Waiting to start..

[Jg91]

Hey, I'm reaching 31, on CGM and have been attending prenatal clinic appointments for coming up to a year. I feel like I'm getting no where. I'm so desperate to start trying for a family with my husband but feel like I keep hitting brick wall after brick wall. My hbA1c is currently 73mmol (8.8%), at the start of the journey I'd managed to get it down to 63mmols from 80mmols and then got told not to start trying as my time I'm range wasn't enough which really knocked me down and I've spiralled since. I would really appreciate any tips on getting my hbA1c down and when realistically others have started trying?

I'm so down about it and I just want to start my family

 

[EllieM]

What are your team doing to help you? Have they offered you a pump, and would you want one if they did?

My pregnancy days were pre-cgm so they just wanted a good hba1c (or fructosamine). What are they after as regards TIR and what is the range in that TIR?

Lots of virtual hugs. Hopefully you'll be in a better place soon.

 

[Marie 2]

First make sure you have the right basal rate. If your basal rate isn't right then your other calculations will be off.

I find timing of my prebolus is one of the best keys to control. I prebolus 1/2 my dose 30 minutes before I eat for most of my foods. With some adjusting made to what food I eat (like high fat I dose closer to eating). That works well for me because the second dose after I eat is adjusted to what I actually ate. 30 minutes is too early to prebolus for some, I have a friend that was complaining about how high she was going before her levels would start dropping, but if she prebolused 30 minutes before she dropped too much. For her what ended up working is a half of her dose 20 minutes before she eats. She is super insulin sensitive with a super low fat diet. (Mastering Diabetes)

You can do it! It does take some work. Just start taking some small steps and when they work refine it!

https://integrateddiabetes.com/basal-testing/

 

[Jg91]

What are your team doing to help you? Have they offered you a pump, and would you want one if they did?

My pregnancy days were pre-cgm so they just wanted a good hba1c (or fructosamine). What are they after as regards TIR and what is the range in that TIR?

Lots of virtual hugs. Hopefully you'll be in a better place soon.

My nurse is seeing me monthly and helping me making little tweaks to adjust (ratios and carb counting etc). TIR needs to be 70%, mine sits around 45% - it's the variations and quick changes in your glucose and the spikes that are harmful and they want a lovely straight ish line!

With regards to a pump I had asked about it but they don't think I'm suitable currently and to be honest I wouldn't want one if I don't have to have one

Thank you x

 

[EllieM]

Hmm, how confident are you in your basal rate? I find things a lot easier to manage when that is right.... (I've been offered a pump but prefer to manage without if at all possible). Unfortunately my basal rates are a bit variable so I do have to be prepared to tweak the basal dose as well as my bolus.

I can have several days with perfect (ish) levels, followed by a day or so where they refuse to go anywhere I want them to be, seemingly for no obvious reason, so I can empathise with your situation. How long have you been T1 and how long have you had a cgm? I find it a massive help but it does take time to take maximum advantage of it and it also takes time to learn to have the confidence to tweak your own doses to prevent highs and lows.

 

[Jg91]

Not long switched to twice a day basal insulin, currently seems fine. Levels seem to be absolutely perfect until I start eating so I feel like it must be my ratios that are out. I've been T1 for 11 years, diagnosed at 19 and on CGM consistently for coming up to a year. I have the mentality of 'I will if I must'... been seeing a psychologist the last 5 weeks and my relationship with diabetes is poor at best!

I really appreciate both of you responding! I've been having a read of that link Marie 2 sent!

X

 

[Marie 2]

They have a nice calculating insulin dosing chart you can enter your information onto. A pump, a smart pen, or some aps do the same thing for you. The group was started by Gary Scheiner who wrote Think Like a Pancreas, an excellent book. He is really well respected in the diabetic community.

But I am really wondering if working on your timing will help. I have found for me that once I pass a certain higher number, it takes more insulin to bring down those numbers and you stay stubbornly higher when you are there. And then sometimes you rage bolus because you don't seem to be dropping trying to get BG's levels to come down, and then you end up dropping too much. I think it's much easier for me not to reach those numbers in the first place. It takes less insulin and if your timing is close (of the right dosing) you don't usually go too high or at least don't stay there and then also don't end up going too low because you added more insulin.

Always make small adjustments when changing what you dose.

 

[Jg91]

They have a nice calculating insulin dosing chart you can enter your information onto. A pump, a smart pen, or some aps do the same thing for you. The group was started by Gary Scheiner who wrote Think Like a Pancreas, an excellent book. He is really well respected in the diabetic community.

But I am really wondering if working on your timing will help. I have found for me that once I pass a certain higher number, it takes more insulin to bring down those numbers and you stay stubbornly higher when you are there. And then sometimes you rage bolus because you don't seem to be dropping trying to get BG's levels to come down, and then you end up dropping too much. I think it's much easier for me not to reach those numbers in the first place. It takes less insulin and if your timing is close (of the right dosing) you don't usually go too high or at least don't stay there and then also don't end up going too low because you added more insulin.

Always make small adjustments when changing what you dose.

I'm trying to take my insulin 15-20 mins pre meal, one day worked perfectly the next day it wasn't enough and it was the exact same food its such a battle constantly, but I keep trying! Maybe I'll have to do it 30 mins before x

 

[Marie 2]

Unfortunately other things can play a part in what works. I like to judge it’s working if it works a majority of the time without a bad result of going too low. But even being more tired or stressed or exercise earlier in the day or even intense exercise the day before can play a part in how you react. So if it worked perfectly one day that was good. I would try the same thing again to see whether it works before making a change yet.

All you can do is try. One step at a time.