April 2, 2011
It has begun. That fun thing that women with diabetes talk about when they’re pregnant… Those dreaded two words….Insulin-resistance.
And for me, it has hit this week for sure.
I’m now at 22 weeks and basal rates have increased by about 0.1 - 0.15 units per hour in my pump, and boluses for meals, well, those are still a work in progress.
My endocrinologist knew this was coming soon, so he wasn’t as upset or shocked over the numbers as I was after printing them out and seeing them in black and white. I, on the other hand, have been an emotional wreck about them since seeing them all laid out. Guilt, aggravation, frustration, and total confusion have left me in tears many times this week because I’m not used to not being able to pinpoint a reason for something and fixing it. I’m not used to a blood sugar plummet or spike happening just because it can, not because of something I didn’t do right when figuring a bolus or scheduling exercise. This week has taken a big mental toll on me, and if it weren’t for a few friends in the Diabetes Online Community on Twitter, I think I could have easily gone insane. The biggest thing I’m having to remember is that when I’m figuring out what may have gone wrong, is that most reasoning that I knew before pregnancy doesn’t apply now. This is a whole new ball game with a different set of rules.
Another new component that I’m having to deal with along with the insulin resistance that normally comes along in pregnancy is the start of what could be gastro paresis. He said that not only is my uterus growing and putting pressure on the stomach, but the hormones associated with pregnancy can cause delayed food absorption. Lately, after some (not all) meals – low fat, high fat, complex carbs, fast carbs, any type of meal – I will still feel miserably full for hours. My blood sugar will fall into the low 30’s, I’ll treat it trying to keep from going too low, only for 3-4 hours to pass and my blood sugar will be on its way to the stars quickly. It’s not every meal that this happens, so I explained that it’s hard to know when to wait to bolus or to prebolus to keep from dropping low or spiking too high from miss-timed boluses. So, we came up with a plan. I am to use a combo-bolus (also known as a dual wave bolus) to where some, but not all of my insulin is given up front, and the rest is given over time. This way, we’re hoping to help both problems out. I’ll be faxing him blood sugars next week to update how it’s working.
I’m also starting to keep a log of every food, every bolus, and every prebolus time to send to him too. He’s probably going to hate me, but I am really doing it for myself. I’m trying to calm my brain from blaming myself for all the highs and uncontrolled numbers and prove to myself that I’m doing everything I can possibly think of to control my numbers and keep me and this baby healthy as possible. Going overboard? Maybe. But if it helps me keep my sanity right now, I’ll do it. After all, I need to keep as much of my sanity as possible at least until the baby comes, right? ;-)