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Type 1 and newbie Pregnant saying hello!

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Nemchenk

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Type 1
Hello, I am type 1, 11 weeks pregnant and struggling with doses and blood sugar. At the beginning, my blood sugars went crazy and high and I knew I was pregnant before the test showed positive because I woke in the night with a reading of 18.0! My Lantus went from 16 to 22. Several weeks later the story has changed...

Now most mornings I wake up low (yesterday 2.2 and today 3.4) and I have been dropping Lantus down a unit most nights - now it is at 12...how far down can it go before it has an effect on everything else? It doesn't seem to matter how much I snack before bed -in the morning it is all gone - someone is taking it all! 😉

I am on a 1:1.5 ratio of Novorapid with meals (taken about 15mins before) and sometimes hitting 12.0-14.2 at 1.5 hrs later. Then 2-3hrs later it usually drops right down again, sometimes hypo-ing.

I am cutting the carbs I eat to 100g max per meal (bread/pasta/rice) and have cut out yoghurt/fruit with dinner and save that for if I need something before bed. I am really worried that I am not hitting the targets for after meals but that if I increase the ratio to 1:2 I will end up with more spectacular lows.

I don't feel like I am eating properly at all. I tried a no-carb breakfast at the suggestion of the temp diabetic nurse and it still went up plus it made me feel pretty queasy. What should I be eating that won't cause a spike?
 
Hiya again 🙂 It's hard work, isn't it?!

What targets are you aiming at for post meals, & how long after eating are you testing? I'm wondering if it might be worth taking your injection a bit earlier before eating?...tricky I know, esp if you're getting morning sickness, but it might help. Otherwise I guess it's low GI foods like wholemeal stuff, oats, & (i think) basmati rice?? (u might want to double check the last one!). You'll probably find 'naughty' foods with fatty contents like pizza hit the system more slowly too, although they're not ideal (typical eh?!). Yoghurts should be fine, just be wary of the low fat ones as they tend to make up the flavour by packing them with sugar! I think temperate country fruits (apples, pears etc) are supposed to release more slowly too.

I think all you can do is try not to go crazy on corrections (whether high or low!) - my doc always says to get rid of the lows to get rid of the highs, & it's good advice!

All the best,

Twitchy x
 
Hiya

What some ladies have success with is to test every 2 hours and react accordingly at the time so take enough fast-acting insulin to stop the spike, then add a snack 2 hours later to avoid the hypo. Plus the injecting 20-30 mins before eating as twitchy has already suggested.

Don't worry that it isn't normal procedure, this isn't normal it's just while you are preg. Lows won't harm your baby, highs could. So just firefight. That's what you have to do except it usually isn't for 9 months. This is an exception!
 
Hi twitchy, hi trophywench! Thanks for all your good advice 🙂

Yes, can't believe it is 3 months already, feels like years!

I'll try injecting 20-30mins before instead of 15mins - bit worried about hypos before eating but I'll give it a go...

Seems the less I eat, the less I inject, the lower the spike. Today I had one slice of granary toast with chunky soup and it worked perfectly. (I had also gone for a walk after lunch too). How much carbs does a growing baby need a day? Always prefer basmati, and was told to go for multigrain bread which is my fav. Probably need to up the meal-time ratios and premeditate snack to avoid the hypos like you say.

The diabetic team at my hospital are looking for fasting blood sugars of less than 5.5 and post-meal (1.5hrs after a meal) blood sugar of less than 7.5. I bought a casio watch so I can set an alarm each time otherwise I forget.

The fasting score is not hard for me to do - low on waking every morning now (last night at 4.30am!) it is the after meal which is tricky. But having said that, I am not sure I am going to bed with enough sugar to make it through. Late dinners and early nights a bad combination. My hubbie has dinner when he gets home at 8pm. I get very tired before dinner and put off making it on time :( He also gets up at 6am weekdays and 10ish on weekends which plays havoc. I am trying to establish my own routine now. I know...gotta look after number 1 and precious cargo 😱)

Right, I will fix the hypos to avoid the highs. It's 'draining the swamp and fighting the alligators'.
 
