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Insulin values early pregnancy

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mrsnnm

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Type 1
Hey everyone. I am currently 7 weeks pregnant. On apidra and lantus with a dexcom one monitor. Today my bloods have been all over the place high after lunch today and then after injecting to self correct, came rocketing back down. Treated blood low now high again! High numbers of 16-18! Im so tired and drained. I increased my lantus a few days ago. Do i increase my meal ratios from 2:1 to 2.5:1? Advice needed please, thankyou
 
Welcome @mrsnnm and congratulations 🙂 I had highs early in pregnancy. Be warned - they then quickly swapped to lows and I had to reduce my insulin. I increased my basal to deal with the highs. I see you’ve already done that, so that’s good. Have you been offered a pump for pregnancy? Have you been offered a Dexcom G6 or G7?

Are you confirming the lows by fingerpricking? To stop rebound highs, it helps to be strict about hypo treatments. I used Dextro tablets and stuck to a ‘dose’. If you’re high two hours after a meal, I’d correct but do this cautiously to start with until you’ve worked out what was going on. Do you have a half unit pen?
 
Hey lovely, thankyou so much for your reply i will keep with the meal ratio increase. And i haven't been offered a pump yet as my first appt with midwife is in 2 weeks time. Is a pump helpful? I am on a dexcom one meter (cgm). No im not confirming with fingerpricking, it has been with the cgm to confirm the lows. I used the same hypo treatment as usual - 4 jelly babies and 2 biscuits (20g carbs) so couldn't quite believe the spike i do not have a half unit pen. Just full single units.
 
A pump does help for a number of reasons. Firstly, you can get your basal insulin much closer to your needs - that’s a massive benefit. Secondly, it’s easy to do basal increases, either temporary (for a few hours) or longer term. You can also wear the pump during delivery. In addition, the pump allows you to bolus more precise amounts for your meals, eg 5.25 units and to do tiny corrections as needed - ie little nudges. All just a few button presses.

All lows and ‘funny’ results from a CGM should be confirmed with a fingerprick. It’s possible you weren’t as low as the One said, so shot up high. You might have to adjust the way you treat hypos in pregnancy - perhaps have less glucose/carbs at this stage.

When you have your appointment, you could also ask if you could upgrade your Dexcom. Have a think about what you’d want before your appointment so you have a good idea when they ask you. I also found it really helpful to take a list of questions to my first appointment. It makes it more organised and makes sure you don’t forget anything, which is easy to do!
 
I am a little worried about having a pump is it all very fiddly with the tube in you and how that happens...like it kinda scares me as i don't know much about it from what you are saying, it does sound useful!
That is a good point, i will also carry my meter with fingerpricking so i can double check my lows. I will also adjust my treatment, maybe one biscuit and not two?
Thankyou so much for your advice, it is really appreciated i will definitely get a list of questions together, i have a couple in mind
 
No, it’s not too fiddly. I’m the clumsiest person I know and I manage a pump so I’m sure you could too 🙂 I noticed the tube the first few days but then you get used to it and are so pleased with the results that you forget it. I don’t notice my pump at all. The cannula is tiny and very short. I can’t feel it at all. The tubing runs from the pump to the cannula, but it’s not visible. It’s under my clothes. I’m not aware of it at all. It’s very thin, transparent tubing. Having the pump and knowing it’s programmed to give me the basal I need over each of the 24 hours is fantastic. During pregnancy, it’s also nice not to have to do injections because, as you’ve found, pregnancy can mean lots of corrections.
 
You've put my mind at ease a little about the pump...how is it inserted first of all? As i have heard a few horror stories and it really has put me off overall it does sound more useful than a hinderance in pregnancy
 
The pump is just like a little mini phone size-wise. You can wear it in a soft belt, in your pocket, etc. The only bit that goes into you is the cannula. They’re usually made of Teflon and are very small and short. They’re inserted with a introducer needle, a bit like a CGM, which is then removed, leaving only the tiny, thin Teflon bit under the skin attached to a white sticky bit - again very much like a CGM, except the CGM has a filament whereas the cannula is a tiny tube that the insulin comes through.

You change the cannula every 3 days, which just means ripping off the white plaster bit and the tiny tube comes out with it. Less of a nuisance than removing a CGM sensor.
 
The way you explain it doesn't sound so bad at all. But where i assume the cannula is in your tummy, does it not affect baby?
 
mrsnnm said:
The way you explain it doesn't sound so bad at all. But where i assume the cannula is in your tummy, does it not affect baby?
Click to expand...

I put the cannula in my thigh. You can use your tummy, thigh or bum, but it’s hard to turn round to reach your bum when you’re heavily pregnant :D
 
mrsnnm said:
why did i think it could only be your tummy?
Click to expand...

They tend to start people off on their tummy, like they do for bolus injections, but, like injections, it’s best to rotate pump cannula sites and use more than one body area. I don’t think I could have stomached sticking a cannula in my tummy when I was pregnant (excuse the pun!) but some women do. I found the thigh much better.
 
mrsnnm said:
why did i think it could only be your tummy?
Click to expand...
You do know that you can inject your insulin into other areas not just your tunny don't you? Thighs, buttocks and arms are all recognized sites for injection. I use my buttocks for my morning basal insulin, my tummy for bolus and corrections and my thighs for evening basal and occasionally my arm if I am out for a meal and wearing a dress which makes my tummy inaccessible. Tummy and arms tend to absorb the quickest which is why I use them for bolus insulin and thighs and buttocks are usually a little slower so makes sense to use them for basal for me
 
I rotate my infusion sets between my thighs, lower back and upper outer arms (above my CGM). I didn't find my stomach comfortable for infusion sets.

I would think that thigh would be easiest to get to for applying and disconnecting. I sometimes need an extra hand disconnecting from my upper arm and I can imagine lower back would be hard to reach while pregnant.
 
Inka said:
They tend to start people off on their tummy, like they do for bolus injections, but, like injections, it’s best to rotate pump cannula sites and use more than one body area. I don’t think I could have stomached sticking a cannula in my tummy when I was pregnant (excuse the pun!) but some women do. I found the thigh much better.
Click to expand...
I completely understand what you mean, thankyou
 
rebrascora said:
You do know that you can inject your insulin into other areas not just your tunny don't you? Thighs, buttocks and arms are all recognized sites for injection. I use my buttocks for my morning basal insulin, my tummy for bolus and corrections and my thighs for evening basal and occasionally my arm if I am out for a meal and wearing a dress which makes my tummy inaccessible. Tummy and arms tend to absorb the quickest which is why I use them for bolus insulin and thighs and buttocks are usually a little slower so makes sense to use them for basal for me
Click to expand...
Yes i did, but didn't realise that your arm is for quick absorption, so thankyou
 
Finn said:
I rotate my infusion sets between my thighs, lower back and upper outer arms (above my CGM). I didn't find my stomach comfortable for infusion sets.

I would think that thigh would be easiest to get to for applying and disconnecting. I sometimes need an extra hand disconnecting from my upper arm and I can imagine lower back would be hard to reach while pregnant.
Click to expand...
That completely makes sense, thankyou
 
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