BG creeping up in the evening

[Sobriquet 848]

Still new to diabetes, and pregnancy -

I have noticed the last two nights that by BG's start slowly heading up, from about 6.30 on, and there seems to be nothing i can do to bring them down.

The first night i had a low GI carb meal, then a no carb meal the second night, but i can't get it to come down - I have been walking both nights, been active after dinner etc.

The first night they stayed at 130-140 and refused to budge below 130, no matter what i did, including 20 minutes pretty strenuous walking at 1.30am. In the morning (ha! 4 hours later) they were down to 108 on waking up, and 133 an hour later after i had been moving around a bit, trying to get it below 100.

The second night they went down after the walk to 83, then increased back up to 94 an hour later. I went to bed, hoping... and this morning they were 125.

maybe not so drastic in the big scheme of things, but why is this happening?

Doctor said never to inject a correction before bed, but if exercise isn't working? Or is it normal to be out wandering around at 1am because you are diabetic and pregnant?

Or do i need to adjust basal?

(I'm on Humulin basal NPH early morning and late night, and Huminsulin Normal (German brand name, it's a non-analogue fast acting) for food.)

Any tips?

 

 

[Lady Imp 583]

Ugh, I hate NPH insulin, I had good A1c's on it but it made my blood sugars swing dangerously - any high BGs I had were offset by lows that I probably shouldn't have even lived through. It looks to me like you're susceptible to the NPH swings as well. I'll be honest with you, I didn't have good control until I went on the pump, so I really don't have any advice for you. I hesitate to even recommend a 24-hour insulin, since my experience with it was terrible as well, especially when pregnant. But some people do have success with it, and you may want to consider talking to the doctor about it.

 

In the meantime though, I would be correct in assuming you're taking the NPH twice a day? You might want to try tweaking one of the doses up a tad. NPH peaks anywhere between 4-12 hours though, so it will be tough to say which dose needs the tweaking, it's going to take some experimentation on your part. I'm inclined to tell you to try taking your AM dose up a unit and see what that does. Given that you're not insanely high, I would highly recommend tweaking only one unit at a time to prevent any extreme crashes while you're experimenting. Keep a lot of fast-acting glucose on hand while you're doing this.

 

I'm also wondering exactly what you ate in this timeframe. I know with me, if I  eat something that is disproportionately high in soluble fiber, I will be completely fine for three hours after eating (in some cases, even without bolusing at all), and then see a spike after four. I tend to pay very little attention to GI numbers and only pay attention to exactly how certain foods affect me for this very reason - through a lot of experimentation, I have learned when to take how much insulin while eating certain foods and depending on how my BGs are looking before the meal. It's an art form that will take some time to learn.

 

Just keep in mind that you're insulin needs are going to change CONSTANTLY while pregnant, so you're going to have to get very comfortable with adjusting insulin on your own, and fast. I know that you're very new to this and this will be incredibly intimidating, but seriously this is the best piece of advice I can give you. You're in a lifelong science experiment here, and you will be continually collecting data and adjusting according to it for the rest of your life. Just right now, those adjustments are going to be sudden and occurring on a near daily basis. 

 

I really wish I could be more help, but holy crow do I loathe the insulin you're on and it's been a while since I've been on it myself - and like I said, I had very limited success while on it. Hopefully someone will have a little more insight.