BG targets for pre-conception
before meal: 68–94 mg/dl (3.8–5.2 mmol/l)
1-hr post-meal: 103–139 mg/dl (5.7–7.7 mmol/l)
2-hr post-meal: 90–119 mg/dl (5.0–6.6 mmol/l)
These are the BG targets for pre-conception promoted by the diabetes and pregnancy clinic at my local hospital.
I cannot imagine how I could ever meet these targets. My 2-hr post-meal BG is usually between 126-162 mg/dl (7-9 mmol/l), and I often go low before my next meal. If I were 139 (7.7) one hour after eating, I'd be hypoglycemic constantly. (I use a pump, and I have a very low basal rate and I am very sensitive to insulin. My TDD is usually around 13.5 units).
Does anyone actually meet these targets? How?
Wow. Thanks for the information. Very helpful!
That was the schedule I was on too, and at the between meal were snacks of 15 carbs, a protein, and 1/2 cup of whole milk. I wasn't on a pump or CGM. It was Humulin R and NPH. The doctor would change the insulin amounts according to my insulin and carb records and my pre and post prandial readings. There was lots and lots of food, insulin, and carb diaries for the doctor.
I'm hoping to officially start my pre-pregnancy routine in June.
I agree with the previous posters. I am 39 weeks pregnant, and I have found it easier than I thought it would be (although not "easy") to hit those post prandial targets. I was having problems initially with crashing from meal boluses 2 hours pp (one hour was often fine), so I upped my basal rates around meal times.
I stuck to a fairly regimented breakfast, but not nearly as much so with lunch and dinner, but I found a way to make it work. My A1c has been 5.3 or lower the entire pregnancy (was 5.6 at conception and lowest was 4.8).
However, later in pregnancy HAS impacted my digestion - it has slowed down - so I really have to watch after 2 hours pp, because sometimes it does CRAZY things, even with reliable meals. Test, test, test. That is the real reason I've been able to keep my A1c's so low.
Test frequently, correct aggressively, and don't be afraid to tinker with basals...but really one step at a time so you can figure out what's going on!
I've also found that eating low carb really helps to keep things stable.
My daytime basal is actually a bit higher than necessary, which helps to even things out.... but I do test frequently and on schedule to make sure I'm not going low....
It is so daunting and overwhelming. I am in a preconception program now, mainly to figure out the right basal/bolus rates for me and to get my A1C under 6.5 so I can get the go ahead to conceive. I have been doing this for 3 months now and it is so much work. I have similar goals, they want me 70-90 at fasting, 90-100 pre-meal and 100-110 post meal. It is so tight, and I have been running high prior to this program that when I get near this level I often go low-- sometimes it just seems impossible! The one thing that they keep telling me is that I have to be comfortable going low, cause when you are pregnant it happens often and hitting these numbers the first 12 weeks are super important. I talk with my Diabetes educator/nurse every week and go in every two weeks to review all my sugars, food diaries and pump settings. This really helps me stay accountable and on track. If this is something you can do I highly recommend it. Each visit we fine tune something and my numbers are coming down. Agree with the other users change one thing at a time, cause if you do diet, exercise, and pump rates changes all at once you won't know what worked. I also have found that a regimented eating schedule really helped. I am on a strict 1500 calorie meal plan that is relatively low in carb and includes lots of lean protein,veggie, fruit and dairy options. Also eating about every 3 hours to keep everything steady. Another thing that has helped me is that 2x a week I will try to eat the same exact thing, at the same time, do same workout, etc so I can see any patterns/trends in what my Bolus and Basal rates are doing. The scariest part to me is all the lows, cause it happens often but is just part of the process. I got a CGM and that has really helped me ease my mind, especially overnight. When I feel overwhelmed or that it is impossible I come to this site and read all the wonderful and inspiring stories of other women who have done this. I also try to take it one day at a time and do the best that I can and try to not beat myself up if I have a high or a low- it is all just part of the process. Good luck to you!