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Pregnancy and abroad!

L

LunaLG

Active Member
Relationship to Diabetes
Type 1
Hello,

I am currently 7 weeks pregnant and am living temporarily abroad (in Australia). I was due to fly home today but am having to postpone for at least a few more weeks as I have had some small internal bleeds that are being monitored.

As my diabetes team is in the UK, I feel a bit like I am winging it with my BG management; I can’t get put under a diabetes team here unless I plan to have the baby in Australia, which I don’t! (Though they have been fantastic monitoring the actual pregnancy).

I’m on MDI and have managed to keep my BG within the 3.5-7.8 range for about 80% of the time since finding out I’m pregnant (I found out 3 weeks ago). My hba1c is around 40 and I’ve been on 5mg of folic acid for several months, so I think I’m doing as much as I can right now (the pregnancy wasn’t entirely unplanned but we definitely didn’t expect it to happen as quickly as it did).

I am now starting to experience the sudden hypos; initially I had to up my background insulin but now I literally only need one unit of levemir overnight otherwise I’m dipping too low. I am also potentially looking at adjusting my insulin wait time; I’m on Novorapid and usually wait around 15 mins before eating, but I’m finding if my BG is already under 5 then I need to eat sooner.

If there is anything else I should be thinking about at the moment that I’ve not mentioned, advice is much appreciated! My diabetes team at home know but won’t really offer me any support until I’m back.

Have changed my username on here for this post as my family don’t know I am pregnant and I think they sometimes browse the forum!!
 
It sounds like you’re doing everything right @LunaLG Congratulations on your pregnancy 🙂 Do you have a Libre? If so, setting your Low alarm at a higher number will help you spot impending hypos. As you’ve probably found, pregnancy hypos can come on very fast and quite fiercely. Have hypo treatments everywhere so you always have some in reach. I found liquid ones worked best. I used Lucozade but they’ve messed that up now, removing too much sugar, but there are also Lift Gluco Shots if you can get them in Australia.

I had to reduce my basal by 25% early in pregnancy. I also found I had to eat between meals to keep by glucose up at certain times of the day. This is quite normal in pregnancy due to the strict post-prandial targets. Yes, bolus with your NR at times that work for you, not by a random rule. Have you had any nausea yet? Be prepared for that and get some bland foods in.

Edited for clarity - eat between meals without a bolus.
 
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Thank you!

Yes I’ve got my Libre and luckily I brought loads of spares with me, so I have enough to last me until my second trimester if I need to stay here until then!

The nausea is just starting to set in the past two weeks, I’m finding that snacking on apple slices and ritz crackers is getting me through so far. It’s definitely worse if I don’t eat so I’m trying to have small meals with snacks in between - I’ll definitely try not to bolus with the snacks as per your suggestion as I think that will help with my hypos.

I’ve run out of dextrose tablets and the glucose tablets in Australia are awful!! I’ve been using fruit pastilles and orange juice as my hypo snacks; but I think I can get liquid glucose shots as per your suggestion so I will try that also.

It’s reassuring to hear I’m generally on the right path so thank you for that - it’s a bit daunting to have a first pregnancy let alone having it abroad!
 
Sounds good @LunaLG 🙂 Yes, not eating can make the nausea worse. Because of my lower sugars, I sometimes found I could suck a small fruity sweet to relieve the nausea and that that kept my blood sugar ticking along nicely. With the snacks, I found I had to keep a close eye on my blood sugars after meals, particularly lunch, so that I could see them dropping. I’d then eat a small snack, keep watching and then add some more snack if needed (without boluses) That’s what pregnancy control is like - lots of little taps this way and that way to stay within the strict limits as much as possible.
 
Congratulations.
Sounds like you're doing everything right!
I hope the bleeding stops soon and the hypos get better. All the best x
 
Thank you @Lauren - it’s a bit like learning diabetes management all over again I feel!

My UK team did call me and advised me not to eat until my sugars are less than 5.3; I did this for two days and oh my gosh - this approach made my hypos insane! So I’ve stopped doing this and if my BG is under 6 I’m pretty much bolusing right before I eat, or if it’s over 6 I’m waiting no more than 15 mins to eat. This seems to be working far better. I’ve also halved my correction doses (when I do need them) and that seems to have helped.

I agree with your analogy of lots of little taps @Inka - I’ve also taken your advice with the sweets and am enjoying drip feeding myself fruit pastilles throughout the day - this is also really helping my cravings for sweet things!

Thanks both for your advice and hopefully at my check in scan in two weeks the bleeding will be looking better and I can fly home to my proper healthcare team 🙂
 
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