I don't know where to start

[Hellbunny]

I don't even know where to begin. I can't cope with this anymore. I'm pregnant and i've had t1 for 3 years, recently come out of my honeymoon period so on insulin, i can't live normally, i'm ill with anxiety over hypos, its taking over my life. I'm 24 weeks along and my control has been horrendous since i've found out i'm pregnant, my hba1c was 5.9% before i found out but as soon as i was pregnant its like my pancreas gave in so i ended up on insulin.
Morning my readings are between 8-10, i can;t lower them because i go low in the night, the dawn phenomenon is pushing them up but other than the pump i've no idea how to get around it. i can go to bed with a reading of 7 and test at 3am and its in the 5's, but then it ends up high around 6am.

I'm supposed to keep my 1hour post meal readings below 7.8, they're all between 10-15. I'm purposedly pushing them up to prevent a hypo. DSN has told me to test at 2 hours and aim for less than 7 but i can't even do that without panicking and testing 25 times a day.
I can't go out alone with my kids now incase they run off/someone takes them if i pass out from a hypo.I can't sleep properly for fear i won't wake up. I need to get this sorted but i've no support and i can't keep complaining to my partner.
I'm only young (22) so i want to get this sorted, i want this baby to be healthy but at this rate he won't be because of my levels.
I can't deal with the fear of hypos anymore, i'm making myself ill from panic, my heart just races all the time i'm awake due to panicking. I can't see no light at the end of it all. I know i just need to get a grip and stop panicking but i don't know the difference between a hypo and anxiety because my symptoms are the same.

 

[Hellbunny]

I just need a kick up the rear with it all, its probably hormones making me think its worse than what it is, i just pray my kids don't get it. Does anyone have any advice on combating the Dawn phenomenon on injections? Also in terms of foods, i know about low carbing but i can't do it fully whilst being pregnant, i get the starvation ketones and i know its not good, plus i've zero energy and feel i need some toast/carbs to get me through the day as my little boys are only 1 and 3 years. I could really do with a diet/meal plan that won't shove my sugars high, but isn't extremely low carb. I seem to get on okay with pitta breads and burgen bread.

What seems to be happening is when i've had my levemir at 9pm, i get a hypo 1-2 hours later, so i have to eat some toast before bed which pushes me up to around 12mmol, i don't want to be going to bed so high though! Yet if i lower the levemir i wake up even higher.

 

[Dillinger]

Hellbunny,

Your last HbA1c is exceptional! I would say that fewer than 5% of Type 1 diabetics get that sort of control. It is really excellent.

But for the moment you need to calm down; breath!

The raised morning blood sugars could be dawn phenomenon but they could also be because your basal/bolus is a bit off; the exact thing was happening to me - what solved it was to take less short acting with my evening meal and more long acting. That meant I was not going too low before bed and was waking with a good stable morning level; have a think about that.

Are you carb counting? If not you need to get on a course as soon as possible; speak to your diabetes team and insist that you go on a DAFNE course.

The other thing is that anxiety is real and is not something that you can just ignore; you need to deal with it and I would strongly suggest that you speak to your GP about it. Hypos are unpleasant and a pain but you shouldn't be in mortal fear of them. If you are scared that your sleeping levels are unpredictable perhaps you could try and get your diabetes clinic to let you have a constant glucose monitor for a few days (they won't give you one for much longer alas) but it might help you get a handle on things?

A way to move further away from hypos whilst maintaining good bloods is to reduce the amount of carbohydrate that you are eating (and the insulin of course) that way you don't get the swings, I think it is not a good idea to run high whilst pregnant though.

Lastly, you can cope with this and there is a light at the end of the tunnel; that is you and your baby in great health.

Best

Dillinger

 

[Pilgrim22]

Hellbunny, you could also try splitting your levemir in half, one half am and one pm, keeping them twelve hours apart. Let your DNS know you are doing this first though. Get your base levels steady first before trying to change your bolus. This way you avoid the hypo peril.



