I just turned 27 weeks & it seems like for the past month no matter what I do, or how I increase my basals I have a TON of highs. It's really starting to bring me down & make me feel like a terrible terrible mother. Anyone else have issues with awful IR?
Sounds just about right! Don't be afraid to increase your insulin doses every 2-3 days. That's what I needed around this time. In the process, I had a lot of highs too. Pregnancy was so full of worries, but I can tell you that my healthy 15 month old is just perfect (except when he throws stuff and shows signs of starting the terrible twos already!!!).
It sounds normal. Just keep checking your BS every hour or so to catch the highs and take insulin when needed. Just make sure you have glucose tabs or whatever you use in case you overdose with insulin. My insulin needs pretty much tripled in the last trimester, so I just watched it closely and treated my lows when needed. I was very worried about every single high BS I had, but I did well and now have a healthy newborn baby :)
Sounds about right :-) I adjusted my rates at least every week throughout the pregnancy, but made significant changes once or twice a week in this stage. Hang in there! The best is yet to come (after the birth)!!
Mine came about at 22-23 wks and I finally have them wrangled into control at 24-26 wks. My basals are at least double my "un-pregnant" rate and I:C rates are ridiculous (at least for me) at around 1/5-1/7. Just keep working at changing things...my way of figuring it out was to watch a certain time period for 2-3 days (as others have noted) (example, AM to Lunch then lunch to dinner) and get it working for you one time frame at a time. I didn't depend on my Endo very much to tell me what to do, as I'm not attached at the hip to them and do most of my own figuring. Most of my issues were not basal rates, they were getting the insulin to carb ratio down. Best of luck to you!
I'm going through this now too! I'm 26 weeks and just reaching my pre-pregnancy basals (was very sensitive in the 1st-2nd trimester) and my I:C ratio is about 1:6 or 7. I'm glad to hear that you ladies are empowered to change your basals every 2-3 days. I was doing that for the past couple weeks, and uploading my info weekly for my doctor's review. He now commented that I was reacting too quickly, and changing too many things at once. My feeling is that he is not pro-active about helping me in stay in a target range of 70-90. If I wait a week each time for his approval to increase my basals, I've been 150-200 all week. By the time he nudges things up a bit, I'm ready for another increase. GRRR! Really frustrating. I think he is just trying to cover his butt by not 'causing' lows.
In what increments do you increase your hourly basal? I'm on the Medtronic pump and the doc suggests going from .850/hr to .875/hr for example. So I double what he says, and go to .9 and am fine. I wear the sensor and test 12 times a day to avoid lows.
I had the same feeling about my endo Lilli. She was worried about the lows (which is fair), but I was more concerned about the highs. She refers to the Somogyi effect saying that lows cause highs later (I have not personally noticed this effect, but maybe...).
We used to increase my basals by 0.05 units at a time (or more if we saw need). I never made changes without my endo, BUT she encouraged me to email her WHENEVER I thought that we needed changes. I met her once a week and often emailed one more time per week when the insulin resistance kicked in.
That's a good point, Kristin, and I can live with that. I know I can keep emailing my endo and he or the nurse will respond. I guess if I do that, they won't be so hard on me and so foreboding about lows. Maybe I am feeling this way because I am just sick of talking to them and sick of being diabetic. ENjoying the pregnancy, but wish I didn't have to see/talk to so many health professionals...
I know the feeling Lilli. The pregnancy really burned me out from a diabetes perspective and I took a year (well a year and a half now) to be pretty relaxed about my control. I felt like I talked to my endo more than my husband some weeks! But I was thankful that she would always respond. I know many make changes without consulting the endo and I sometimes wished that was how my endo worked, but then sometimes, I was just thankful to have an endo who cared and would reply to emails!
For me, the drastic changes in insulin resistance did slow down (by week 30, I think). So you should be able to get back to that control. Actually I had problems with lows again from week 33 on... It is such a rollercoaster ride, but it will end with a beautiful baby!
I'm 33 weeks now & around your time my diabetes nurse encouraged me to change things in between appointments and contact her if needed. She told me that every 2-3 days I might be seeing changes and she was so right.
I say, you know your body better than your Endo. If you want to stay in the 70-90 range, do it. It is frustrating seeing numbers like 150-200 and waiting for permission when you know you can change things. I say tweak things slightly at first as to not have a bunch of lows-just like the example you gave above. Then again you're wearing the sensor-lucky you (my insurance keeps denying coverage & I could've really benefited during pregnancy especially). So if you have a CGM, and you're checking so many times a day, I say you couldn't be any more careful-how awesome. Best of luck!
I am 30 weeks now, but I remember at 28 weeks it got a little hairy for me. My CDE told me to not be surprised if my I:C goes 1:1. Right now is the highest it's ever been 4.5:1 for breakfast. I have learned to just plug in the wizard and don't look at the crazy amount I need to take. Sometimes I bolus through syringe because I don't like using so much but then I don't feel as secure with it be documented in the pump.
Like others said, test often, and make sure you have quick acting sugar around to prevent bad lows if you end up stacking insulin. I sort of did that a lot, if I was high at 10 am I would bolus for lunch and just keep watch. By the time my BG was in normal range I could tell how much insulin was on board and if I needed anymore for lunch. Hope that helps.
I was doing shots when I was pregnant with my daughter. I got to the point where I was not eveing doing a carb ratio anymore. At the very end of my pregnancy I was taking 56 units of NPH split between morning and bed time. And ready for this 26 units of humalog at breakfast, 30 units Humalog at lunch and 28units Humalog at dinner. I think that is A LOT!! It was scary and I think now that I am on the pump how will that ever work again??? I might go back to shots lol! It is crazy how resistant you get while pregnant. My IC now non pregnant is 1-10. The most I usually take is 6 units. Your almost there!!! :)