Always hear stories about insulin resistance during pregnancy. Was curious if anyone was already pumping large doses of insulin before they became pregnant and what you did if "doubling" and "tripling" your carb ratios wasn't technologically possible. What did you do?

My story: I'm TTC. Been working with my endo and CDE to get my sugars under better control so I can get the "green light" to drop off my pills. I'm at a 6.3% A1C, but a lot of those are lows. Over the course of about 2.5 months, I've been basal testing. I've discovered that I can survive on very little insulin. However, when I eat, a 1:4 carb ratio barely covers my breakfast in the morning. I'm a very active individual and relatively petite. I just function differently.

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Even if your insulin needs go up by 4 times, then you would use a 1:1 carb ratio (which I think is possible). Some of us give large boluses by injection during pregnancy as the absorption can be better. So that would be an option too.

I had to eat very low and slow acting carbs for breakfast. I ate two eggs, cheese, veggies, and one slice of toast everyday.

You might run into a problem of an I:C you're not able to enter into your pump (mine, an animas ping, doesn't seem to go larger than 1:2). But it's NOT actually a problem mathematically. You could do the math yourself and then manually enter the amount of insulin you need.

Another possibly is that you may find your cartridge emptying out too fast with the larger boluses! I knew someone who wound up carrying a syringe and vial with her for most of her meal-boluses during pregnancy because she'd otherwise have to refill her pump every day.

I just checked and my Medtronic Veo pump allows 1:1 ratio (also can be increased by 0.1 units -- so 1:1.2, 1:1.3 is possible).

But I did what Lizzi suggested and actually just entered bolus amounts, as I was eating the same number of carbs each meal.

Thanks. I have a Paradigm, so it's older. I want to see, since I'm on a new insurance plan, if they'll let me change to a more updated version. (Because I really should be on a 1:4.5 at lunch...) I know I can just do things manually, but... I was just seeing what others did before I had to resort to that.

I'm so glad to hear about your carb ratios!! I'm in a similar boat and had an across the board 1:5 ratio before my pregnancy. I did have a 1:1 ratio by the third trimester. The biggest thing for me (and I was on a pump) was to start giving myself bolus 20-30 minutes before eating, in order to give my pump enough time to give me all of that insulin! I also switched to shots in the morning and did cut back on the number of carbs I would have at one sitting- I really spread it out. I also gave up chinese food! Oh the sacrifices we have to give to have healthy babies! :)Good luck!

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