First Pregnancy at 6 weeks and Nervous

Hi there everyone, I've been following this blog off and on for about the last year as my husband and I were thinking about and actually TTC and I've found it super informative and comforting. I have a A1C of 6.0 and I just found out I am 6 weeks pregnant. What is bugging me recently is that before I knew that I was pregnant, I was getting unexplained highs and lows that I hadn't had in a while, mostly at night time. Before I got pregnant I had really good control of my numbers and now all of a sudden I'm struggling to stay in control already. I've read that insulin resistance or crazy numbers usually happens later in pregnancy rather then the first trimester. I am still getting these highs and lows (usually not above 250 or below 50). I will eat dinner and have a good 2 hour post sugar, but at late evening I will have a high. Whether I correct the late night high or not, I still get a low that is in the low 50s that will wake me up about 3 or 4 am.

I keep reading in other blogs that say to just correct and move on but it's really hard for me to not worry or beat myself up about what it could be doing to the baby. I feel so so guilty when I get a high or a low and worry of what it could be doing to the baby even though I'm really trying to keep in control. I've also ready that it is normal to get these lows in the first trimester but I'm curious if anyone has any advice on something I can eat to help keep my sugar stable through the night or anything else to prevent the spikes and drops. I've been on a pump for several years now. I do have a CGM but I really dislike wearing it, personally I'd rather prick my finger 15 times a day then wear it. 

I'm going to make an appointment with my endo next week for more on what I should be doing and I have an appointment with my OB when I am 10 weeks. Its just hard not to beat myself up about any high or low sugars.  I just know most everyone here has experienced and knows what I'm talking about and would have some good first hand advice and words of encouragement for another worrying diabetic mommy to be! 

Thanks, - Larissa 

Hi Larissa.  Congratulations.  :)

I had a bunch of overnight lows early in pregnancy as well.  I started eating a snack before bed even if it seemed like I didn't need it (I had to eat a snack if my blood glucose was under 150, which I certainly did not have to do pre-pregnancy).  The lows lasted a month or so and then I no longer needed the snack.  My snacks included things like granola bars and chocolate milk.

My early pregnancy blood sugars were hard to manage, and I constantly asked my endo if I was doing damage.  He assured me that the biggest problems occur when you have highs for a few days in a row (that don't come down really at all during that time) and to be careful with the lows and try to stay above 60, but not to beat yourself up about some highs and lows.

It really does get easier to figure out, although your insulin needs will likely change quite often, and you will have some highs and lows.  It sounds like you're doing great and an A1c of 6 is awesome.  Try not to beat yourself up too much.

Good luck, and by all means, ask more questions as you have them.  I found this forum super helpful during my pregnancy.

You should NOT just correct and go on... that's okay for a rare high or low in pregnancy.  But if you're having repeated issues you need to correct it right away.  

Are you pumping?  Your basal rate isn't accurate if you're having highs and lows.  Ask your doctor to connect you to one of the 24 hour glucose monitors (it's like a CGM, but more accurate and you can't see the readings until after the test is complete).  Eat low carb or fast for part of the time to get the best information.

In the meantime, for a couple nights in a row set your alarm to wake up and test every hour between midnight and 4am.  I know it's a pain but it's the best way to see what your blood sugar is actually doing and will allow you to adjust your basal to prevent the lows.  

I had problems in pregnancy  with my evening meal taking longer to digest, so I'd have normal blood sugars at bedtime but highs in the middle of the night.  Because of that I avoided high carb or high fat meals at dinner.  For me it didn't start until the 3rd trimester, but may be something for you to try.

Hi Larissa.  I'm currently 31 weeks and I was having the same issues with lows that were waking me up in the middle of the night in the first trimester.  I won't disagree - it was definitely scary and I was worried (still worry, honestly) that it was harmful for the baby.  But, I'd have to say stressing is the last thing that is good for you or your little one.  So far, all of our tests have come back perfectly normal and baby is even weighing in at a normal birth weight (a little bit larger than average, but dr's still aren't overly concerned with her size).  The best advice i can give you is try and stay positive - eat as healthily and consistently as you can - i know harder to say than do!  (my weakness has been ice cream!)  and definitely try to stay as active as you can throughout the pregnancy and exercise when you feel up to it.  Good luck!  

Hi Larissa-

Woops… Didn’t mean to send! I know how you feel. Whenever my sugar is above 120, I get upset and wonder what damage I’m doing. I’m 9 weeks now and found out when I was about 5. I haven’t been above 220 since I found out, but I do have my fair share in the 120-150 range, which I know isn’t perfect. I get low often between 2 and 4am. What’s really bothering me recently is what you mentioned- I have good readings 1 and 2 hours after dinner, but then start to climb. It’s been happening for the past week and I don’t know what to do about it! Have you found anything that has worked? For those of you who made it through pregnancy or are close to the end, did you have sugars in the mid to high 100’s? Is that to be expected? I am averaging about 100, but I do have fluctuations. I feel like I’m trying so hard to be perfect, but I don’t know if it’s good enough. Jen

