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Pregnant type 1 diabetics, step over here...

(1000 Posts)

I seem to have filled up the old thread and thought I better start a new one! grin Still got ages to go, don't leave me now...

Am currently sat waiting for my 16 week antenatal appt, been here an hour so far and just had BP done and that's it.

Mylittlepuds Thu 17-Jan-13 21:46:20

Pfft! How embarrassing Spotty! Hope they weren't too smelly.

I'm okay Hoping but this night time level rise thing is v. annoying! Almost hit target tonight (8.5 90 mins after eating so quite chuffed) but then to my utter annoyance I could see from the CGM that it started rising! Took a correction but it's obviously going to be another couple of hours before it's down again. I just can't understand it! This has happened to me on occasion when I've had something really fatty to eat, but that's not what's been going on here. Did the docs give you any explanation for it? Is it the long acting running out of steam do you reckon? Did you say you'd brought it forward an hour?

Also ladies re. my little problem above, how many of you split long acting, why did you start doing it and has it helped? Is it just a case of literally splitting your dose (so if I take 14u long acting on a night taking 7u morning and 7u night?) Do you do it with breakfast or earlier? And is there an adjustment period in terms of your ratios? Sorry for all the questions!

Aww I hope Zach doesn't get the cold - my MIL had a bad one when DS was new and he thankfully didn't get it. I think you just go into protective mum overdrive!

Evening all.

I'm fine, feeling kicks more often now (20+5) which is reassuring, scan is on Monday pm, antenatal appt on Tuesday am, heart scan at a different hospital is Friday pm.

We're off to my niece's christening on Sunday (weather allowing!), with associated buffet do afterwards, I'll need a bit of luck for that I think.

I also need a good kicking, I am taking/have taken my eye off the ball with BSs recently. I just can't bring myself to be bothered, this is BAD. I think it's related to my last PG, as it was about this far along that we first developed twin to twin transfusion syndrome and went into a maelstrom of diagnosis, treatment, and ultimately being told that 2 of our triplets had died. What do I do? Don't know if I can bring myself to talk to anyone about it IRL, even typing this is making me teary.

Mylittlepuds Thu 17-Jan-13 22:07:05

Oh Rue! I'm so sorry. That must have been absolutely harrowing. Was it related to the diabetes? Or just one of those things - I know having multiple births can carry more risks?

When you say eye off the ball is it because you are thinking so much about what happened last time? How off the ball? I think we are a hard working lot here and our 'eye off the ball' really isn't too bad. I know from when I've chatted to midwives that there are diabetics who are repeatedly admitted with complications though continual high sugars, like through the roof ketones etc.

Hopingforno2 Thu 17-Jan-13 22:37:22

rue im so sorry that must have been the worst thing to go through and not having gone through it i can only say im thinking of you at a difficult time thanks

puds i was told a few theories that just didnt seem right and u will know as ur on cgm, was told i could be dipping without knowing and the steady but steep rise was due to this or if i wasnt quite 4 hours post meal my rapid may still have some effect after i went to sleep hence the low at 3-4am after correction. In the end i decided to bring my night dose of levemir back to 8pm as this means my 2 doses are 12 hours apart and for 80% of the time this works for me. I was on latus till around 14 weeks then my dsn changed me to levemir split dose which took a good cpl weeks for my bgs to settle with but now im thinking thay yes i did need a split dose. At 1st i did half and half but now its 11 morning/ 13 night so not much different but not half split, i think that hormones and baby growth spurts have a big affect on my bg sometimes it doesnt seem to matter what i do.

Hopingforno2 Thu 17-Jan-13 22:44:06

and its gonna be one of those nights tonight, have gone from 6.9 to 11.1 in just over an hour sad

Mylittlepuds Thu 17-Jan-13 22:47:32

Thanks Hoping. I'm at the clinic Mon. Will tell them what you've said so thank you :-)

It's SO frustrating sometimes but I've now run out of angry tears at not being in control despite my best efforts. Breakfast is usually a disaster and now so is dinner! Over night I used to be great but now i'm hovering at 7ish all night long and that's a good night! I totally agree re. the hormones. I'm just going to have to accept what's happening and try my best. X

Mylittlepuds Thu 17-Jan-13 22:48:40

Oh Hoping - know how you feel. I've been at 10 for four hours despite two corrections...

