Getting ready for baby...
I'm been MIA around the blogsphere as of late, because my thesis is slowly but surely nearing completion. Now, if my advisor would only get back to me about our next meeting...ARGH!
Friday afternoon my husband and I cut out of work early to attend our "Pre-conceptional consult" appointment with the Diabetes and Pregnancy Group at UCSD. I first contacted the CDE, June almost a year ago! Well we were finally ready to met the doctor and discuss my strategy for a healthy, diabetic pregnancy.
I felt so, so, so great about the appointment. This group is going to help keep me very healthy! My husband and I had a great rapport with the doctor right away. Both he and the CDE were supportive and really listened to my input. Since we were the last appointment of the day, we spent over an hour with both of them... simply amazing! I haven't had that kind of concentrated attention from a medical professional in years!
Now, onto the hard work.
My fasting blood sugar target is 90 mg/dl (not too bad, that's what I've been aiming for).
My premeal blood sugar target is also 90 mg/dl or less (again, that's been my goal).
My 1 hour postprandial target is 120-130 mg/dl (here's where I'm having the problem!!!)
I've always tested 2 hours after meals, never just 1 hour. As the CDE noted, "If you're 130 mg/dl at 2 hours, you could've been 170 mg/dl at one hour... we don't want that." Oh man!
So, for the past two days, by 1 hour postprandial blood sugars have been steadily in the 150 to 190 mg/dl range. Opps, a little too high.
I'm thinking that the answer is to bolus about 20-30 minutes before meals, so that the insulin is kicking in just as I'm starting to eat. Now, it's just a matter of getting into that habit. I'd become pretty comfortable with adding up my carbs and bolusing (or injecting) just as I was starting to eat. Aren't these antilogs supposed to be a lot faster?!
Any tips from diabetic mommys-to-be would be greatly appreciated! :)
Friday afternoon my husband and I cut out of work early to attend our "Pre-conceptional consult" appointment with the Diabetes and Pregnancy Group at UCSD. I first contacted the CDE, June almost a year ago! Well we were finally ready to met the doctor and discuss my strategy for a healthy, diabetic pregnancy.
I felt so, so, so great about the appointment. This group is going to help keep me very healthy! My husband and I had a great rapport with the doctor right away. Both he and the CDE were supportive and really listened to my input. Since we were the last appointment of the day, we spent over an hour with both of them... simply amazing! I haven't had that kind of concentrated attention from a medical professional in years!
Now, onto the hard work.
My fasting blood sugar target is 90 mg/dl (not too bad, that's what I've been aiming for).
My premeal blood sugar target is also 90 mg/dl or less (again, that's been my goal).
My 1 hour postprandial target is 120-130 mg/dl (here's where I'm having the problem!!!)
I've always tested 2 hours after meals, never just 1 hour. As the CDE noted, "If you're 130 mg/dl at 2 hours, you could've been 170 mg/dl at one hour... we don't want that." Oh man!
So, for the past two days, by 1 hour postprandial blood sugars have been steadily in the 150 to 190 mg/dl range. Opps, a little too high.
I'm thinking that the answer is to bolus about 20-30 minutes before meals, so that the insulin is kicking in just as I'm starting to eat. Now, it's just a matter of getting into that habit. I'd become pretty comfortable with adding up my carbs and bolusing (or injecting) just as I was starting to eat. Aren't these antilogs supposed to be a lot faster?!
Any tips from diabetic mommys-to-be would be greatly appreciated! :)
posted by Kelsey @ 2:34 PM
8 Comments:
At 6:08 PM,
Felix Kasza said…
Um, I am not a mommy or mommy-to-be :-) -- but the key to lower post-prandial BGs is the combination of:
- a low-glycaemic-load (low GL) diet; see http://www.mendosa.com/gi.htm;
- reduced carbohydrate intake (but check with your doc before increasing protein to the skies, especially if you already have kidney or liver trouble);
- bolus early, bolus often;
- and regular exercise, ideally cardio-vascular work-outs six days a week and strength training two or three times.
Oh, and "reduced carbohydrate intake" does not mean a fringe diet like Atkins. It just means to skip the bread, grape jelly, and brownies and to nibble on a carrot instead. Or at least to reduce the portion sizes ....
Cheers and all the best --
Felix.
At 6:18 PM,
Lyrehca said…
You can also try lowering your carb to insulin ratio to meet the one hour post prandial, then eat a piece of fruit an hour or so later to counteract the low.
Good luck!
At 1:34 AM,
Chrissie in Belgium said…
Kelsey - good luck!
To avoid postarandial highs I try to postpone eating until bg levels are in the 80s or 90s. Take the bolus, then wait and test to check what is happening to the bg level. Be very careful b/c an entire mealb without food can bring you down very quickly. Hopefully you will soon a pattern that will guide you in determining when to bolus before a meal given the particular bg level before the meal. A walk after the meal also helps. Stressy sports work less well. Pregnancy and the D is a HUGE balancing act but the prize at the end couldn't be better.
At 1:39 AM,
Chrissie in Belgium said…
I forgot to say that I think it is really important to try and choose carbs that have a low GI index. MY bg values are at their highest 2-3 hours after the meal. Basically you have to try to know how your body will react so you are one step ahead.
At 4:15 AM,
Lyrehca said…
Hey Kelsey--Just thought of something else for you. Yes, as others said, eating higher-fiber carbs (oatmeal, grainy bread, etc.) over white carbs makes a huge difference. Also, if you do up your insulin ratios and DON'T want to eat the piece of fruit in an hour to counteract lows, talk to your doc about lowering your basal rates a few hours after meals. Also, eating similar meals day to day (knowing the exact carb count of a meal and how it affects you) has helped me a lot.
At 8:22 AM,
Nina said…
I'm not a mommy-to-be yet but I just wanted to comment on what Lyrehca said - it is so helpful to me to eat basically the same things everyday (Chrissie knows what I am talking about too!). My blood sugar readings are always similar everyday at certain times as a result of that. On days when I try to "mix it up" a bit I get all out of whack and I find that frustrating. Keep us posted!
At 3:11 PM,
Felix Kasza said…
Riffing on Lyrehca -- you may want to consider what I was taught as the "super-bolus": Figure your meal bolus; add in the basal you would get over the next, oh, two hours. Bolus the whole thing and set a temp basal of 0 for those two hours. Essentially, you are taking some of your basal up-front.
At 11:41 AM,
Erica said…
Yay!! I'm so excited for you guys!
Like Lyrecha, when I was pregnant, I upped my insulin:carb ratio to fall into that range a little more easily. Although rather than fruit I found that a carb/protein combo kept me more stable. Peanut butter on triscuits is what I would eat.
It gets really tricky in the first trimester though. In my first tri, my insulin needs increased a bit but then I would get all kinds of crazy lows out of nowhere.
I should mention though too that I have never found the correct bolus for cereal/milk. If I underbolus, I'm sky high about an hour afterwards and then I'm super low within the next hour. If I bolus properly I'm okay at 1 hr and then low again!
Have fun 'trying'! ;-)
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