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[Hellbunny]

Thanks so much, i do feel like i over react abit at times, its probably pregnancy making me a wreck! I just feel guilty for having bad levels as i know they are detrimental to the baby, so i guess i beat myself up over it when it doesn't go right. I currently take 10 units before bed, if i don't snack before bed i drop, but when i do reduce it i wake up high in the morning. I've spoke to my DSN about a pump but she doesn't seem to think i need one just yet, and we can sort the morning highs out without one, i'm still early on with all of this so i understand those who have had this longer/or young children deserve the pumps more than me, so i'm willing to play around abit on the injections first!
In terms of breakfast, burgen bread and peanut butter or cheese works well, it keeps me ticking around the 5mmol mark 2 hours later, so thats something :lol:

This bedtime thing is driving me nuts though, how would i go about splitting it? I've seen people do this on here but my requirements are more so first thing AM, if i do a fast day (which i haven't for a while due to being pregnant and hungry :mrgreen: i will go low off my basal around 2pm in the afternoon, so although levemir doesn't last as long as lantus, whilst i'm still early on with all of this i think it stays in me for quite a while, as yesterday i skipped my evening meal, i still went low off the levemir around 6pm.

 

[Hellbunny]

I should of added, i did a carb counting course a couple of months ago, but in pregnancy its difficult as the ratios keep going up, one day i can eat something and be normal 2 hours later, the next day i will get a reading of 13 afterwards, it just feels like theres no pattern at all

 

[Hellbunny]

Was 7 after evening meal, had my levemir with a piece of toast and now 11.5, what I can't understand is why go to bed high, they keep telling me to eat before bed to prevent a drop in the night but to make sure my fasting is under 6, I don't know how to go to bed normal And wake up on target, it just doesn't seem possible? Last night I went to bed on a 7, and woke up on 7.6 which means to me the basal is right but it's not below 6, thought if I increase my basal I will drop in the night (as I tend to be at the 5mmol mark around 3am) sorry if that's aload of codswallop!

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[hale710]

Was 7 after evening meal, had my levemir with a piece of toast and now 11.5, what I can't understand is why go to bed high, they keep telling me to eat before bed to prevent a drop in the night but to make sure my fasting is under 6, I don't know how to go to bed normal And wake up on target, it just doesn't seem possible? Last night I went to bed on a 7, and woke up on 7.6 which means to me the basal is right but it's not below 6, thought if I increase my basal I will drop in the night (as I tend to be at the 5mmol mark around 3am) sorry if that's aload of codswallop!

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This confuses me too. My DSN says not to go to bed below 8 without eating. Which means if I'm at 6 I have a slice of toast and wake up at 8.5 or something! If I don't eat before bed though I don't drop by more than 0.5 so personally if I'm above 6.5 I ignore her and don't eat. Otherwise my hba1c will never improve! I've tested through the night and I definitely don't drop

 

[Hellbunny]

It's confusing isnt it, I even went on a dafne style course and they said then not to eat before bed as it will put bs level up and its better to keep the basal ticking right and we should wake up within 1mmol either side,

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[hale710]

Yeah that makes more sense to me! I've only been diagnosed 3 months so I'm not on DAFNE until November so I'm reluctant to not do what my DSN says, but my levemir seems perfect dose for me and it just doesn't make sense to eat!

 

[Faith*]

Last night I went to bed on a 7, and woke up on 7.6 which means to me the basal is right but it's not below 6

This sounds like you do have the basal spot on. I think that if you know a routine that does work for you then carry on doing that i.e if you don't want to eat something before bed and think you will be ok then go for it. Your DSN is just offering her advice through other diabetics experiences. I can't get away with a bedtime snack as I tend to go high over night.

You sound like your doing really well though, don't worry too much as your sugars will go up too. As Dillinger said, just breathe and your Hba1c is amazing, that's what they're mainly looking at during pregnancy. I'm sure your little one will be a gorgeous healthy blue eyed heart throb xx

 

[Hellbunny]

Thanks everyone x
Last night i went to bed on an 8.2, this morning was 7.6, higher than what they want in pregnancy but its the stinking Dawn phenomenon pushing me up, so i guess theres not much i can do about that being on injections.
Levels much better today, yesterday was just a bad day i think and i hadn't slept much the night before, i'm due another hba1c soon but the 5.9% one was in october, i know for a fact its gone up! ahh hopefully the next one i have done with be back in the 5's!

 

[nixiepixie]

Good luck hellbunny! I hope things get easier for you soon xx

have to say it's comforting though to see other people struggling with this crazy disease as much as me. i've been T1 diabetic for the last 24 years and feel like i've never got a grip on it. However, i always felt like i was on my own in that and everyone else was perfect and had it all figured out!