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Positive Result! Worried about post-food spikes. Type1.

Erin85

Well-Known Member
Messages
116
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

Not posted on the forum in a while, but found out last week that I'm pregnant obviously nervous and hopeful all will continue to be happy and healthy.

However, my main concern is my bg levels. I had a really good hba1c in Sept 2015 and was given the go-ahead to start trying to conceive. My husband and I decided to wait another couple of months, to let my body adjust to being off the pill, and we were very lucky to be successful in our second month of trying. My insulin needs increased over Christmas (ratios, rather than because I was eating more, so think my honeymoon was ending. This was pre-conception). I am now trying to understand my new needs for every meal, as well as trying to keep within targets for fasting levels and 2 hours post-food. My DSN has advised that these should be <5.5 and <7.

The majority of my fasting levels are within range (and I am correcting if they are not), but I'm worried about the 2hour post-food spikes. I am testing 2 hours after I finish my meal (I'm assuming this is correct, rather than 2 hours from injection?) and am so discouraged to find them high I have been told not to correct at 2hours, only 4hours after a meal, when my current insulin is out my system. Also concerned about bedtime readings. I am on Levemir once a day (before bed, and once a day because I am sensitive to insulin and DSN doesn't think I need a second Levemir).

My bloods the last 2 days have been:
Sat
B/f: 6.8 (with correction dose)
2hrs: 7.8
lunch: 4.9
2hrs: 5.3
dinner: 5.5
2hrs: 11.1
before bed: 6.9

Sun
B/f: 4.7
2hrs: 8.9
lunch: 6.9 (with correction dose)
within 2hrs: 2.0
2.4
3.0
4.8
dinner: 5.5
2hrs: 6.6
before bed: 7.6

Today
B/f: 5.4
2hrs: 8.4

I think I might need a bit of extra background insulin to counteract the bedtime highs, and an increase in breakfast dose and slight increase in dinner dose.

I know I can't really ask any of you for specific advice on my numbers and insulin, but I just wanted to share with you all (someone who understands) and maybe for some reassurance that these numbers are either ok, not harming baby, or can easily be rectified?

Thanks for reading the rant lol x
 
Hi honestly these aren't really bad just a couple of little spikes here and there. I would be fairly pleased (had 2 pregnancies).

First of all what point do you inject your bolus at meal time -before/during/after? Try 15 mins before and see what that does.
Also what are you eating? It was recommended to me to have low GI diet to try prevent spikes. It might mean having a snack 2hrs after to prevent hypo. I used to test half hour after a meal sometimes to see if I was on track. With corrections you can overdo it ie go hypo I assume that's why they so not to correct until 4 hours but I personally would (this works for me not necessarily others).

Have you tried an extra unit of levemir to help your morning sugars-what does it do? You could possibly try splitting it? I was on a pump with both pregnancies (for specific reason of wanting a family and having better control) so not an expert-others might be.

You are doing well-I know with mine any reading over about 8 and I started to worry but as long as you keep them in target for majority of time. It's all worth it xx
Ps test test test is the key (in my opinion)
 
Thanks @1Sarah1 !

I bolus before my meals. I will try and remember to inject 15mins before and see if that improves! I am willing to try anything to keep myself and baby safe and healthy. Although, if I need to give up my morning porridge, I might cry lol! I have tried a GL diet before (pre-diagnosis), so will go back to my cookbooks and refresh myself on what's what.

I had only been on 5 units of Levemir (resulting in a variety of results from 4.9 to 6.3), but have upped my dose to 6 the past 2 nights (resulting in a 4.7 and 5.4). I have never split my background insulin before (was previously on Lantus), but will speak to my DSN and ask her how I go about it.

It sounds like I'm similar to you in that I worry with any readings outwith target. I wouldn't normally be so strict, but I obviously want everything to go as well as possible.

Thanks so much for your input x x
 
these numbers are pretty good, so well done........

and yeah, experiment with the timing of your dose beginning at 15 minutes as @1Sarah1 suggested....

and congrats....
 
I would increase your levemir a little to help the night time highs this what happened with me , I split my dose over am and pm , also I've been told in pregnancy to test an hour after not two , good luck d
 
I'm on a pump, but I agree your numbers look pretty good, and once you get used to how pregnancy affects your sugars, you'll improve them even more, I'm sure

When I was pregnant, I had to significantly increase the time in advance I had my breakfast bolus. If you like porridge, you should be able to manage it with experimenting with bolusing in advance (when I used Humalog I had to bolus 45mins in advance in late pregnancy but always be very careful and move the timing gradually and with the utmost care). I ate a big bowl of granola mixed with all bran and could manage that all the way through with bolusing in advance and, later on, a big increase in my insulin to carbs ratio.