I am currently at 37 weeks and the baby is doing great. My a1c’s have been from 5.8 to 6.2 through the pregnancy and although I usually have good numbers they were not always perfect and sometimes there would be a few days when everything would seem not to work, sometimes seeming like I went from lows to highs and never staying in the right range. I have gone up to 180 at points which made me feel guilty but usually stayed below 120 after meals. In those case where I was frustrated I found it helpful to test a ton and keep an accurate log to look for patterns that needed adjusting. During these times I would try to have a similar sized meal at a similar time for a few days. Example, 50 g carb supper at 6 pm each day. And I stuck to foods that I knew would not affect me weirdly, like fatty carbs or beans which hit me differently on different days. Also, if you are high in the evenings you could adjust your basal if on a pump - I found that during pregnancy my insulin needs would go up or down in different proportions during the day. I might need less overnight but more in the evening. If not on a pump try a short walk after dinner or just taking a unit or two if insulin. As for overnight lows, I set my alarm for 2 am each night and tested. Annoying but it worked and prevented going too low. Having severe lows can make your sugar spike hours later.

Thanks for the advice ladies, I've just been completely stressed out and worried about it though. I've been having highs in the 250s and lows down to 50 for the last two weeks and it really scares me. I just saw my endo this afternoon and he didn't seem to overly worried. He suggested I keep my meals as fresh and unprocessed as possible and to try to keep my meals under 50g of carbs and no more then 150g of carbs in a day. From my log book he said I'm obviously working my butt off trying to stay in control (since I'm testing around 15 times through the day and night) and stress could be factoring into why I just can't gain my control back. So my goal is to limit my carb intake even more so and to stress less. He said the baby can take a lot more then I think he/she can and to try not to over worry myself out about it. I'm working hard to fix my sugars and there is no reason that I wont still have a healthy baby in a few short months!

Keep in touch ladies! Hope to keep hearing good advice and learn from others along the way too! It's nice to know I'm not alone in what I'm experiencing! 8 weeks down, 32 left to go! Happy thoughts and good luck to everyone else in their pregnancies as well!

I had blood sugars in a higher range when pregnant.  Every type 1 diabetic will.  I had 300s a couple times, but for the most part my numbers were really good.  

My target blood sugar in pregnancy was 80 but my A1c was 5.1, which averages out to 100.  Even though those are amazing numbers and I've never done so well since, the reality is that I was was having highs some of the time which made my A1c higher than my goal.

Despite occasional highs or lows my son was born with a normal glucose and the only diabetes related issue I had was high levels of amniotic fluid (I wasn't aware of it until my water broke; when a nurse commented there was a lot of fluid another told her that diabetics often have a lot of amniotic fluid).

The biggest threat from high blood sugars is your baby will be fat and have hypoglycemia after birth.  Not good, but it just means you're more likely to have a cesarean, which doctors will be pushing you towards anyway as a type 1 mom.  And once your baby is born he/she will be given supplemental glucose.  

I was more concerned about preventing lows since glucose affects brain and neurological development.

My son is now 7 and is healthy and intelligent and extremely handsom (okay, maybe I'm a biased mom!).  No sign of diabetes.    

Hi Larissa! Congrats on the pregnancy!!! :) I know EXACTLY how you feel, my friend. I am in a similar situation. My numbers have been all over the place! I am trying really hard to control them with the help of a dietician and CDE. To try to put my mind at ease, I ordered the book "Balancing Pregnancy With Pre-Existing Diabetes". It's helped put things into perspective. With my first pregnancy (this is my second), I had a rough time controlling my sugars. Once I finally got them under control, my A1C's hung out in the 5.5's to 6's. Now that I'm on my second, I feel like I'm teaching myself about diabetes all over again! It's not a cakewalk, but it's so worth it in the end!

Hi Larissa- I’m 8 weeks pregnant now and have been finding Ginger Vieras book about pregnancy with T1D so valuable.
She wrote that in the first weeks of preg basal needs would likely increase- I pump and use a cgm and saw that I needed a total 10-15% increase up until 6 weeks when I had sudden drops at 3-4 pm and from 2-4 am. I’m now setting my basal rates back for these -20%. She writes about how our immune systems are suppressed and our bodies may be capable of making some small amounts of insulin that cause this ( and can also happen bc of eating though I haven’t noticed that yet). The book suggests that basal rates need to be shifted whenever a two day pattern is witnessed so that’s different than the slower adjustments we are used to. It also talks about slowed digestion for uptake of nutrients by baby which may shift how food bolus insulin looks- setting an extended bolus for high fat/protein or splitting dose and taking some an hour after eating.
So tricky but waking up repeatedly in the middle of the night- I feel you- and riding the line of a 70/60 the cgm which is ok for preg without the sleep dep aspect. I’ve had the snack before bed once and can try that again but I just need to avoid taking insulin as a correction before bed so I’ve been trying to eat earlier like 4 or 5 pm and then just a few nuts and cheese as a snack if needed.
Added: just realized this thread is from 7 years ago! So maybe not helpful but maybe will be relevant to someone

hi @linsey Welcome to Type One nation. Hey even though @larissalinder’s baby may be celebrating a 6 year birthday, what you wrote will certainly help others, so thank you for the thoughtful contribution and please let me wish you congratulations and the best of luck!