Fasting #'s not coming down with insulin??? — The Bump
High-Risk Pregnancy

Fasting #'s not coming down with insulin???

Hey ladies,

I was put on NPH insulin at bedtime for my fasting numbers. My endo started me off pretty low (3 units) and has been conservative in increasing the does. I am currently up to 10 units because my fasting numbers will not come down. They are usually between 100-115 with some here and there that are in the 90s. Yesterday, it was finally down to 86! But then this morning it was back up to 100. The only difference was that I went to bed later than usual on Wednesday evening than I did last night.

I am concerned because I know it is bad to have high fasting numbers for as long as I have been getting and LO already is measuring in the 86th percentile at 32 weeks. I know that growth ultrasounds aren't completely accurate and I have only gained 12 pounds total since my first appt and my belly measures spot on at 32 weeks.

Any advice? Thoughts? My post-meal numbers are usually always below 140 after 1 hour, although I am on 4 units of Novolog before dinner.

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Re: Fasting #'s not coming down with insulin???

  • I can see as much as an 8 point difference in my fasting depending on whether or not I drink some water in the middle of the night.  I don't drink a lot, but take sips when I get up to use the bathroom.  Even though the A/C is on, I guess I am still getting a bit dehydrated at night.  Or maybe, I don't drink enough fluids in the latter part of the day.  Give it a try.  It seems like your numbers are not wildly out of control and this may help you out. 

    I remember that you played around with your bedtime snack and that it didn't help you.  I would call the office on Monday if your fasting numbers are not under goal by then.  It doesn't hurt to let them know before your next appointment.  They may tell you that 100 is close enough, or they may decide to increase your insulin a bit. 

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  • Thanks rainlily.

    I try to drink water in the middle of the night, when I get up to pee, but it usually doesn't help because I don't always wake up during the night! I may just try to pound water before going to bed, lol!

    What's funny is that my weekend numbers are almost always in the 90s and I was told it is because I go to sleep way later. I get probably the same or less sleep (in terms of hours), but my numbers will be better.

     

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  • Just for some perspective, I take 96 units of NPH and bedtime and I still can't get them all under 90. I do find that eating a high carb snack before bed makes my number lower in the morning. Last night I had a slice of bread and butter, and it was 93. A few nights ago I had a slice of cheese and it was 122. There really is no exact science to this, and I swear your baby will be just fine. I think they make it sound alot worse then it really is.

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  • imageermaderma:

    Thanks rainlily.

    I try to drink water in the middle of the night, when I get up to pee, but it usually doesn't help because I don't always wake up during the night! I may just try to pound water before going to bed, lol!

    What's funny is that my weekend numbers are almost always in the 90s and I was told it is because I go to sleep way later. I get probably the same or less sleep (in terms of hours), but my numbers will be better.

     

    Are you eating your snack later on nights when you go to bed later? Less time between snacking and testing fasting means less time for your body feels like it needs to produce it's own glucose. 

    I would try the water drinking like rainlily mentioned, but you might just have to keep trying to up the insulin :( I'm at 15 units of NPH at bedtime right now, and with DD I was up to 24 by delivery. GL!

    Mama to two sweet girls
    DD1 Feb 2010
    DD2 Sept 2011


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  • I was up to 95  units nph before bed to get my fasting numbers down and 80-85 fast acting before meals. You may want to talk to your endo about having a bit of a sliding scale. Basically if my numbers were higher then they needed to be I would up my next dose by 5 units. 

    Also, my OB didn't freak out unless my fasting was 115+, even though my Endo wanted it to be 89 or below. So while 100 isn't perfect, don't stress yourself out to much, ok lady?

     I agree with the water too. Good luck Erma! You're almost there!!  

    Diabetic, 2IF, PCOS; blessed beyond words to be called "mommy" to Drew (6/30/09) and Alynn (5/16/11).
    Parenting author for Women of Worth. Mom Blogger and photographer.

     Andrew David: mixed receptive/expressive language phonological disorder, sensory processing disorder, Disruptive Behavior disorder-nos and insomnia.


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  • imageHeather & Nayt:

    I was up to 95  units nph before bed to get my fasting numbers down and 80-85 fast acting before meals. You may want to talk to your endo about having a bit of a sliding scale. Basically if my numbers were higher then they needed to be I would up my next dose by 5 units. 

    Also, my OB didn't freak out unless my fasting was 115+, even though my Endo wanted it to be 89 or below. So while 100 isn't perfect, don't stress yourself out to much, ok lady?

     I agree with the water too. Good luck Erma! You're almost there!!  

    Boy am I glad you posted! I sit here thinking I am the only one on high insane amounts but yay for finding someone else that took alot.

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  • imageDisneyFreeek:
    imageHeather & Nayt:

    I was up to 95  units nph before bed to get my fasting numbers down and 80-85 fast acting before meals. You may want to talk to your endo about having a bit of a sliding scale. Basically if my numbers were higher then they needed to be I would up my next dose by 5 units. 

    Also, my OB didn't freak out unless my fasting was 115+, even though my Endo wanted it to be 89 or below. So while 100 isn't perfect, don't stress yourself out to much, ok lady?

     I agree with the water too. Good luck Erma! You're almost there!!  

    Boy am I glad you posted! I sit here thinking I am the only one on high insane amounts but yay for finding someone else that took alot.

    LOL  your welcome! :D I started insulin at 7 weeks KU and by 20 weeks I was already at 30 units at a time. It sucked but it was so worth it when DD was totally perfect at birth. I felt like every day I went up a little bit, and I was really strict with my diet, my body just falls apart. 

    Hang in there mama! 

    Diabetic, 2IF, PCOS; blessed beyond words to be called "mommy" to Drew (6/30/09) and Alynn (5/16/11).
    Parenting author for Women of Worth. Mom Blogger and photographer.

     Andrew David: mixed receptive/expressive language phonological disorder, sensory processing disorder, Disruptive Behavior disorder-nos and insomnia.


    Image and video hosting by TinyPic

  • My endo started me at 8 units of NPH and told me to up it by 2 if I had a high reading 2 days in a row.  I got up to 14 without any change, so she told me to up it to 20.  Still no change so she said 25.  That brought me down to the high 80s, and I guess she wasn't satisfied with that, so she increased it one more time to 28.  That's working for me for now--fasting numbers are usually 75-85.  This all took place over the course of about 2 weeks.

    So don't stress yet.  You may have to keep tweaking it 'til you get to a dose that works for you.

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