Spikes are a common problem. I had a number of spikes up to 11 or so and I used correction doses. As @1Sarah1 says, we can only tell you what we did, not give advice to you as you may be different, but I always used to test 90-120 mins after eating and corrected then if necessary. I then retested a number of times to check all was well.

Apart from my breakfast, I found my evening meal was the other place after which spikes could occur. I don't know if that's because what I ate varied more or my activity level was different or what, but it was something I kept an eye on. I always prefer to correct earlier rather than later in the evening, and experience showed me how my blood sugar was likely to progress, so I got more confident in spotting troublesome spikes ( as opposed to sugars that were a tiny bit out of range but would come down).
 
Thank you for all your replies and support. I injected 10-15mins before eating today (fasting: 4.9), however 2hrs afterwards, my bg level was at 11.2 today I have had a look online and think it might be because I have started mixing my porridge with pomegranate (usually blueberries), and it looks like they are much higher in sugar with a higher GL.

I also spoke to my DSN this morning. She is happy to have my Levemir at 6, still once a day, but increase my breakfast ratio (this was after I'd eaten, so will try that tomorrow). I asked her if this was harming my baby and she said no, so that is a bit of comfort. I had started trying to avoid carbs, to in turn avoid spikes, but she's told me not to do this, obv because baby needs carbs too.

So still a guessing game, but is so nice to know that I'm not alone in this and that you guys understand. I really do appreciate it x
 
Hi have you done some basal testing? Ie don't have any carbs and see if the spike is caused by the meal? Porridge is low gi not sure about pomegranate xx
 

Yes, don't be afraid of carbs - I was told they were necessary for pregnancy too (and breastfeeding). For me, it really helped to get my head round the idea that my insulin needs would increase A LOT by the end of pregnancy. Knowing this helped me adjust my insulin and, also, to realise that a high wasn't necessarily 'my fault' as my body was bathed in loads of pregnancy hormones and functioning in a very different way!

You could check out the carbs for pomegranates and incorporate that into your carb count maybe? I dont normally drink juice but during pregnancy I had a small glass of orange juice with my breakfast and my blood sugars stayed in range as long as I had my bolus at the right time. Just a case of testing lots.

Don't panic about the spikes. I know how scary it is to see them on the meter after having it drummed into you to keep your blood sugar in range, but I doubt there's any woman anywhere who hasn't had some spikes during pregnancy. Keep up the good work - and keep us updated as to how it's all going
 
Glad you spoke to her , yes I got told I needed 30g 50g and 50g carbs per b l d , don't worry about the spikes mine are spiking last week after great control x
 
Me and my wife, or should I say my wife are having the same issues, I really feel for her as she has always been so stringent with her testing and her carb counting but the last week (6th week of pregnancy, or at least we think?) she really has been struggling with high blood glucose. Today she has been 12 for the best part of the day and has continually been correcting but still no drop.

Before the pregnancy her levels were always managed and she had the odd spike but not to this degree. I feel for her as she has followed the nurses/consultants advice word for word, she wakes up in the middle of the night every night to test and correct.
I believe pregnant Diabetic women should get a medal as well as a baby at the end of your pregnancy, you all have to go through so much. Its not just the testing but also the worrying about the affects the highs have on the baby and to add to that all you have the hormone changes that the every day pregnant lady gets.
Erin your control seems tight and although you are having the odd spike you really do seem to be doing a great job, as I tell my wife you should be proud of yourself.
Although I'm not T1 myself it really helps to hear other peoples stories and its nice to know we aren't alone with our worries.
 
Hello, sorry for the late reply! I have been doing some basal checks (and the hypo's outwith the 4hr insulin injection supports that it's too high!) Have had my first diabetes pregnancy clinic and my DSN and consultant have helped work out new basal rate (which I have already reduced again), and new ratios for each meal. It's really reassuring to have the professionals tell you you're doing ok

Have incorporated the pomegranate into my carb count (actually not too different from the blueberries!), and trying to get a grip on my spikes. Sometimes no spike, sometimes huge, very hard to predict.

Thanks for the support @CTume sounds like your wife and I are quite close in our pregnancies, we reached 7weeks on Tuesday.

x x
 
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