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Just need to vent...I am 23 weeks pregnant and have officially entered the insulin resistance nightmare as of about a week and half ago. In the past 3 days my basal has been increased by 6 units and my mealtime insulin needs have skyrocketed! I am completely overwhelmed and am feeling like if this is what the next 3 months is like I may not make it without losing my mind haha. I am barely able to eat, taking a boatload of insulin, eating low carb, increasing my insulin daily, and my blood sugar is STILL skyhigh. I have almost had to go to the ER twice this past week for blood sugars in the high 200s that would NOT come down and did not come down until after many many corrections and 12+hours. I am scared to death because I know I am hurting my baby girl. Does this huge spike in insulin needs slow down or is this what the rest of my pregnancy will consist of? My insulin to carb ratio is about 1:3, I'm eating low carb, and I still always go to 200 after meals AHHH!!!!!!!! I feel like I am starving my baby on top of having neverending high blood sugars.

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Right on Marps
I completely understand how you feel as I am now 21 weeks into my own insulin resistance journey. Mine started more or less from conception so I've had a while to come to terms with it.

The main thing to remember is, as Marps said, insulin is your friend not your enemy. There is nothing wrong with taking extra insulin. There is no such thing as too much. You take what you need to keep your blood sugar under control.

I was on 1 unit insulin to 5 grams carb before pregnancy; from conception day that jumped to 1:2.5 and has stayed that way. I am told that I will probably need more insulin in the weeks to come. Well, bring it on.

Each of us is different. You were on a minuscule amount of insulin before, especially your basal. So the increase to the current level might feel like a steep slope to you, but it's actually still a lot less than what many (non-pregnant) people take as basal. Just take what you need and don't sweat about it.

I have also found that highs are much more stubborn now than pre-pregnancy. So I totally understand your frustration. I have found that the only way I can avoid highs, and also the only way I can meet the one hour post-prandial target, is to inject a little extra. That usually helps meet the 1 hour target - but also guarantees a hypo at the 2 or 3 hour mark. I don't have a CGMS so I test like crazy and try to catch the hypo before it properly hits. So for example if I'm 120 one hour post meal, and 90 two hours post meal, I am absolutely guaranteed to go hypo at three hours. So at 90/2 hour post meal, I have 10g of carb and that usually helps stop the hypo. I am terrified of going high because it seems that anything above 190 just hangs around for hours and hours and corrections don't do anything for two hours - only to sometimes kick in with terrifying vengeance later. Whereas it is much easier to keep on the lookout for hypos, and correcting a low is almost instantaneous. This does mean pitifully calloused fingers (somedays I can even feel it when using the keyboard) and of course, it means a lot more insulin.
Oh my gosh...I am freaking out!! I am only 5 weeks along and seem to be taking a lot more insulin than normal. I will take my dosage for my meals and my CGM wont budge. My BG begins climbing to 180-210 and stays for HOURS. I correct and correct. I just upped my basal setting and am thinking I am going to need to lower my I:C ration from 1:6 to 1:4 to start. I don't go see my endo till 9/21. I go in for my second blood tests tomorrow morning. I'm hoping my Hcg and Progesterone are up. Did anyone have issues with their BS so early on?
Yes it is normal everyone is different some people struggle with highs the entire time while others have lows the first trimester followed by insulin resistance and highs. At this point I would say do not freak out, in a few weeks you may start hitting those lows and need to lower your insulin needs before raising them again, just take however much insulin you need and you will be fine. One thing that really helps with those highs that won't budge is exercising after you take your correction bolus, even if it's just a 10 minute walk. Exercise really helps your after meal spikes and insulin resistance. I have found it very helpful to increase my basals every few days even BEFORE I start seeing the highs and it helps stay on top of them and especially having a CGM (I do as well) I personally would rather take more insulin than I think I need and deal with a minor low than be stuck high for hours.
With my first pregnancy, my highs started in week 6 and I never got the lows. With this pregnancy (#2), I had a random week of lows last week in week 16, but otherwise, pretty quickly jumped to I:C ratios of 1:5 and 1:6 from the get-go.

Rather than ask if it's normal, learn to ask, should I be concerned? I'm learning that no two pregnancies seem to be the same. :)

Just wanted to say THANKS for this post and all these responses... I am week 25, and going CRAZY. Gaaaaah.

I change my basals and carb ratios practically EVERY DAY, and my postprandials still suck. OK, they could be a lot worse -- I've only had one >200 in the past several weeks -- but they suck. I aim at <120 at 1 hour, and hardly every reach that goal anymore. I try to keep my morning fasting reading <100, and it takes constant vigilance. A basal adjustment that put me back down in the high 60's 2 days in a row has suddenly given me 90's again. So frustrating.

I don't low carb, and honestly don't see how I could -- pregnancy seems to have given me carb cravings and an overwhelming sweet tooth. I moderate, of course; I probably eat half the sweets that a non-D pregnant woman would eat... but the thought of not having a donut until delivery honestly makes me want to cry.

I am glad I am not alone.Whew! I am 26 weeks now and my insulin resistance started a few weeks ago. I am constantly changing my basals and carb ratios. Any advice on keeping BG's down and trying not to freak out knowing I may be hurting my baby would be much appreciated :)

Just read through all of these responses and feel infinitely better! I am 23 weeks (how weird that its the same exact week for a lot of us) and my resistance has started. I have been eating low carb the past 3 days, but that doesn't seem to be helping. I have almost doubled my basal rates for 12 of the hours of the day. Somehow the other 12 hours I seem to be fine. My fear is that with all the extra insulin I will gain weight and that will cause a vicious cycle of needing even more insulin. Thanks for reminding me that what really matters is the blood sugar levels and that baby doesn't care how much insulin I need or how chubby I get ;). I am going to continue raising my levels, taking walks several times a day and eating frequent small meals. Thank you all!

An update: I'm now 38 weeks -- omg!! -- and things largely stabilized, I dunno, around 30 weeks maybe? At this point I'm taking *5 times* the basal and probably 3-4 times the mealtime insulin. My TDD is in the 90s now, though I don't do low carb (and yes, eat ice cream or a donut almost every day...) Actually, the past week I've had to dial back my basal a bit, and treat a lot of lows. My doctor says this is normal at the end.

My last A1c was 5.3, and at 36 weeks my doc estimated the baby's weight at a perfectly normal 6 pounds. He's letting me go til my due date, and aiming at a normal delivery.

So -- we *can* do it! Just up your insulin vigilantly, basals as well as mealtime doses.

Great news!!! Best wishes for the excitement ahead!!

That's fantastic, Kestrel!! I am 27 weeks now and hitting major insulin resistance.Hope it ends soon.




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