Third Trimester FRUSTRATION

Hey Ladies!

I have made it Week 29 of my pregnancy! Baby Holden is doing great growing.. maybe a little too well... at last check he was measuring in the 75th percentile! I have another ultrasound in two weeks to check his growth.  

My frustration is with my blood sugars! I have been waking up with crazy fasting highs! For example, I went to bed Tuesday night with a 116 blood sugar and woke up with it being 336! My first reading in the 300's in almost a year! I was MORTIFIED! I typically wake up with blood sugars hovering in the low to mid 200's even though I go to bed with blood sugars around 100.  

My A1C has been 6.2 throughout my pregnancy but I can't seem to work out getting my lasting sugars down.  I am taking a tremendous amount of insulin but it takes struggling to get them down.  I am starting to stress about the blood sugars and how they are effecting baby.  

Please offer any advice that you have for me! I'm trying my best, but that isn't seeming like enough these days.  


PS: I see my doctor every two weeks and she is a specialist in diabetics and pregnancy.  She is a professor and clinician at my local Medical University (best hospital in the state).  We have adjusted my basal rates every visit for the past couple of months.  We are trying to be proactive, but my body seems to have a mind of its own! 

Hang in there momma... the homestretch is really hard to deal with BGs with insulin resistance.  By the end of my pregnancies, I was doing 1:2 carb ratios.  I was going through 200 units of insulin a day (which was 6 times what I used non-pregnant).    Keep working at it and making changes on every few day basis is likely coming.  By the end of my pregnancy, I was seeing dr once a week and making changes on my own in between - might be time to ask about more frequent dr. appts or sending in BGs via email for help making basal/bolus changes.  

Keep doing what you are doing.    (Also note - they said my 2nd daughter was going to be big 8lbs +... she was 6lbs 13oz delivered at 38 weeks)

Thank you for the encouragement! I am at a 1:3 ratio... and I am going to request more frequent visits when I go on Monday.  I am adjusting my basal rates on my own, but it's hard to stay on top of it!

I'm due May 12, but no one seems to think I'll make it out of April before he's born.  My struggle is definitely taking a toll on me... Thankfully I am not working full time right now... I am substitute teaching this semester when I feel up to it.  I just finished graduate school in January so I'm (thankfully) in a transition period and have a wonderful, understanding husband that tells me that taking care of myself is my number 1 priority!

I am going through a ton of insulin everyday! It;s kind of scary... I know this would have killed me a few months ago but now the amount of insulin STILL isn't enough!

Thanks for the support!

Hey Sarah,

I felt your pain! I felt like there was nothing I could eat ever without having my sugars jump through the roof. It was insane! And then I got steroid shots during a preterm labor scare and had highs for two weeks! What really helped me out was being in frequent contact with my endo. Every time I felt my sugars were too high I would contact him and he would review my pump setting and suggest changes. At the end of pregnancy my carb rations were ranging from 1:4 to 1:6 and my basal rates were about triple what they were pre-pregnancy. Now, postpartum, I'm struggling to find a new balance. It sounds like you've had pretty good control though, and I'm sure you will be fine :-) Keep on truckin'!

Thanks for your reply! It is such a struggle! I feel like I'm in a constant battle with my sugars! I knew it was going to be a challenge, but this is crazy! And I feel like I'm not even close to the end! I know I just have to hang in there, but it's easy to get frustrated!

I know it feels wrong to take so much insulin but your pregnancy is causing progesterone levels to increase, which causes major insulin resistance.  

By 3rd trimester I was taking more than double my usual dose and was adjusting my basal and bolus numbers almost daily.  

Large doses (10u or more) will absorb better if you inject instead of using your pump.  But be careful using your pump's bolus wizard because it won't be able to correctly calculate insulin on board if you're injecting.  

Could the 336 be caused by what you'd eaten the night before?  Tonight try eating an easy to digest meal (no fried food, high carb, or potatoes) and then test at 12am and 3am to see what your numbers are.  Then call your endo for dose advice or adjust your basal on your own if you know what you're doing.  

With meals it will help if you take insulin before eating.  Then test about an hour after eating and take a correction dose if needed.  ONLY DO THIS IF YOU'VE TAKEN THE BOLUS BY PUMP, NOT BY INJECTION.  

Ultrasounds are an estimate.  They are often inaccurate.  Because you have diabetes ultrasound techs and physicians tend to expect large babies.  Don't stress about it.  Just keep doing a good job with your numbers and everything will be fine.

Hi Sarah - I am just a couple days shy from 28 weeks and I hear what you are saying.  This last week has brought about some craziness to my blood sugars during the evening hours. One day last week I went to bed at 110, got up at 12:35am and I was still at 116, then 5 hours later I was at 213. I couldn't believe it!!  What I found was that my basal rates - starting at 9pm had to be increased, especially the one I have from 12am to 3am.  I have a hard time sleeping these days so checking my blood sugars every hour or every two hours to see the trend, really helped me out.  I also did a 'controlled' study on myself with limiting my carbs at dinner and eating a bit 6pm instead of 7pm...and did not eat an evening snack.  There are times when I think I am doing everything perfect, and for no reason, I get a high number, so I feel your frustration.  Managing Type 1 diabetes is like putting together an endless puzzle sometimes...but we mostly have all the pieces...everyone now and then, a corner falls off or something ;) But thankfully, we have each other and our support team!

I have my growth ultrasound next week Thursday to see how my baby is measuring :)

Good luck and keep at it.  I'm sure you'll get your numbers down.