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kmcd23

Higher at 2 hrs PP than 1 hr PP?

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kmcd23

I've been having weird climbs the last two weeks, and I just don't get it. Today, for my mid-morning snack, I had a 1/2 of a Luna bar with a glass of unsweetened soymilk. 18 carbs total, 11 grams protein. (I'm really trying to up my protein still.)

 

I'm supposed to use a 15 carbs to 1 unit insulin ratio, but I know Luna bars spike me a little bit fast and hard, so I took two units, and figured I could add a little more to my snack if I started to go low. (I prefer a 10 carb to 1 unit ratio, but my endo is adamant that is too much for me. I'd rather correct lows quickly then wait two hours for insulin to correct a high. But that's a conversation for my next appt.)

 

Pre-snack was 84.

1hr. post snack was 91.

2 hr. post snack, at insulin peak, was 149!!!

 

This is the third time I've had this happen lately, and not always with things as sweet as Luna's.

 

I'm also rising a little from my 3am check, usually in the 70's, to my 6am check, which had typically been in the 70's but is now creeping to the 80's and 90's. But not every day. Other days, I'm waking in the 50's.

 

Is this a sign of needing to up my insulin as I approach the 2nd Tri? Any insight? I feel like sometimes I need to take a step back because I'm losing myself in the details. There are days when I feel like I'm really getting good at this, and other days when I feel like I'm floundering about, and baby is paying the price.

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aiah23

Okay first off, your protein heavy snack isn't going to be digested at the 1 hr mark so it wouldn't have all hit your bloodstream at that point. I am not surprised your 2 hr is higher, although that isn't a bad number all things considered. You're going to see a big jump in your insulin requirements around the 18 week mark. I don't remember a significantly higher jump prior to that date, but it's been a couple years. Also, your I:C ratio will change not only as the pregnancy progresses but throughout the day. I noticed I was SUPER sensitive to carbs in the morning. My mid-morning snack had to be switched to cucumbers and hummus with a slice of cheese, very few carbs from a pregnancy perspective, and I still had to take insulin for that. Nowadays, I don't take insulin for that same snack, even if it's a mid-morning snack. Sounds like your endo is trying to keep you away from lows. If you haven't had any severe lows yet, I wouldn't be too worried. Endos, etc. always seem to worry more about those early in pregnancy than the occasional high.

 

Fawn

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kmcd23

Thanks Fawn. I hadn't considered that the protein would slow it down so much. I mean, I knew it helps even out the rise, but I just usually don't see patterns like this. I appreciate the info!

 

I did have several lows a week for a while, a couple in the twenties, most in the 30's and 40's. My OB's were happy with that, but when I finally got in to see the endo, he was not happy with it at all.

 

Thanks again!

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aiah23
Thanks Fawn. I hadn't considered that the protein would slow it down so much. I mean, I knew it helps even out the rise, but I just usually don't see patterns like this. I appreciate the info!

 

I did have several lows a week for a while, a couple in the twenties, most in the 30's and 40's. My OB's were happy with that, but when I finally got in to see the endo, he was not happy with it at all.

 

Thanks again!

 

The issues w/ the lows are how quickly you can fall. Realize that the baby will take as much as it needs from your system. The night before I found out I was pregnant (09/27/10), I went to bed w/ a blood sugar of 84. I felt I was going low so I opened up a juice but I don't know what happened after that. All I knew was that 2 hrs later, I was drenched in sweat with my husband encouraging me to drink a second OJ. He found me unresponsive in bed w/ light on and juice opened. He tested my blood sugar at 12. That 12 was 42 minutes after I tested at 84. OBs generally don't care if you have some in the 20s b/c they assume someone is around helping you, there are real possibilities that that won't always be the case and endos are aware of this (since they generally have to write letters to MVD, etc. stating your competency at blood sugar regulation or, worst case scenario, how it's improving after you or someone else has caused an accident while low). The liability falls on the endo, not your OB for such situations so that's why your endo will always freak out more. You may have to further reduce your basal insulin (either your hourly rates or your shots if you're on MDI) to prevent some of those lows. They wipe you out quite a bit and, compounded with pregnancy, make it hard to get much done.

 

Fawn

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-Lee-B

Are you on a pump? Might be a good time to use the square wave bolus, anything with a lot of protein can take longer to hit the blood stream so the square wave can help. I usually try it at 50% now 50% over a half hour and it seems to help a fair bit.

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kmcd23

No, not on a pump. I want to be, but endo said I have good enough control with injections so he doesn't want to risk messing that up during pregnancy unless we have to. So right now, I use Levimir pens twice a day, and Novolog pens when I eat.

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aiah23
No, not on a pump. I want to be, but endo said I have good enough control with injections so he doesn't want to risk messing that up during pregnancy unless we have to. So right now, I use Levimir pens twice a day, and Novolog pens when I eat.

 

For the morning, and when you're doing higher fat/protein meals, take 60% of the insulin before you eat, take the remaining 40% of your dose 30-45 minutes later. It really helps! Did pregnancy on both of those pens as well....

 

Fawn

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