Hello Kendal,
It is possible to get an A1c below 6 without low carbing. I manage to do so (5.8 these days and eat 200-250g of carbs on average). This is less than the ADA standard amount, but still enough to make Bernstein blush... It includes breads, rice, pasta, cous cous, fruit, the occasional cake etc. Nothing is off limits. All ethnic diets greedily eaten...
My secrets (such as they are) are as follows:
Ensure you basal test and get this set up correctly. Nothing else makes sense if your basal is off. It also allows you to go to bed at a low (but safe) number and have the confidence that you'll wake up
Having your BG between 5 and 6 (90-108) through the night will really help bring the HBA1c down. Too much basal plus the inevitable snack before bed does not help your A1c quest.
Work out your I:C ratios and also your correction factors. Be aware that these may change throughout the day. Be willing to adjust them when your body changes, which it will...
Learn your insulin profile; you need to know how quickly it kicks in, when it peaks, how long it lasts. Only then will you be able to safely pre-inject and correct.
Carb count effectively. Buy some good books, good scales and (at home) weigh everything. I have the Salter nutrition scales and they are great.
Test before each meal and then test 2 hours afterwards. Correct as needed using your ratios and your understanding of what insulin you have on board.
Learn how to inject for different foods. If something that you love gives you grief at the 2 hour mark, try pre-injecting / over inject and then snack at the 2 hour point. But be safe
Treat hypos with 15g of fast acting carbs (glucose tabs preferably). Wait 15 mins and test again. Treating with chocolate, cookies etc will not be effective and gives you rebound highs.
Consider pumping if you can get access to it. It adds better overal control and wellbeing IMO. My HBA1c is unchanged from MDI to pumping at 5.8, but I manage it now with far fewer hypos than MDI + many other benefits. My Animas allows 1/20th unit increments for bolus so you can really match the food effectively.
Hope this helps, good luck with the pregnancy.
Gary
__________________
A poem about my Wonderously Wanton Basal (WWB)and it Felicitous Flirtations (and how I tamed its Wicked Ways)
...And through the night it's love is free
It whispers and it flirts with me
And then it takes me, hard and deep
Rolls over, farts and falls asleep
And I would wake up, feeling used
My body broken, bent, abused
But now I match it, hump for hump
I give it plenty with my pump
Pumping with Apidra in my Animas 2020 since April 2008
