My induction date is 10 days away (woo hoo!) and I'm starting to think a bit more about post delivery!
BASAL RATES: I'm working with my endo to set up a 2nd pattern for my basal rates that I'll switch to as soon as I deliver the placenta. She was originally thinking to just go to my pre-pregnancy settings... but we're going to talk again on Monday as I didn't have nearly as many adjustments based on "time of day" pre-pregnancy as I do now. I'm wondering what worked for other people... I know everyone is different but it's always nice to hear what other people experienced. I was thinking that rather than just go to my pre-pregnancy settings I should keep some of the "time of day" differences I'm using now and focus more on making my total basal insulin/day the same as pre-pregnancy. I didn't have CGM before I was pregnant, so am not sure if some of the "time of day" changes I made were pregnancy related or me just having better knowledge to make those adjustments (and they may have already existed if I'd had the CGM sooner). Right now my basal rates are ~65% higher than pre-pregnancy.
BOLUS CHANGES: I am also wondering what people experienced for their bolus changes. I only had 1 bolus ratio pre-pregnancy and now I have 4 different ones... so similar questions to above did people experience a change in needs by "time of day" due to pregnancy and did your bolus requirements change as much as your basal requirements? Since I just had the one ratio before some of mine are still the same as pre-pregnancy but some are giving me as much as 70% more insulin.
Insulin Sensitivity: Same questions on sensitivity as I had above for bolus changes... Although, I don't think my pre-pregnancy sensitivity factor was right at all (it's amazing what patterns you can see and learn from with the CGM), so kind of want to approach the post-pregnancy change a little differently.
Active Insulin Time: I'm also wondering if others changed their active insulin time as a result of pregnancy. Starting at about 30 weeks I changed mine from 4 hrs to 3 hrs... but even before I made the change to 3 hrs I often found myself needing 2 corrections if it had been more than 2 hrs since my last bolus (because the active insulin calculation was too high so the reco'd correction was usually too low). So similar to above, I'm curious to know if other people also made this type of change and if so, did you go back to your pre-pregnancy sensitivity after delivery.
Breastfeeding: Last question on the topic of post delivery insulin requirements... my endo is recommending that I take my basal rate to 50% while breastfeeding. Is this similar to what others have done and how did it work? Any advice on this topic would be appreciated as well.
Overall, I had good control before I went on CGM (consistently had A1C's in the low 6's), but am just unsure if some of the fine tuning I've been dong throughout the pregnancy were truly pregnancy related or just me having better information...(my A1C is now 5.5). I'd hate to lose some of the learning’s if they're still relevant.
Thanks in advance for any info!!
Theresa