type 1 diabetics help please

[Hopingforno2]

Hi all

So as well as my other posts re blood streaked cm that comes and goes i would appreciate advice from any fellow type 1 diabetics.

In my 1st preg i was not given a way to or asked to monitor ketones, this time have been told they poison the baby! Im trying so hard to keep my bs between 4-6 but finding this a challenge. I have just been changed to a split background insulin in the last week to combat early am lows but im finding that im having high 2 hour post meal bs in last cpl of days followed by a low before bed (myb my fault) which then ends up with a high bs later on that result in ketones!!! This is the 3rd night ive been up nursing my bs back down and flushing out 0.2-0.5 ketones :( im so tired and worried about this i could scream and obv 1st time il be able to get a hold of diabetes midwife is monday.

Any help much appreciated

Hi hoping

I was diagnosed with T1 about 2 years ago, although not been through a pregnancy with T1 (yet!). I had gestational with DD which then went away after her birth, then suddenly a year later I felt awful, went to GP, took blood etc etc straight on to basal/bolus injections for T1)

Anyway... I don't have a huge amount of advice re: ketones. I remember having them a few times with DD (when I had gestational diabetes) and the midwives going in to a flap about it, but then when I went to the diabetes centre they were relatively unconcerned .

With regards highs & lows, presumably you are on a basal/bolus regime? Have you done a DAFNE course? How do you decide how much insulin to inject - i.e. do you have set insulin doses or do you match insulin to carbs?

In order to help avoid the high 2 hour post meal I'd suggest trying a couple of things...

Try to stick to low GI foods where you can, as they will release slower and help to avoid a post meal spike.

Consider taking your insulin a little earlier than you eat (e.g. I would do it immediately as I sit down to a meal, but you did it say 10 mins before eating it would already be getting to work and could help to reduce a post meal spike (not sure where I read this - might have been on the diabetes.co.uk forum)

If you are following a carbs:insulin match ratio (such as DAFNE for example), consider reducing your carb intake at meal times (and therefore your insulin) as this could help to avoid BS swings (you could also do this in combination with low GI)

Do you have a BG diary you could post (readings pre & post meals, what you ate and how much insulin you took and we could try to spot a pattern?)

I hope some of this is helpful? Try to stay relaxed until you can speak to your DNS on Monday (easier said than done, I know).

DH and I are hoping to TTC again in the near future but doing it with T1 scares me in a way that getting GD never did! There's just so much to balance and consider right from the outset.

Why do you think you are having a hypo/low before bed? (you say "maybe my fault") Are you correcting your post meal high before your original dose has worn off perhaps, or are you eating foods that will 'spike' you but then you drop rapidly after?

Sorry every1 having an awful
Day :( was in maternity this morning with bleeding and they have found a small area of seperation at the fundus?? Or a haematoma they called it so im very scared at the moment tho they said most work out fine if it gets bigger then the baby will be comprimised so my heads all over the place.Yes the lows r mayabe my fault for correcting the after meal highs and or over compensating the lows, i have done a carb counting course and have 'set doses' with to adjust if im part high or low having a big/small meal etc

Sorry cant think just so worried

Sorry to hear you're having a stressful time. .

WRT insulin doses, have you been made aware that your insulin requirements are likely to increase significantly throughout pregnancy? For example, I currently inject a ratio of 1u insulin per 10g carbs, but my understanding is that this could potentially triple during pregnancy. Important to keep a BG diary so that you'll be able to spot patterns as your pregnancy progresses and select the right doses rather than correcting highs and lows and swinging all over the place. Maybe speak to your DSN and see if they can get you a place on a dafne course, or refresh/ review your carb counting education?

I'm sure it's hard to concentrate on your diabetes when there's so much other stuff going on, but I'm sure you're well aware of how important it is to keep on top of it, especially during pregnancy.

Good luck x