Insulin now not lowering my numbers?!

FrozenMommy

So after a month of some strange LOW activity, I finally had found a balance. Now all of a sudden, the insulin isn't lowering me after meals. Like, 1 hr PP at breakfast was 110, and here 30 mins later it's still 110. I am upping my doses again suddenly, where I had been lowering them for a while. Any idea what is happening? I feel like now I cannot eat fruit and yogurt for my snacks if this continues.

millereliz13

How many weeks are you? There is a hormone surge between 28 to 36 weeks that can make the insulin resistance higher. You may want to call your doctor for further advice. I am 24 +5 myself and have been warned about the surge.

FrozenMommy

Just hit 21. It was weird because for the first few weeks I was taking more, then lowered it by about 12-16 units per meal. now I guess it's back up. So strange. 

PedsIsHardcore

The further along you are the more insulin resistance you will have. Just tweak it a little and you will be awesome! You can do this! Your numbers are pretty awesome to me.

leylacorbett1

The bigger the placenta gets the worse the insulin resistance. I am at 25 weeks and my carb ratio is at 5 lol

FrozenMommy

You mean 5 units per serving? Mine is more like 10 it seems! I just wasn't expecting it like overnight to change so drastically, lol.

FrozenMommy

I was just thinking about something. I keep feeling like maybe I have a UTI again, would that possibly mess with numbers? I read an article saying stress on the body can cause wacky numbers, and that would totally make sense since it literally came overnight. Tonight, I had the same dinner I have been having for weeks, chicken, green beans and rice, and 135 after taking 40 units of insulin?!? Last week this same dinner with 24 units I was at 93 after dinner. Something doesn't add up. I'm going to call in the morning and get in. So tired of these damn UTI's this pregnancy.

FrozenMommy

Ok, well. This morning I opened a new bottle, did higher than normal amount for breakfast, but 113 at 1 hour and 78 at 2 hours. Soooo, I wonder now if my insulin has gone bad after just a week of being open? I mean, I guess it can happen right? Whatever the case, that's much more normal for me, rather than it hovering for 2 hours. Hopefully lunch and dinner have the same story. 

Seed0824

My insulin needs have had those sudden needs to rise also which is a result of resistance that comes on at various points in pregnancy. My doctor slowly ups my dosages until we get it right but certain foods are not as well tolerated in pregnancy. I was told in the beginning not to eat fruit before lunch because it's a common cause of spikes in pregnancy.

FrozenMommy

The food thing has always been strange for me. Where I can eat a ton of pasta, some can't. Fruit has been fine for me as a snack this time, but not my other pregnancies. My hardest time is breakfast. I can barely eat 1 carb serving or it spikes. I have been sticking with 1 egg, 2 egg whites, high fiber english muffin with T of Peanut butter, seems to be working.

SLGILL1978

Your numbers look good. My doctor was fine if my readings were below 120 an hour after eating. The further along you get, the more insulin you will need. Just keep in contact with your doctor. 

leylacorbett1

1 unit of insulin for every 5 grams of carbohydrate I ingest

tuckerjoy

I'm so frustrated as well! I'm 32 weeks and on insulin three times a day but haven't seen any improvement in my numbers. To the point where I'll check a couple times to make sure and the numbers seem to have a high variance @15 point whether I use the same finger or within minutes. My GD counselor says there can be a 10% variance. Besides the fact that I'm hungry all the time I wonder if I need to increase the insulin units too? Currently only on 7-8 units depending on the time of day.

FrozenMommy

@tuckerjoy, yes I would say increase your units. Currently, for me to have 30-45 grams of carbs, I have to take around 42 units. And I am only at 22 weeks! The thing is, you can increase it, eat the same, and then if you fall low just drink a bit of juice or have some fruit. I would rather drop low than have the crazy highs at this point. Low's are so easy to correct, but the highs you just have to wait out until they drop. 

jham201

I am 22 weeks and I feel like I need to increase my insulin intake every week, sometimes more.  Depending on the situation and what my doctor says, sometimes I slightly increase my basal rate and sometimes my carb ratio.  I am currently taking one unit for every grams of carbs.  It feels so nerve-racking to be taking sooooo much insulin, as if I should pass out at any moment.  The doctors all said it is normal with the growing placenta and increasing hormones and I will just keep needing more....possibly up to triple what I was taking pre-pregnancy....CRAZY!

The best thing to do is keep close contact with the doctors and monitor yourself constantly to look for trends because that helps with how to treat it. ( I have breakfast issues as well)

It is so much work and so frustrating, so know you are not alone!  Good luck!  