Hopingforno2 Thu 17-Jan-13 22:55:44

puds long night for both of us then lol im trying not to be as wound up as it normally gets me im waiting an hour then as long as its gone down by even a little bit il go to sleep n set an alarm for 3.30-4 am just to make sure im not at one extreme or the other. Let me know what they say at ur clinic would be good to get another view of why it happens and ways to solve it i seem to get a few nights when im fine followed by a crappy night or 2

Thanks puds - it was just one of those things that sometimes happens when you're carrying identical multiples. We were unlucky in how quickly it happened and how severely too. In my head I know that we had the best outcome medically possible (we had a 50% ish chance that none would survive the surgery) but that doesn't always help.

Re how far off the ball, I'm testing twice a day atm, first and last thing, so at least I'm stable overnight (thank goodness for my pump!). Im sometimes testing during the day, but not often and eg today I know I had a hypo, treated without testing and just carried on. Stupid behaviour, and I need to change it. Question is how I actually manage to do it. I'm fed up of always having to be in control and sensible.

Mylittlepuds Thu 17-Jan-13 23:26:46

Rue I hear you there. I want to go out with my mates, get pissed, dance the night away and buy a takeaway on the way home. Oh and sleep in. But I couldn't even do that non preggers!

The pressure is too much. The control you need - and willpower you need to show - is just ludicrous. It's little wonder we sometimes get fed up. I just want a massive bowl of cereal at a random time WITHOUT shifting myself about insulin requirements. Too much, too little - it's enough to drive you insane (I am a bit but no wonder).

Tomorrow is a new day. Get testing after each meal again and you might be pleasantly surprised at how you've been doing. There's no point adding to your emotional load by feeling guilty. Hope you feel better soon:-) I want at least four tests out of you tomorrow mrs!

Mylittlepuds Thu 17-Jan-13 23:28:07

* shitting yourself, obv!

dieciocho Fri 18-Jan-13 06:51:01

Rue as has been said before, we're the "good" ones because we care enough about our health and all who it affects to be arsed to join threads and ask Qs. You're doing fine; a couple of "off" days will not be the end of the world. I agree with puds - a few more tests from you!
You can do this and you know we are all here to support you in whatever small way we can. brew

BonaDea Fri 18-Jan-13 11:15:15

Rue - sorry to hear about the loss of two of your triplets last time. Very hard thing to deal with.

As for you 'taking your eye of the ball' I think as has been said above you are probably doing a better job than the majority of people with diabetes so don't beat yourself up. However, you do need to try to get back into the swing of testing. I tend to find I don't test when I feel I've been 'bad' and I just don't want to see the results! But it is a bad habit, because a) it means that you can't fix things if they are going slightly awry; and b) you're running the risk of losing hypo awareness if you're not picking up on them. I don't need to tell you this, do I? So, perhaps take it one step at a time. Add one more test around midday - possibly before lunch? That way you're breaking up the day with just one test, and it is easy to remember to do it then. You'll probably find you're BGs are fine and it might incentivise you to get back up to the one squillion tests a day my fingers are currently not enjoying wink

puds - re splitting long acting. Be warned it only really works with Levermir, not Lantus. Lantus has a much longer profile and so splitting hte dose means you get unhelpful overlaps. I moved from Lantus to Levemir and started to split because my morning readings began to get worse and worse but I found that if I was increasing the Lantus too much I would be fine first thing but madly hypo-ing mid-morning and lunchtime. So, I split mine because generally speaking I need WAAAAAY more insulin overnight than I do in the day. I think that is quite common and can relate to dawn phenomenon. So, pre-preg I was taking 7u in the morning and - I think - 19 at night.

When you first split the dose, I think the done thing is just to split it evenly (50/50 as you describe) and take it from there, tweaking if you feel the need to have more at a particular time of day.

Did anyone watch One Born Every Minute this week? I watched it on catch up last night. There was a lady being induced due to Gestational Diabetes. She and her husband were asking whether she had to be induced or could they wait for labour to start naturally. The doctor was very kind but explained 'the small, but significant risk of sudden death of the baby' and also said that they have no real knowledge about why it happens. I don't think I've heard it put so bluntly before - explanations I've had range from deterioration of placenta to size of baby. Anyway, not new news, but it was quite interesting to see the induction (she had all the drugs going in the end including epidural and had a forceps delivery in the end).

