There are definitely solutions to combat your morning highs. You just want to not introduce any more hypos in your efforts.
What time so you take your Lantus now? I struggled to remember the split dose in my last pregnancy if that is something they suggest.hopefully you are a more organised woman than me!

My insulin requirements in this pregnancy, now I'm on a pump, have at least doubled so far. My lowest infusion rate is now 0.950/hr and pre pregnancy and early pregnancy this was 0.350/hr. In early pregnancy I got a drop in requirements. Each person is different. I must say my requirements did not increase to this extent on MDI but I've always had a bit of a 'hypo happy' disposition (which is very dangerous when you lose your hypo awareness in pregnancy) that gets me in trouble with my consultant. So in keeping my Lantus dose high, I was constantly battling hypos, all day long. If I lowered it then I would get highs and that stressed me out no end so I upped the dose again to the same results. So it was not good in my case.

Anyways currently I find I have highest insulin needs at 12-3am. My carb ratios has gone from 13g:1 to 3.5g/1u in the morning and less dramatic changes the rest of the day but still bigger than before. Total insulin has gone from 20u/day to about 35-40u. HBA1c is 36 (5.4%) but I've been told this is 'too tight' and I need to 'chill out' see my reference above to being hypo happy and you'll understand where they are coming from.

I've also dropped my carb consumption to about 70g/day from about 200g/day. As I write this I realise my insulin requirements have actually already well more than doubled!
Make my own low carb breads, scones etc is the only way I do lower carb. I need at least the illusion of bread, be it low carb. Hospital are totally unsupportive of lowering carbs in pregnancy btw as they say the evidence doesn't support it and it could be risky. I argue that I'm still eating 70g a day if not a little more so it's hardly the Atkins diet. I cannot get anywhere close to recommend numbers after meals if I eat carb heavy meals. Doesn't work for me.

My major piece of advice would be: loss of hypo awareness is sudden and scary. Outside of pregnancy I have clear and early warning signs, these went in pregnancy and it was seriously dangerous in my first pregnancy.

Diabetes is really full on in pregnancy, as it's in constant flux. Totally worth it though to have your lovely baby at the end.


XxX
 


Wow, thank you so much for such a lengthy and detailed response, it's really great to read all that information and see how different we all are and how our bodies and needs change so much when we're growing another human!
I currently take my lantus at around 9pm, if im right in remembering that it peaks around 6 hours after then perhaps i'll try taking it slightly earlier as i did a 3am BG check the night before last and I was already showing a high reading by 3am.
I've never been hugely keen on the idea of a pump or CGM as the thought of having something constantly attached to/in my body doesn't sit right, but in this case I can see that they're so helpful and probably completely worth it so i'll mention it to my team for sure.
I also have been low carbing for the past few months, I initially wanted to do a Keto diet but i think the amount of fat that you are advised to consume wouldn't be good for my or my blood sugars as they have a delayed effect on BG, I try to stick between 70g-120g of carbs a day just to keep my bolus insulin on the lower side of things, especially now im having to increase so much. I do enjoy making the occasional 'keto treat' though which is normally some kind of mock cake/bread and contains a fair amount of fat.
I had no idea that awareness of hypos could decrease, but actually thinking of it the past two hypos I've had were much lower that normal before I felt anything - I'll keep a close eye on this.
I can tell the next several months are going to be extremely full on, especially with my job at the moment which I actually don't know i'll be able to continue if I want to be able to safely and regularly monitor my bloods. Either way I'm determined to do whats best for me and my baby, even when things are unclear and confusing!

Thank you
 
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