FrozenMommy

It is SO much work. One of the main reasons I didn't want anymore kids really. Because I didn't want to have to deal with 2 littles and focus so much on being pregnant! But here we are now lol. Dinner was whack tonight. Tested at what I thought was an hour, 174. Then 30 mins later, 86. Whatever....

leylacorbett1

Are you guys real diabetics or gestational?

leylacorbett1

I have a love hate relationship with my pump. Feel like crap today and just now come to realize my damn infusion set wasn't in properly. Ugh

FrozenMommy

I am gestational, and I fluctuate with my A1C. Last reading 2 years ago was 6.7. Pre-pregnancy, even with the tons of sugar I was eating in Fro-Yo almost daily, my A1C was like 5.7, so not too bad. So I bet in 10 years I will be a type 2. Poo.

leylacorbett1

Not necessarily. 5.7 is great. I am a type 1 diabetic going on 16 years, and my A1c has been at 5.9. Recently crept up to 6.2. Hard not to feel discouraged at times. The good thing about type 2 onset though is that you can prevent it by being proactive. Type 1 is unfortunately a different story.

jham201

I am Type 1.   I had to work really hard to get and keep an A1C below 7 before getting pregnant, which is my goal through the pregnancy but it is getting really, really hard the further into this I get.  It feels like my body is changing faster than I can keep up with it!  Every 2-3 days I am increasing the basal rate at this point!

leylacorbett1

Same here, Jessica. How far are you and what's your a1c? My highest basal for the day is 1.35u/h, sensitivity is 20, and carb ratio is 4. I am currently 27 weeks and a1c is 6.2. Diabetes is a big old pain in my ass. Having a bad day. All I want is a milkshake.

emzabq

I'm at 24 weeks and pre-pregnancy was only in metformin (type 2). Now I am on 85 units nph at night and 65 units each meal! And it goes up every day. It's just crazy how much re insulin resistance increases with each week I go along. By the end I'll probably be on U500 and a pump. What a crazy ride!

jham201

Right now at 24 weeks my carb ratio is 6, my basal is 1.3, and my sensitivity is 60.  I am going to ride this out for the weekend then send my pump data to the endo to look at again because I am still not happy about my numbers.  It feels like it is taking forever for the insulin to get into my system but the food is getting in there just fine so it goes up, stays up for too long in my opinion, then plummets down.  So annoying!

A milkshake sounds so good right now!  Ugh!

FrozenMommy

emzabq said:

I'm at 24 weeks and pre-pregnancy was only in metformin (type 2). Now I am on 85 units nph at night and 65 units each meal! And it goes up every day. It's just crazy how much re insulin resistance increases with each week I go along. By the end I'll probably be on U500 and a pump. What a crazy ride!

Thank you for posting this! Now I don't feel like I am taking so much insulin. I am about 60 NPH and 50 per meal, climbing every week. All you type 1 ladies, talk about basal rate and sensitivity, that's nothing discussed with us type 2 or GD. They just kind of say, take as much as you need to cover what you eat, and if it's not enough, take more next time! At least that's how my doc is. She's very trusting of my ability to figure it out. A1C yesterday was 5.5, she expected it to go up. But I think having a carb at night, it is actually raising my numbers passed the 2 hour mark, and making me high before bed. Considering I ate no carbs after 6 the other night, instead had an all protein snack, and my fasting was actually 81! The second time this entire pregnancy that it was under 90. Today, 120, Of course last night was my mom's birthday so I had a bit of cake. And it was not a great idea lol. 

emzabq

Yes I wish they would give me a carb ratio to use but I think mine is changing constantly. It's very frustrating. I had the exact same breakfast and activity level two days in a row and one postpriandial was 48 and the next day was 147. Just no rhyme or reason to it. I am now up to 90 nph and 65-70 each meal. I'm gonna beg for an insulin pump at my next visit

jham201

The endo told me I need to change my pump settings every few days.  I wish for a reading of 120!!!  It is causing me so much stress that my numbers keep getting higher and higher.  It is like barely any insulin is actually getting into my system.

FrozenMommy

So that's funny to hear, because stress seems to lower mine. Got in a fight with my mom and sister, tested right after a movie and was 119, then get home an hour later and it's 51. I chalked this whole post up to a bad bottle of insulin, and I have been lower since. Took 50 units this morning for my protein bar, then had some popcorn at the movies. Now 51, having a handful of chocolate before eating lunch so I don't drop lower. I am SO sick of diabetes!

katiesm95

I have a lot of problems with UTIs and my endocrinologist said that it does cause high readings!

