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Bailey17

Trying to get a handle on things... :(

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Bailey17

Having a hard time with this whole diagnosis of T2.

Backstory: I found out I was pregnant (a surprise, but a happy one) back in September.

Went to doc, after 1st blood work, it appeared I had hyperthyroidism so I went to an endo for treatment. Have finally gotten that stabilized.

A few weeks ago, at about 15 weeks, on the advice of my OB/gyn, I did an early gluclose test which revealed a very high number and had my Dr. sending me immediately back to endo. It appears I was an undiagnosed T2, I believe my endo I dictated my A1C was at about a 7 (which, in an effort to comfort me, she explained wasn't a terribly high number, but that we needed to get it down especially because I'm pregnant).

At first she put me on glyburide, which didn't seem to do much good.

About a week later, she put me on Levemir at night. We have gradually increased the dosage to now 20units. It has helped some but my fasting number remains too high for her liking (usually about 120-130).

My after eating numbers are usually 130-140s, with an occasional 160 to 170 every couple of days.

So NOW she just added the fast-acting stuff (Novolog-2-4 units depending) my #s are above 100 before eating, and took me off the glyburide.

I am still so frustrated about the fasting number most especially. I do not know what I can do to bring it down and feel somewhat helpless.

My endo wants my fasting number in the 90s, and my after eating number below 120.

The dietitian I met with was telling me I needed to pair all carbs with proteins and vice versa. She was telling me I needed to eat 4-5 servings of carbs and 5-6 servings of protein at lunch and dinner. This is impossible for me as I don't have the appetite to eat that much.

It seems like the times I eat a small, mostly protein based lunch or dinner, I have the best numbers.

I am so confused, though I've been really trying to eat as healthily as possible.

Does ANYone have any advise/expertise/suggestions on what I'm doing wrong?!

I'm about 18 weeks now.

Thanks in advance!

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Tanikit

Congrats on the pregnancy - finding out about diabetes is a shock at the best of times - during a pregnancy makes it even more complicated.

 

I have never done a pregnancy on low carbs, but apparently it is possible and it might work better for you. You will need to increase the fat to get enough calories. There are many posts about fasting blood sugars - do a search. Different things work for different people. First I would make sure the Levemir is enough - which means testing through the night about every 2 hours - this will also show where the insulin has its peak effect so that you do not drop too low (going too low at night will result in higher fasting readings and you do not want that). You can also add a protein snack at night - this keeps the liver busy so that it does not drop glucose into your system in the mornings and can reduce the fasting readings.

 

5-6 servings of protein in one meal sounds excessive - it is hard to eat a lot of protein as it fills you up. The protein is usually meant to stop your blood sugars spiking rapidly - it is possible to get the same effect by increasing the fat content of your meals without having to eat so much protein.

 

You are going to have to increase your insulin as your pregnancy advances - insulin resistance starts in the second trimester at some point (often 20 weeks or so, but can vary for individuals) - it will not just come right and stay right - you have to stay on top of it and keep testing and readjusting your doses.

 

Go and look at the diet threads in this forum - while they are not for pregnancy they may give you an idea of what you can eat and what will help with your sugars. You do need to get enough nutrition for your baby, but it is not true that this nutrition needs to come from carbohydrates.

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Lady Imp

Pregnancy does some seriously wonky things to diabetics. One day, you'll be completely normal, the next day your blood sugars are off the charts. Thank all the crazy hormones! I recently started the third trimester and like clockwork, my blood sugars went through the roof and I've been tweaking the pump on a near daily basis as a result. The new diagnosis complicates things as well, as it normally takes a very long time to achieve a balance - it certainly doesn't happen overnight. Your fasting sugars are going to take a long time to get it stabilized - and I will warn you now that once you get into the 3rd trimester, you're very likely to see a spike again, and medicine dosages are going to have to be adjusted. I'll be honest and say that the way to best handle insulin dosing is to not be afraid to tweak yourself, but if you're going to start doing that, do it VERY slowly, and only unit by unit. You are only just starting to figure out what insulin does to you and how your body reacts to certain foods - and that is an ongoing and continual process that will never end. Right now, you're essentially in an experimental stage, you're only just figuring out how food affects you. Best advice I can give is to start keeping a detailed food journal - write down what you're eating, exact portion sizes as well as carb counts. Include your before eating and after eating blood sugars as well. This will help you determine what foods do what to your blood sugar, so you know what is a good thing to eat and what to avoid in the future.

 

I have a feeling you may have misunderstood your dietician, as 4-5 servings of carbs in one meal is not only suicide for a diabetic, but impossible to eat - that's a ton of food there! I wonder if she meant that was the total amount of servings in one day, which makes way more sense. I agree that you should pair your carbs with protein, it will help keep you fuller for longer. I would highly recommend though to abstain from extreme lo-carb diets though, as your cells need the carbs to keep pumping out the extra energy to keep the baby growing, and babies need a full, balanced diet. That being said, don't be eating anything and everything in sight, either. A pregnant woman only needs an additional 300 calories a day, after all, which really isn't a lot. Stay away from processed carbs, all they're going to do is spike your blood sugar. A general rule of thumb is "the browner, the better." Know all the synonyms for the word "sugar" (i.e. "corn syrup," "high fructose corn syrup," etc) and don't eat anything with them in it. Eat lots of vegetables. Make fiber your BFF - it will not only not affect your blood sugar nearly as much, but it will also help keep you from getting constipated, which is a very common problem in pregnancy especially the further along you get.

 

Congrats on the pregnancy, and let us know how things are going!

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samuraiguy

One protein portion is 2 ounces so unless you want to eat a 10 - 12 ounce steak at lunch and dinner what I do is have 5 medium sized meals during the day; breakfast, morning snack, lunch, afternoon snack, dinner, all spaced about 2.5 - 3 hours apart. This allows me more flexibility in my food choices while still getting my daily requirements. I can still get 150 net carbs (I only eat high fiber carbs getting over half my carbs from non-starchy veggies) per day with no more than 30 net carbs per meal. The 10 - 12 servings of protein they want you to have can then be spread out to 2 - 3 servings per snack/meal, i.e. 2 eggs with breakfast, 1/4 cup nuts for morning snack, 4 ounces turkey breast for lunch, etc...

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