When did insulin resistance start for you? I'm 22 weeks and for the past couple of weeks, I've been higher than normal. My correction doses aren't working as well, I haven't really had lows, and I end up spiking after meals that used to be ok. It's somewhat inconsistent, though- some days my sugars are good, but most days they're higher. Is this what I should expect from here on out? It's so frustrating!! On the positive side, my 20 week anatomy scan and fetal echo went well! What a relief! :-)
Awesome about your 20 week scan! So great to hear and such a relief right???
Mine started at the end of 7 months..It was frustrating but as long as you stay positive and keep correcting every two hours you will be ok. Just be sure to keep in contact with your diabetes team and OB too! I contacted my endos office ever week to make changes.
Congrats on the awesome scan! I started noticing a need to increase insulin around 25 weeks. If I had two readings higher than expected in a row, I contacted my endo and we adjusted. Once I got past 30 weeks it was almost a daily occurrence. I had a great endo though, we did it all through email and he always got back with me within a few hours. Some endos will share a formula telling you that you can use to adjust your rates when you notice the need for it. It might be worth asking!
It's definitely a relief to know that the baby (boy!) is developing ok despite some sugar fluctuations!
I e-mail my sugars to my endo every week, but she seemed a little reluctant to increase my insulin too much last week. I really like her but I think sometimes it's hard for doctors to know as much as we do about what's going on just by looking at numbers on a sheet of paper. I had decreased by doses by so much in the first trimester, so it seems like I'm getting back closer to my pre-pregnancy amounts.
I had slowly increasing insulin needs in the 2nd trimester (went from 40u a day to about 50u by end of 2nd trimester).
But it was in the 3rd trimester when it got crazy (went from 50u a day to over 100u a day by end of 3rd trimester).
Eating the same breakfast every day will help you identify when you're having a more insulin resistant day. I had a different carb count for breakfast too.
To deal with the post meal spikes test an hour after eating and take a correction bolus. I also had to avoid high carb and high fat meal at dinner time because it took too long to digest and would cause a high in the middle of the night.
And obviously if you're having high blood sugars at the same time each day, you need to tweak your basal rate. You can do it on your own, if you are comfortable doing so, or get your doctor's advice.
I just had a visit with the nurse practitioner at my Dr's office and I'm frustrated. She said that my numbers look great and to keep doing what I'm doing. They only look great because I test every hour or two and give myself corrections a lot! I don't think I should have to. I'll be fine up to 2 hours after meals, and then start climbing. Then I take corrections that do very little (I was 190 the other night 3 hours after dinner and had to take 6 units to get to 80. My correction is supposed to be 1:70). My theory is that my corrections are just keeping me from climbing more and I should increase my basal. She resisted, but I basically told her that I'm going to try that for a few days and see what happens. Just kind of annoyed right now!
Your medical team is just glad you have good results. But as the person with diabetes you have to figure out how to get good results in a way you can live with. It's frustrating, but it's just part of diabetes.
It's great to always keep our eyes on the positives! I'm happy to hear your 20 week scan was good! Trying to control our diabetes while pregnant has enough downers as it is. I experienced exactly what you wrote at about 25 weeks and I am now 28 weeks. All my 12-6am sugars were so much higher than they had been in the first trimester and my bolus rates weren't keeping my sugars stable anymore. I took the liberty to adjust a little on my own but also bring in my meter and CGM every two weeks to my endo as well email him whenever I see a pattern lasting 3 days.
I found that I really had to reduce carbs and take humalog about 1/2 hour before I eat. My correction bolus went from 1:50 to 1:20 and meal bolus' climbed from 1:8 in week 25 to now 1:4 (and breakfast is 1:3) and my basal rate has also increased each week. I also wake up and correct in the middle of the night when necessary.
Some days are great and steady all day. Some days have random spikes I can't explain.
You are doing a great job! Remember that there is not always a "formula" and that you do know yourself better than anyone.
I think around 22 to 24 weeks I was back to my pre-pregnancy insulin needs , and things slowly climbed from there. One thing I found surprising was that the changes were not consistent through the day. My carb ration changed from 1:10 to 1:7. My evening basal almost doubled, but for other parts of the day was up only 39 or 40 %. I think this whole blood sugar management is sometimesore art than science, so trust your instinct and do what you think. Doctors don't get that and sometimes thing it is easy to spit patterns and make changes. Listen to your doctor, but make the changes you feel comfortable with. I made my own changes and my doctor was ok with that. Sometimes she made suggestions and I took those into account. Good luck and keep up the great work!