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High morning readings!
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<blockquote data-quote="eabhamurphy" data-source="post: 1753354" data-attributes="member: 21358"><p>Hi! </p><p>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?) </p><p>Alternative to that is splitting the dose so you have peaks where you need them. </p><p>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. </p><p>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! </p><p></p><p>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. </p><p></p><p>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. </p><p></p><p>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! </p><p>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. </p><p></p><p>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. </p><p></p><p>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. [emoji173] </p><p></p><p>XxX</p></blockquote><p></p>
[QUOTE="eabhamurphy, post: 1753354, member: 21358"] 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. [emoji173] XxX [/QUOTE]
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