Hello - I tried to reply to you the other day and lost the whole thing, so trying again.

There's a few of us in the grimness of first trimester at the moment (which I'm feeling strangely reassured by!) so I'll see what I can add.

I can only say personally, but with readings like that post meal I'd definitely be upping the ratio. The way I got thro my first pregnancy (I've got a 2y 9m son, and am about 8w with number 2) was to use a ratio that got my one and two hour post-meals in target, then snack to prevent a hypo. Not ideal, but it did work and helped with the nausea too.

I don't really dare inject more than 15min pre-meal, because I'm so uncertain at the moment of how much I'll actually manage to eat.

I started splitting my lantus in my first pregnancy, which helped with overall background coverage - can't think how we managed it, but my consultant was very helpful.

It's hard work, that's sure!
 
You are far better off eating 'little and often' rather than going for a heap 3 x a day - at the moment.
 
Hi Monkey, Hi trophywench 🙂

Thank you for your help, it is so reassuring to be able to talk with ladies who understand or who are going through the same situation. My family and friends do their best but no-one really gets what it is all about.

Just waiting for the grimness to stop now...woke up again before dawn with 2.6. Lantus down to 11 units now - there is going to be none left if I have to keep dropping it every night! I thought it was supposed to start climbing soon.

My diabetic nurse seemed to think the night hypos / fasting lows were to do with increased ratios at dinner but last night dinner was at 18.45pm so surely most of the Novorapid would have stopped working by 23.45pm?

4.3 @ 18.30 Before dinner
8.1 @ 20.00 1.5hr after
5.0 @ 22.00 Started snacking 3CPs
9.9 @ 23.45 Bedtime and Lantus

Perhaps I should have chosen a more sensible longer lasting snack, like cereals. I just don't know any more.

First scan tomorrow morning, wish me luck!
 
Oooh, enjoy the scan. I've got a viability scan tomorrow, so we can be nervous together!

I'd be tempted to try a smaller snack at 10ish and see what happens - I'd personally not want to go to bed at 9 unless unavoidable. Or could you move the timing of your lantus altogether - in the morning rather than the evening? (I need to add the disclaimer that I wouldn't without DSN input, it's just another thought.)

Nemchenk said:
Hi Monkey, Hi trophywench 🙂

Thank you for your help, it is so reassuring to be able to talk with ladies who understand or who are going through the same situation. My family and friends do their best but no-one really gets what it is all about.

Just waiting for the grimness to stop now...woke up again before dawn with 2.6. Lantus down to 11 units now - there is going to be none left if I have to keep dropping it every night! I thought it was supposed to start climbing soon.

My diabetic nurse seemed to think the night hypos / fasting lows were to do with increased ratios at dinner but last night dinner was at 18.45pm so surely most of the Novorapid would have stopped working by 23.45pm?

4.3 @ 18.30 Before dinner
8.1 @ 20.00 1.5hr after
5.0 @ 22.00 Started snacking 3CPs
9.9 @ 23.45 Bedtime and Lantus

Perhaps I should have chosen a more sensible longer lasting snack, like cereals. I just don't know any more.

First scan tomorrow morning, wish me luck!
Click to expand...
 
I just had a quick read here and it sounds more or less identical to my early readings (before I went on a pump which has helped).

Insulin for breakfast was and still is at CRAZY levels. I used to take 4.5 units with breakfast and now I take about 22 for the same meal. It seems to work but no matter how great my after breakfast reading is I am ALWAYS, and I mean without fail, hypo late morning. For this all i can do is eat about 50g carbs insulin without insulin - cereal bar, toast, biscuits - whatever. Sometimes I am still hypo though but this amount does seem to work most of the time.

It feels totally alien to what I am used to doing so feels wrong but it all works so must be right.

I also have this late afternoon sometimes but not as severely.

Wishing you both well x
 
congrats and all the best... i have had two kids whilst type one and it aint easy but deffo worth it... the ladies in here are well clued up and i wish i had been on this forum when i was pregnant.... 🙂
 
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