FrozenMommy

Man, I dunno what the hell happened last night and today....I ate some chicken strips last night, and then had 2 leftover today so I had them to see if they same happened. Basically my insulin totally failed, as if I took none. Weirdest thing ever! Last night I was at 180 after dinner, and it pretty much didn't lower for the next 3 hours, so I took 30 more units, then it came down. Today, even less of the chicken, we are talking 30 G protein and like 30 carbs, and at 3 hour mark, it spiked back up from 120 to 170...What in the hell??? Not sure if the chicken or the insulin, but not eating those again. Sucks because I have had them a few times before, and this never happened. Going to open a new bottle too just in case it's that. Man I am so over this shit!

jham201

That is happening to me more often too and my doctor told me that the insulin resistance really picks up around the 24-25 weeks because of the hormones being released from the placenta at that time.  I need to constantly and gradually increase my basal rate and carb ratio.  I get very frustrated as well because my body is not acting how I am used to it acting and its changing constantly and drastically.  I have had several post meal readings over 200 recently because insulin is taking sooo long to get into my system, but I think my doctor and I have a better handle on it this week.  You are not alone in your frustration. It is a very fickle disease and much more difficult to manage than most people realize.  

Have you talked to your doctor about it?  I send him my data every week so he can help advise me about my insulin intake.  It is important to have the doctors' input because too much insulin can be very dangerous as well.

On another note, I have an app for my phone called FatSecret that helps you count and track your carb intake.  I have found it to be very useful because it has a large database of foods, including restaurant meals. Do you have anything like this already to help?

FrozenMommy

@jessicaham201, it's weird because normally my highs are lowered very quickly, so the few times they haven't, I worry. But this was different in that it never got lower. I had to take 30 more units just to get it to come down! But tonight, switched bottles, took 60 units, had rice, chicken, veggies and corn. It was 92 after meal....I think it could be when I take the bottle of insulin with me on trips. This is the second time I have just taken the bottle on an outing because I didn't want to fill needles and take them, and within a few days it stops working. Soooo, going to try not doing that anymore. It is such a fickle disease. And insulin can be so super sensitive. 

jham201

When I take it out in the vile I usually keep it in a small insulated cooler with a cold water bottle or small ice pack so that it doesn't overheat.  Try that.  For travel over a long period of time, I have a special one with gel beads that stays cool called a Frio.  It is approved by the TSA for air travel and stays cool for several days.

For some reason insulin is fine in the insulin pump for several days.  That little device does so many awesome things.

emzabq

I had posted a few days ago that I was having to increase my insulin dose every few days. I was taking over 275 units a day by the start of this week! Well, after I saw my diabetes clinic, they switched me to U500 and it really seems to be helping. Not as many highs and my swings aren't so wide. And best of all, it's only twice daily with no nutritional dosing!

FrozenMommy

Wow, what is u500?

jham201

So glad you found something that is working!!!  That is great news!!

leylacorbett1

Jessica is your sensitivity still set at 60? That might be why it's taking forever for you to drop...that is very high. My sensitivity is now at 16 lol.

jham201

We lowered the sensitivity and changed the basal and carb ratio since my last post about it and I feel like we have a better handle then we did.  I feel a little like the third trimester hormones hit me quick and hard.  My last A1C was still below 7, which is my goal for the pregnancy, so I am overall happy for now.  The changes just feel like they come on quickly, which is frustrating for me, but then again, when is this disease not frustrating?

I hope everyone else is doing well!!!

FrozenMommy

Can someone explain to me the basal rates and sensitivity stuff? All I know is, 60 units this morning and it didn't even cover my dang english muffin!!! WTF!!! Came down within 20 mins, but at 1 hour it was 155. For 15 lousy carbs!!!

emzabq

Sorry for the delay answering. u500 is 5 times as concentrated as regular insulin and also acts as a long acting. So far I like it. But you have to be very strict on diet and mealtimes.

jham201

Basal rate is the amount of insulin you are getting in the background constantly.  For example, my basal rates vary depending on the time of day, but right now I am getting about 1.5 units per hour as a constant drip.

Sensitivity refers to how much the insulin is dropping your blood sugar.

Bolus is the larger amount of insulin you get at once.  For example, if you are eating and need to cover your carbs.

FrozenMommy, I can tell that you are frustrated but as someone who has been battling Type 1 for the past 14 years and on insulin, I think you are doing better than you are giving yourself credit for.  Going up to 155 is really not too bad.  On many days I hope to have that kind of result after a meal and am happy if I do and that'a after years of practice.  You seem like you are actually doing pretty well.  More power to you!