It was good to see my endo, although on the way to see him I'd done a blood test and got a result of 20.1!!! I was shocked and completely freaked out worrying about the effects on my baby. Something had gone wrong, probably with my pump site, and I had no set change materials with me. Luckily I had a syringe and some short acting insulin, which I had in the car as we hurtled towards my endo appointment at the hospital. Within an hour it had brought my sugars back down and my partner had returned with a set change for me. Phew. Still I was pretty frazzled sitting there in my endo's office and I think he was surprised that I didn't seem more excited about my pregnancy!
He did a HbA1C which was 5.6, very reassuring for me. But according to him,...
I was having too many hypos. He'd guessed that when he weighed me. I was 54 kgs. Four more than I had been last time I'd seen him. And going from a HbA1C of 6.9 down to 5.6 in one month was a sure indicator of hypos. I explained that because I'd had a few really high sugars in the first two weeks after conception I had probably been a bit trigger happy with the insulin ever since (ie erring on the side of hypos rather than highs). So he told me to cut back.
He said he would either be having holidays in December or January, so there was a chance that he'd be away for the birth and the lead up to the birth... the period in which I'd be needing really close monitoring of my blood pressure and oedema. But I was reassured by the fact that the endocrinologist that would be covering for him was excellent and had _plenty_ of experience with diabetes and pregnancy. I'd had him visit me in hospital after the birth of my daughter when my endo was away and he was very good.
He told me that my bsls would probably start dropping (most common between 8-15 weeks) and this is definitely what has been happening over the past week since I've seen him. He wants me to email my bsls to him every week or so.
I'm aware that I'm making lots of changes to my basals as I go along, trying to keep my sugars down, and I tend to eat foods that I'm only guessing at carb wise sometimes, so the over-insulinising will probably continue to some extent.
I've always found it hard to eat set amounts at set times each day which is why the pump has worked so well for me. But I realise this makes it much harder for my endo to look at my bsl results and suggest adjustments.
For me to achieve the sort of blood sugar levels I need for pregnancy whilst still eating some foods with slightly variable carbohydrate content, I find I have to adopt a mind-set of over-insulinising rather than my usual under-insulinising. I know this can lead to more hypos, and isn't what my endo would recommend, but I feel it's the only way I can do it.
Hmmm, yes... now it's time to go and eat my highly predictable breakfast....Posted by M.A. at June 14, 2005 06:54 AM