High-Risk Pregnancy

Insulin lows

So all of a sudden at week 19, my insulin has been all over the place. Taking the same amounts, the same time before meals, the same amount of carbs, and I have been dropping low like crazy! In the morning, about an hour before seemed to be the only way to cover even 15 carbs. A small bowl of cereal, a piece of toast, english muffin. This morning, since I was low most of yesterday, I took it just 20 mins before. Tested 90 mins PP, and I was at 62. I just don't get what is happening. I see my diabetoligist Thursday, but honestly she's not a help. She's basically giving me control of what works and doesn't, but I am frightened at these lows. I feel like it's forcing me to eat extra food, and because of it I have gained like 6 lbs since starting insulin. I was doing fine on glyburide. I have had to drink soda now on like 5 occasions. Yesterday I had no soda, so I ate some pure sugary sorbet. Of course a lovely treat for my mouth, and fat free, but still, shouldn't have to be doing that just to keep myself alive!!! I just saw baby on Friday and he was active and everything, so I hope something hasn't happened. I really really hate this! I guess I just need to lower the insulin and lower the carbs, but then I may as well not be taking the insulin and go carb free. Any advice?
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Re: Insulin lows

  • I don't know anything! But I have a good friend who's a registered dietician at hospitals who's always happy to answer questions if you want me to see what she thinks?
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  • @plainjane8350, I SURE WOULD love an outsiders opinion. My diabetoligist, well she's a sweet woman, but she's not listening to my body. I told her I was fine on glyburide. This morning, I tried lowering my insulin dose, took it only 5 mins before eating, and my after meal was 92. So well in range. But now just 30 mins after testing, down at 68, and I am having trouble breathing, starting to feel the effects of the lows. So I am eating a sugary yogurt. Hell I am fine with getting to eat the sugar, but I am worried about how it's making me feel. Also worried as to why all of a sudden I am dropping way lower then I was a few weeks ago. I see her Thursday, but a second opinion would be lovely. I feel so trapped with this woman, she won't listen to what I want to do. So I am just lowering my doses and seeing what works, but it just doesn't make sense to me that I am needing less when it should be more. 
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  • I'll copy all of this and email it to her. Pharmacists can be really helpful, too. The next time you're near one, is stop in and see if you can bend their ear. Some insurance companies have free "dial a nurse" help lines, too. I'll let you know what my friend says!
  • If you are having lows, you need to back off your insulin. Adjust it. That's all your diabetes specialist will do. I'm a type 1, a nurse and I do that myself. Start with a few units less (like 1 or 2 depending upon how much you take). Lows can be dangerous.I know people say lows are okay, but while pregnant I have almost died and almost lost my daughter. You could pass out or worse while low. Check your blood sugar more often when you are adjusting and you will be fine.
  • Yes thank you. I did that today, lowered my doses for the day. It's just shocking to me that a few short days ago I needed to take it so far in advance and so much. Can your body like get used to it, and it metabolizes quicker? I dunno. Diabetes is so dang confusing!!! So for dinner I took 8 units less than normal, 20 mins before. Still haven't tested PP yet. Luckily the lows hit me at around 70 and I start to feel it. Although the other day I got down to 36 very quickly, I think I hit a vein with my shot. I just need to remember also, if I am going to be on my feet a lot while I cook, I shouldn't take it until just before I eat. That makes a huge difference. 
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  • You might not need to take it so far before eating meals. I am type 1 and I used to take my insulin right before I ate.
  • @seed0824, when I first started taking it, doing it right before wasn't kicking in fast enough to cover, but now it is. I don't understand why. Like I said, maybe my body needed time to adjust to getting the shots? I'm not sure? But yes 5-10 mins seems to be doing ok. My lows are usually happening 2 hours after a meal, or heck even 2 hours after a snack too. Like yesterday, I assumed after 6 hours it would be worn off like usual, but it wasn't, and while making lunch before shooting, I got down to 62. So I am gradually lowering it and taking it closer to meals, and making sure I eat something exactly 1.5-2 hours after a meal.
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  • I don't understand why you were taking it so far before eating.  Fast acting insulin takes effect within 5-15 minutes, so you should take it as close to eating as you can.  That is what I did with my first and current pregnancy.  Make sure you are very vocal with your Dr about your concerns.  Some Drs need an aggressive patient otherwise they just assume as long as the BS aren't high you can treat the lows.  Thankfully my Dr is not that way, but speak up and see if you can change her mind :)