Hopingforno2 Fri 18-Jan-13 12:48:01

I watches one born and ive never had it so bluntly put to me either.

Im sooo fed up today got my bg down to 8 before i went to sleep last night but was running late for breakfast so it was 6.9 i took an extra unit with breakie n just tested as about ti drive 11.4 sad wtf!! Correction taken as lunch wont be for at least an hour.

dieciocho Fri 18-Jan-13 19:07:45

Update is that we have had our first breastfeed! So happy.
Using Medela nipple shields (thanks for recommendation smile) Violet fed for 10 mins at elevenses, 10 at lunch and 30 mins at dinner! I can't do it alone as her breech arms are still up near her face a lot of the time, so she knocks the shields off - DP has to keep replacing them.

Hope everyone else has achieved something today too grin.

That's great diec! You must be really pleased smile

Ds still tries to eat his hands when I try to latch him on, sometimes I just wrap a thin blanket round him to stop him.

Mylittlepuds Fri 18-Jan-13 19:12:33

Ahh well done Diec and Violet! The start of something wonderful :-)

Thanks Bona - that's really helpful info. Is ANYONE still on Insulatard long acting or is it just me?! Maybe that's where I'm going wrong!

Wow puds, I don't know about insulatard! Old school, I was on that in about 1985 grin

Well I've managed 3 tests today so far, so at least 2 more than "normal", hoping I can keep it going. Did hypo late morning just before lunch (did the same yesterday), again didn't test before treating, but did test afterwards before eating lunch and got a 6.2. Before dinner I got a 8.1 so not horrible but not fantastic either (esp considering I had no-carbs omelette for lunch).

Lots of snow today, think morning hypo was caused by dragging DS to playgroup on a sledge...

Mylittlepuds Fri 18-Jan-13 20:46:39

Ha! Really?! I was offered a 'newer' one but was too scared to try it. Is there any difference in their power?

Well done Rue - and certainly not horrible. If I just 'left' myself after breakfast I'd definitely hypo every mid morn due to the ridiculous amount of insulin I need to get to a reasonable level 90 min after eating. In fact even though I generally 'catch' myself going down due to the CGM I still often get to 3.5 despite trying to offset it.

I've tried to be a lot more relaxed about hitting target a.m. for this reason. I find if I hit 7.8 in 90 mins I'm looking at a terrible hypo. However a gentler 9 within 2 hours it's not so bad - although I'll still go low mid morn with even that reading. I think sometimes the targets are foolish as they can do more harm than good - I.e treating the hypo and then going too high. But if I get say to 11 a couple of hours after and leave it I'm at a perfect 5.8 for lunch. What does everyone else think? X

I thought the profile for insulatard means it works for 12ish hours but not as a flat profile like the modern ones (levemir/lantus) do? So it does have a peak then tail off. I think. Don't quote me on it though!

Hopingforno2 Fri 18-Jan-13 21:18:22

puds my clinic doesnt encourage me to test between meals too often unless im not feeling good ie suspect a hypo or going very high. They just want me between 4 and 6 at mealtimes but obv im too uptight for that lol also is insultard a cloudy insulin?? I was on one u had to shake at night at 1st diagnosis but was changed to lantus a long time ago due to it lasting longer then levemir in this pregnancy due to splitting it.

dieciocho Fri 18-Jan-13 21:59:26

That sounds much better Rue, keep it up.

I haven't been on Insulatard for over 10 years Puds, is it even possible to get it in pen cartridges? I used to have it with a syringe back in the 90s!

Yes, Spotty, midwife gave same advice re: hands. Will try it tomorrow.

Mylittlepuds Fri 18-Jan-13 23:15:24

Oh my God I'm a diabetic cast out!! How embarrassing! Yes it's the cloudy one!

When you switch do you have exactly the same amount? Do you need to tinker with fast acting? I daren't do it!

dieciocho Sat 19-Jan-13 06:16:41

Hmmm, it's been so long puds I can't really remember. I'd speak to your team before changing re:doses and maybe arrange to call one of the DSNs every day for the first week (or is that a service that's only offered in paeds.?)

Hopingforno2 Sat 19-Jan-13 08:21:59

puds ur not an outcast, but like diec ive been on lantus then levemir so long i cant remember what the change over was like but insultard just wasnt working for me i need one thats there all the time lol i can phone my dsn mon-fri or at least get a hold of one of them for advice.

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