For the next five months, readers will be able to track Kelsey's progress and find out how she controls her diabetes while pregnant.
Pregnancy Tracker: 16 weeks
Size of the Baby: the size of an open palm
Biggest Obstacle: Fitting into clothes -- maternity are still too big, but I can't button my pants!
Excellent blood glucose control for a non-pregnant, type 1 diabetic often includes testing many times per day and correcting any high readings. Even with tight control, diabetics are used to the occasional postprandial spike or unexpected high blood glucose. However, once you add pregnancy to the mix, excellent blood glucose control hits an entirely new level. Testing up to 20 times a day is typical, target blood sugars become unbelievably low, and those postprandial spikes, or for that matter any high readings, are no longer bearable for a pregnant woman with diabetes.
An occasional high reading is going to happen while you are pregnant. Yes, I said it: pregnant women will have instances of high blood glucose!
When I first learned I was expecting, I planned to avoid any and all BG spikes for the duration of my pregnancy. Of course, this is an ideal, and we live in the real world where pump tubing gets clogged, infusion sites go bad, carbohydrate counting is not a perfect science, dawn phenomenon rears its ugly head, and pregnancy hormones mess up everything you thought you knew about your body!
Worrying about a high reading does not help, nor does beating yourself up for allowing your BG to rise. Stress is not going to benefit you or your baby, much less facilitate lowering your BG to the desired level. Here are a few things that will help:
1. If you use an insulin pump, make sure your pump is not causing the problem. You may want to disconnect and attempt to fill the tubing with insulin to ensure everything is working mechanically before administering a correction bolus.
2. For real stubborn highs, nothing beats testing, correcting, testing, correcting. Often diabetics worry about stacking insulin, but when facing an unyielding high blood glucose, stacking can work for you. Just be sure to keep testing every 30 to 60 minutes so you can gauge when your BG starts satisfactorily lowering, and be prepared to snack to avoid "bottoming out" later.
3. Being high and hungry at the same time is a pain, but it only makes things worse to eat carbohydrates when your BG is already high. Ideally, a pregnant woman should begin a meal with a BG between 60-90 mg/dl. If I have a blood sugar higher than about 150 mg/dl, I'll bolus 15-20 minutes before a meal, and test again to make sure my BG is starting to drop before eating. If I am absolutely starving, and my BG is too high, I will snack on nuts or vegetables without much carbohydrate content.