Type 1 Too high

[C96]

Hello folks,

I've been reading through this forum for a while for help and thought I would join to help educate myself further to help my wife

My wife is 5 weeks pregnant she has had type 1 for about 9 years and hasn't coped well she ignored her diabetes and I've known her to have highs upto 30+
She has reduced her levels since we got married however she struggles to get help and advice from doctors and nurses she has spent a long time igoring it and pretending she doesn't have it

I really hope someone can advice me so I can help her better, she takes 14 units of levemir before bed and 14 units in the morning she takes novorapid before meals she will go to bed with readings of 6 and wake up and they will be 8+ she eats at about 8pm and takes levemir and checks her levels at about 11pm

What I'm struggling with mainly is figuring out her highs when she is trying her best yesterday she ate at 8pm her levels prior to this 5.5 she had lamb and virtually no carbs, everything was weighed and total carbs where about 10 grams when she checked at 11 her levels where 11.4
She is going on a daphne course next week, i hope that helps us but I would love some help and advice now as I feel every minute is important for us

 

[C96]

I forgot prior to dinner at 8 she had lunch at 12, her levels where 5.5 then when she checked at 8 they was 5.5 still I told her to eat something in between and not be fasting for 8 hours... however I'm not sure if that is correct as I don't understand why they are 5.5 and then high after she has eaten

 

[Deleted Account]

The DAFNE course should help with the carb counting and novorapid doses (bolus).
Depending on the trainers, it may help with the levemir (basal). However, the course I went in only focused on basal.

The reason I highlight this is because it sounds as if her basal dose is not high enough.
The basal mops up the glucose her liver drips into her blood throughout the day (and night). Typically, we use more of this when we are active: during the day. If she is not eating/fasting, her BG rise will be greatly influenced by her basal dose and whether it is enough (or too much) to mop up this glucose drip.
I would advise adjusting the basal with some guidance from her doctors. But bear in mind that although she takes it every 12 hours, it may last longer so making a change one day may take a up to a week to make a difference.
It is also worthwhile considering that the amount of glucose our livers drip is not consistent - it may change at different times of the day and often increases with stress but reduces after exercise and alcohol. I do not know what impact pregnancy has on this.

 

[catapillar]

My wife is 5 weeks pregnant she has had type 1 for about 9 years and hasn't coped well she ignored her diabetes and I've known her to have highs upto 30+

Pregnancy isn't the time to be ignoring diabetes. The targets for type 1 ladies during pregnancy are to keep fasting levels under 5.3 and to have blood sugar under 7.8 1 hour after eating. The targets are tight because high blood sugar levels create a risk of foetal abnormally and miscarriage.

A pregnant type 1 lady should be in close contact with her dsn adjusting insulin doses to keep within those targets when pregnancy hormones create changes in insulin sensitivity.

A pregnant type 1 lady should also be on high dose folic acid.

 

[C96]

Thank you for your replies

She's on 5mg folic acid from the hospital when that was finishing the doctor prescribed her 400mcg which you can actually just buy over the counter instead went to the first appointment at the hospital and they prescribed her 5mg again luckily she was still taking the 5mg one not the doctors lower dosage... controlling the basal rate is difficult because we can't seem to figure it out she has adjusted and then we are both getting upset when she eats and later it's much higher than what we calculated in the carbs.

 

[C96]

I've asked her not to let herself be hungry and try to eat every 4 hours having breakfast and lunch and dinner and in between having low carb snacks every 4 hours, I'm not sure if that is the right advice. She is only in her 20s and this is our first ever baby so we are both desperate now to get this sorted

I've looked into buying her cgm system and I've made her an app on her phone to record what she's eating what her readings are and what her insulin intake is but it's confusing me why she is going high after meals with virtually no carbs or she is taking the required insulin and sometimes it brings it down sometimes it doesn't..