The Third Trimester Struggle

Hey all,

 Another question! What on earth did/ are you eating in the home stretch?! It seems like everything I eat shoots my sugars up no matter how much I bolus for it. My basal rates have more than doubled, which I expected, and my bolus amounts have close to tripled, which I also expected. I have a wonderful endo who gets back to me within a few hours every time I reach out to him and we have adjusted my pump settings many times. Sometimes very aggressively. I'm ok with the drastic increase in insulin, but it appears that I'm going to have to make some drastic changes to my diet as well.

Up until the past few days I was fine as long as I took thecorrect bolus amount for the carbs I ate, but now I'm starting to think I need to eat next to no carbs to keep my glucose levels down. Did anyone else go through this? What did you eat? I find myself panicking every time I test and see a higher number than what I want.

FYI I am ~30 weeks. Expected to be induced at ~38.5 weeks.

I ended up at 1:2 (1 unit for 2 grams of carbs) by the end of pregnancy BOTH times I was pregnant.  :-)   (I was at 1:12 before getting pregnant).  I had to change my 180units of insulin pump cartridge EVERY DAY.  (I use 30 - 40ish units these days per day).    Hope this helps...

So, yes, less carbs would make BG going up less likely, BUT ... babies need carbs to grow.  You can't cut them out.  

Just keep checking, keep your doctors updated and ENJOY!   (I know it's hard, but it sounds like you are doing everything you can.  Just keep doing it!)

Totally normal.  In your third trimester your progesterone level increases and that makes you less insulin sensitive.  By the end I was taking over 100u a day.  

Think I was 1:5 (1 unit for 5g of carb, instead of my normal 1:12g) by the end of my pregnancy.  I would also take insulin with my meal and then test and hour later and use the bolus wizard on my pump to take any extra needed.  It feels wrong to take that much insulin, but it's what your body needs.  I didn't avoid foods for most of the day, but I wouldn't eat high carb stuff for dinner.  Tended to eat a sandwich or something lighter at night.

If you can, try to walk or get exercise each day.  That helps make you more insulin sensitive.  

By the end of my pregnancy I was 1:3 carb ratio. Checking every hour.

Try not to stress so much (It's hard I know) because that can also make your blood sugars stay higher. You need carbs for the baby so I wouldn't cut them out. My carbs consisted of yogurts, lower carb breads, fruits like berries that are lower in carbs and don't spike your blood. But, a lot of the time I didn't really avoid anything.

Thanks for all the input everyone! It's just so dang frustrating! I really hope I'm not hurting my little guy with some of these highs. My ratios vary from 1:5 to 1:8 right now based on the time of day and I still have 8-9 weeks to go! I'll keep working with my endo, testing a lot, and trying to cut out the refined carbs. But still keep the good ones (whole grains, fruits, yogurts, etc). I'll try to do some laps around the office too, maybe that will help :-)

Thanks again!

I hear you! I'm 27 weeks now and feel like I'm playing catch-up the whole time. I keep adjusting and adjusting, but the insulin resistance keeps rising and rising! I've been adjusting every two-three days to keep up with the changes, and even then it doesn't seem to be enough! It has been VERY frustrating. I've already gone from a 1:10 to a 1:4.5 carb ratio and have increase my basals by at least 50%.

I agree about the carbs. I went and talked to the dietitian thinking the same thing and basically was told I have to leave it alone. I've limited my night time carbs some since I've been struggling with nighttime highs, but have kept the other two the same.

i don't know if you are having this problem as well, but I also seem to have huge inconsistencies in how my body handles the carbs. I eat the exact same breakfast everyday, and VERY similar lunches, but my body doesn't respond to the carbs in the same way every time. Sometimes I'm fine, sometimes my blood sugar spikes. Another hurdle on the way to great control.

Good luck to you, you're not alone!

Hi Rebekah! I feel your pain and wanted to share some of the things that have been working for me. I'm 32 weeks and my carb ratio is 1:5 now (used to be 1:15). I didn't want to accept this at first, I hate taking too much insulin, but it works! I check one hour after meals/snacks and 2 hours after. In the morning right after breakfast, I go for a walk, and it seems to set the stage for better insulin absorption throughout the day. I mostly eat only whole grains, or some sort of high fiber breads/pastas. The extra fiber seriously shaves off the peaks of my sugar, it seems like it cancels out a few grams of the sugar.. Can't really explain it, but it works! I'm 29 and have had T1 for almost 20 yrs and this is my newest trick that actually works:) But walking, or getting my heart rate up is the biggest most effective trick... Good luck!!! It'll keep changing I'm sure, but at least we know it and can be proactive! I'm expected to be induced at 38.5 wks too:) Super excited!!

Thanks for the support! the strange things we diabetics have to do....haha I'm trying to incorporate some laps into my daily routine at the office. I get some funny looks, but it seems to be helping. Another tip my endo gave me was to do a temporary basal increase of 10% about an hour before meals extending 1-2 hours after meals. Helpful for times when I know for sure when I'm going to eat! It's just so weird to see such huge bolus amounts!

Another question for you ladies! My insulin needs seem to have peaked and may even be decreasing a little! I have been much lower the past few days.... Often requiring extra sugar to keep my numbers up. Does this mean the placenta has already started aging? I'm 34.5 weeks now....


It could mean that the placenta is aging... I also had the same thing happen to me toward the end, where I didn't need as much insulin. I didn't ask them about the placenta and noone ever said anything about it so I just went with the flow... All I can say is that you should sit back and enjoy haha