I would go ahead and adjust your basals, carefully, and talk to your endo asap. (If you're really worried, is there an MD on call you can speak to?) Do it in the smallest increment your pump allows, and if your bg is still high tonight, do it again. I found in pregnancy that I had to be much more aggressive and make bigger, faster changes than usual. For me it also helped to adjust basals 3-4 hours before the problem. My OB (who managed my diabetes) always wanted me to adjust 2 hours ahead, but it wasn't early enough. What I mean is, if you're having high bgs starting at 10PM, try adjusting your basal starting at 6PM. Good luck and keep lots of glucose tabs handy!
Yes, I remember being shocked by the rate of increase around this time. My philosophy was two days with highs and no lows in that time period meant time to increase the basals. I didn't like to wait for more than a couple days of data.
I think that I started around week 19. So you could likely be entering that phase! As E Louise said, gradual increases to the basal rates, but do them every couple days until you see results. For me I had to really increase things for 4-5 weeks, then increasing in smaller increments.
^ An article about this published last summer. May interest you? I also experienced some resistance around this time. I'm at 20 weeks with my 2nd pregnancy now and haven't hit it yet, but I'm sure it's on its way soon!
my endosuggested using temporary basals to help with changes. my resistance did not kick in until 32 weeks and even then ut was only carb ratios and sensitivity settings, but my endo said that is really unusual. she would not say it but frankly i am a definitely an outlier.
For me, the adjustments did slow down after several weeks and it became easier to stabilize things later! Hang in there! Many of us have been there, survived, and produced healthy babies :)
I would go ahead and tweak your levels, small adjustments at first until you get used to the increments. I would say 20 weeks is about right for when the resistance starts, but mine started a little earlier (I have three kids). I blog about it, including week-by-week updates during my most recent pregnancy, at diabeticbirth.blogspot.com. Maybe reading about my experience will help. I would go with your gut, though, and experiment a little. Just make sure you always have something for an unexpected low nearby!
I would adjust your basil rates.. I mean if you over correct ( and at 20 weeks) it's harder to.. you will know soon..
I think I was closer to 25 weeks when it started to get a bit harder for me. I know in weeks 28 until delivery my insulin needs really shot up. I was getting insulin adjustments sometimes twice a week. One thing I really had a huge issue was with monrning highs. I have dawn effect and it was so much worse during pregnancy. My fasting sugars were in the mid 100's so we did a CGM to see what was happening. We found that for me between the hourse of 5-7 my liver was realeasing too much sugar and my betime Humalin N wasent' stong enough to handle the realease. So I started getting up at 4:30 in the morning and taking my morning Humalin N and eating my breakfast. The only thing that would happen is around 8 I would have to have a snack or I'd go low. For the most part getting up early and doing that helped. I was somewhere around 25 weeks when I had to start doing this, I had my daughter right at 38 weeks. Good luck!
My insulin resistance started around week 23-24 if I recall.