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Sobriquet

Help! Going to over 200 overnight

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Sobriquet

We finally managed to get pregnant- I have no details yet as I've only found out a couple of days ago while we're on holiday.

It was a complete surprise as my numbers have been consistently high- and every night they go up to 180-250. I have upped all doses of everything- last night I injected 10 units NPH, up from my normal 5, and I woke at 3am at 151, injected 2 units short acting to correct, then just now woke at 8am at 158.

I have had to double my carb: insulin ratios and my correction amount (1:25 from 1:50).

What is going on? I am on progesterone as we have lost 3 pregnancies before this one- could that be affecting me?

All I can think is that I am damaging this poor little kid inside me, and I can't do anything about it no matter how hard I try!

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Sobriquet

I must add - the progesterone has only been for the last 2 days- the big overnight numbers were happening before that as well.

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miketurco

I'm really sorry to hear that you're going through this. Sugars are easier to v correct before than after and you're going to have to ride this out. I'm t2 and know nothing about pregnancy and diabetes. I feel for you, though. I am really curious about what you are doing in terms of diet.

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NoraWI

Pregnancy raises different hormones (in addition to the extra progesterone you are taking) and hormones really throw blood sugars off. I doubt that additional insulin can harm your fetus as insulin is a natural hormone. I think you are doing the right thing by raising the insulin dose to combat the highs. I would also cut down on the carbs in your evening meal as that by itself can raise BGs overnight. I assume that you are talking to your doctor(s) about this.

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Sobriquet

I'm emailing my doctor- I'm still on holiday and can't get to doc until Tuesday.

I am either over 150 or crashing into some serious low territory. At the moment I'm testing (and usually injecting) every 2 hours.

I'm trying to avoid the carbs- but we're in Scotland, and low carb food is few and far between! :)

 

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Sobriquet

Thanks for the well wishes - still waiting for doc's appointment - tomorrow morning i should know a little bit more about what we're dealing with.

 

I am afraid this may turn out to be another sad end... But at least we know we can still try!! (They had told us we would not be able to conceive naturally any more due to a bunch of reasons). Trying to stay calm, and not get annoyed that I am still having to inject a correction bolus every two hours - the fat on my stomach is soo puffed up from all the extra insulin i already look like I'm 4 months in!

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jims_forum

While I do not have all the required data; This sounds like the dawn effect where the bad boy liver is dumpining in exess

glucose usually starting at 3:00 am and continuing to 8:30/9:00 am until a dump of insulin helps tell liver to shut up and stop dumping in excess glucose.

\For me; I would see my bg would soar to 238 reliably overnigt. The things I have heard work is to be sure strong enough dose of standard metformin on duty from 2:00 am till 6:00 am or if insulin pump being used - have it add extra doses of insulin at 4:00 am.

 

For me it meant taking a 500 to 700 mg dose of metformin at 10:00 pm and second dose at 12:00 am midnight. DO NOT COMBINE THE TWO DOSES INTO ONE - NO WORK.

 

Others find that a snack eaten late at night will cause islets to throw in a bolus of insulin and tell liver to knock it off.

 

The technical issue is the liver that is signalling on the inverse of the insulin presence in blood. Liver assumes that if insulin is low - you need extra glucose dumped in. This issue is not fully understood by others and leads to poor treatment of this issue to type 2 diabetics!

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ant hill

 

Sobriquet, Congrats on the pregnacy. I would think that you have hormone shock so I would increase the Basel and as you progress I can see the Basel may go up again. Then again I am a Mere Male. I can be wrong.

 

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Sobriquet

Thanks Peter! (and you are not a mere anything - you are Peter!!)

 

Jim - thanks for the input - but i am a type 1 - and with things the way they are right now, snacking is really not the best idea until my insulin requirements settle down. Which is super annoying as snacking is supposed to help settle the stomach for morning sickness- which i seem to have (mildly) all day long.

 

I finally saw the doctor(s) today - they think we are five weeks in, so really early - possibly six, but we won't know until it is a little bigger. I am not getting too excited as we have been here many times before, but it is nice to see that everything is where it should be, so as to speak.

 

My diabetes doctor freely (and apologetically) admitted that she had no experience dealing with women on progesterone- and took extra time through her lunch break to sit with me and go over all my charts...

What we are doing now is 10 units NPH at night, 4 in the afternoon and 9 in the morning.

Carb: Insulin ratio set at 1:2 for liprolog, and 1:1.5 for humulin.

Correction at 1:25 in the morning and 1:50 in the evening.

Basically, as long as i go to bed no higher than 80, i stay low all night. If i go to bed at 100, it rises steadily from the moment my head hits the pillow.

They think it is because i am taking progesterone before bed, and in the morning, and that increases insulin resistance.

 

It's just really strange as i have already more than doubled my insulin intake - even though insulin requirements are not supposed to increase until the second trimester. I'll be using enough insulin to support a small diabetic nation by the end of it at this rate!

Thanks again for your input everyone - even just reading things really help to keep busy and stop worrying.

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jims_forum

Thanks Peter! (and you are not a mere anything - you are Peter!!)

 

Jim - thanks for the input - but i am a type 1 - and with things the way they are right now, snacking is really not the best idea until my insulin requirements settle down. Which is super annoying as snacking is supposed to help settle the stomach for morning sickness- which i seem to have (mildly) all day long.

 

I finally saw the doctor(s) today - they think we are five weeks in, so really early - possibly six, but we won't know until it is a little bigger. I am not getting too excited as we have been here many times before, but it is nice to see that everything is where it should be, so as to speak.

 

My diabetes doctor freely (and apologetically) admitted that she had no experience dealing with women on progesterone- and took extra time through her lunch break to sit with me and go over all my charts...

What we are doing now is 10 units NPH at night, 4 in the afternoon and 9 in the morning.

Carb: Insulin ratio set at 1:2 for liprolog, and 1:1.5 for humulin.

Correction at 1:25 in the morning and 1:50 in the evening.

Basically, as long as i go to bed no higher than 80, i stay low all night. If i go to bed at 100, it rises steadily from the moment my head hits the pillow.

They think it is because i am taking progesterone before bed, and in the morning, and that increases insulin resistance.

 

It's just really strange as i have already more than doubled my insulin intake - even though insulin requirements are not supposed to increase until the second trimester. I'll be using enough insulin to support a small diabetic nation by the end of it at this rate!

Thanks again for your input everyone - even just reading things really help to keep busy and stop worrying.

Thank you for sharing and best wishes.

 

Yes I realize you are type 1 and not being stupid. The excess glucose has to come from somewhere and I assume digestion well over before the increase you are watching. And yes the other items you are on could kick numbers up.

 

But as I said best wishes and good luck and apologies for butting in!

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