    Also that 36 is scary scary low, like I am surprised you were still awake.  I personally feel like crap anytime I am under 80, so I can't imagine dipping like you are so often.
  • @ssinnwell, for the first few weeks, the insulin wasn't seeming to cover me at 1 hour when I took it 5 mins before. I really can't explain what's going on. Last night I took it 10 mins before dinner, and had some white rice. My number was 136 after dinner. Now see if I had waited 5 more mins, it would have been under. And that's really all she cares to see, is the number under 130 is the message I am getting. Even tho just because that's what I test then, doesn't mean it won't rapidly drop just after. 
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  • In fact I had the super strange phenomenon of having a 193 one hour PP?? No idea where it came from. But 20 mins later I was 108. So either I tested in my peak because I was off on my time, or I dunno. I have heard so many people say testing at 2 hours is better. ANd I would be inclined to agree for my body. Because if I am over 130 at 1 hour, it drops so quickly that at 2 hours, if I haven't eaten something again, it will drop to the 50's by then. I am wasting so many strips at this point and I only have 100 a month covered. 
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  • That sucks, my insurance is currently covering 200 a month.  I decided to see for lunch what would happen if I took my insulin 20 minutes before eating instead of 5 and I ate a ton of carbs and my after number was 99.... I know it still did the normal stuff though so the A1C will still show it if it peaked.  Is your Dr checking A1C as well at least every 3 months?
  • It depends on the insulin and her biochemistry. Humalog peaks from 30 to 90 minutes. Novolog acts faster. It just depends on her body and the insulin. Diabetes is not some cookie cutter "same for everyone" illness. You have to MacGyver it. If you are still having lows continue to adjust. You can do this!
  • @FrozenMommy It sounds to me, that you need to be switched to a different rapid acting insulin. Also you need to talk to your doctor about getting a prescription change for more test strips and if your insurance doesn't want to cover it, make your doctor call and tell them they have to. Insurance companies are awful.
  • I had hypoglycemia before pregnancy so I hit lows very quickly. I take humalog about 5-10 min before meals and humalin just before bed. I was diagnosed GD at 9 weeks, I'm 28 today. They had me on glyburide for about 4 weeks but it was horrible and made my hypoglycemic episodes worse, my after meal level would be ok then 30 min later I'd be feeling the low sugar symptoms.

    I've been doing better with the insulin though I detest the injections 4 times a day but I'll do it for my son's health. I recommend asking for a script for glucagon - it's an emergency injection of glucose if you are unconscious. My husband, daughter, friends, and coworkers are all aware if I go unconscious how to use it. I dropped from 130 to 33 in less than an hour so having the glucagon is a necessity.

    I eat a meal or snack every 3 hours - it seems to help with keeping things stable. Also making sure to consume a protein with each meal/snack and having the protein first - it helps with how sugar breaks down (and speed I believe).

    My situation is a little different as I had gastric bypass so I can't eat much to begin with anyway - hence the eating every few hours. Baby is growing fine and my weight gain has been on track.

    I'm just hoping that the diabetes goes away post birth, and I have a ton of respect for those who deal with this and aren't pregnant.
  • I have been eating more like every 1.5 to 2 hours. Yesterday had my normal breakfast, and then a nice spinach, greek yogurt, banana, blueberry coconut water smoothie, and was 65 after all that. Like the McGuyver ref. It's so true. What works for one won't work for another. But I am figuring it out day by day. They are checking A1C every month. Last reading was actually 5.3! I don't think it's from the lows tho because that had just started that week. So I am doing alright I guess. At least I get to eat some good food, on glyburide with baby 1, I was really depriving myself of carb nutrients. 
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