Lows during pregnancy


(Jennifer) #1

Hi there,

I am currently 18 weeks pregnant. This is my first pregnancy.

I have found that I have had to significantly lower my levemir which I take twice a day. I have also found that my ratios are also smaller. This has just happened this week. I was lead to believe that the first trimester could be tricky but after that my insulin needs would continue to rise. So I am a little worried!

Have others experienced this? Am I naive to assume that it would be a steady rise in increasing my insulin needs from here on until the birth?

Any advice would be much appreciated.
Thanks
Jen


(joe) #2

@Jennifer_Anne hi Jennifer,

I saw this was 3 days old so I wanted to say I hear you and bump the topic back to the top.

Congratulations on your pregnancy I bet you are excited.

Diabetes is a bit of a science experiment so my unqualified advice is to Test often and keep good records, and maybe increase your Endo visits for the next 4 months if possible. My blood sugar is harder to predict and control when I introduce “changes”. Having a baby means big metabolic changes.

Good luck and best wishes


(Karishma) #3

Hi Ladies hope you are all well !
I am T1D and 1st time pregnant at about 5 to 6 weeks, I am on manual lantus 17 units a day and apidra for fast acting, I test almost every hour and 2 hours after meals and I found that my lows are between 3.3mmol/L ( 60mg/l) to 4.8mmol/L (86 mg/L) is that normal and how often are you “allowed to experience lows”, also what is considered a high? and often are you allowed to get highs, so far I have had in the past two weeks since finding out I had about 6 lows and I am worried that that is too many in such a short period


(KaraG) #4

Jen, congratulations! I have one child, a daughter, and she’s 16 months old. My pregnancy was as difficult as I had expected, but for very different reasons. My insulin needs did eventually rise, but not until near the end of my second trimester. During the entire pregnancy, my blood sugar was low. I’m not talking 70 mg/dl, more like 35.

Unfortunately my endo wouldn’t see me during pregnancy, so it ended up just being me and my OB controlling insulin adjustments. That was essentially the blind leading the blind- I didn’t have any experience with pregnancy and he didn’t have any real experience with Type 1. I had a couple of non-responsive episodes during the pregnancy, and my a1c throughout was steady at about 5.4%… that’s too low to even be considered pre-diabetic! My OB was thrilled by this, because he just didn’t understand the risks it posed for me to be experiencing those lows.

All this to say that you will hear over and over to keep your blood sugars low. While you don’t want a lot of high blood sugars, I’d suggest focusing on the balance and even tending toward the higher end of your target range if you can. After 40 weeks of barely being conscious (from those lows), my daughter was still born with neonatal hypoglycemia. I had a c-section and was stunned and distraught when I wasn’t allowed to see her after she was delivered. She was whisked away to the NICU and we ended up having some real difficulties with nursing… I’d advise writing a very specific birth plan and making sure you share it with all the appropriate parties.

After the surgery, a nurse came into my room and brought me a meal. She left, I gave myself insulin, and I ate. All good, right? She then returned about 4 hours later with a smile and said, “Okay! Time for insulin for that lunch you ate!” The dose she had already drawn up for me was about 7 times more than my ratio at the time, not to mention 4 hours late. Had I allowed her to follow her orders and give me the shot, I would likely have been in a coma or at the very least unable to attend to my newborn. After a heated argument with the charge nurse, we all agreed that they would write in my chart that I was going against medical advice and I would be handling my insulin needs myself. For the duration of our week in the hospital I was fine. So… talk to the doctor who will be delivering your baby, and make sure everyone is on the same page for what happens afterward.

One last thing. If you will be breastfeeding, be prepared for even more hypoglycemic episodes until your body adjusts to the huge caloric requirement of lactation. I had 1-2 nonresponsive episodes every week (always overnight) for the first 3 months of breastfeeding. This coupled with the lack of sleep can be challenging for you and your partner.

Sorry my reply is so lengthy; hopefully you’ll be able to glean something helpful from it. I’m sure you already know and agree that any challenges you face during pregnancy are worth it!