Now that I've officially announced my pregnancy on this blog, I can finally start talking about all of the diabetes related issues that I face everyday. This week, I've noticed an obvious increase in my insulin resistance. All of a sudden, I'm experiencing highs after meals that take longer to come down, and I find myself quickly spiking to 200 on foods that didn't bother me a few weeks ago. Once you hit the second trimester, the placenta starts producing hormones that increase your resistance to insulin. Being diabetic, I have to manually make all of the adjustments on my pump.
Just this weekend, I went to bed with a high around 200, and even after giving myself two correction doses of insulin plus increasing my basal rate temporarily by 200% (something I learned from my last pregnancy, but my doctor doesn't really like me to do because of the risk of crashing later), I STILL woke up with a blood sugar of 242! I checked my CGM, and I had been high all night long! Since I was sick, and I just hit the second trimester, I figured that this could be a one time thing and I didn't make any changes on my pump. I did call the doctor on call at my Maternal Fetal Medicine office, and she agreed that the sickness and possible second trimester resistance could be the culprit. She said that I was doing everything I was supposed to be doing (checking my bg often, making corrections and temporarily increasing my basal rate), but warned me not to correct more then once in two hours. I have a problem of freaking out when I see highs while pregnant, and then over-correcting. Luckily, the doctor assured me that a temporary rise in blood sugars overnight will not do any damage to the baby. It's the extended extreme highs (in the 300-400s), and the overall long term effects of high blood sugars that can cause problems.
Having been though this before, I am prepared for the drastic increase in insulin that will continue from now until I deliver. By the end of my last pregnancy, I was taking as much as 3Xs the amount of insulin I usually take, and was super resistant to insulin, especially at certain times of the day. At the time, I thought I'd never be the same again, but as soon as I delivered my baby, my insulin needs went back to normal and I had my usual insulin sensitivity.
Although I'm prepared for it, the biggest problem I am currently facing with this resistance is that I can't use exercise to bring it down. With all of the bleeding I've had so far this pregnancy, my doctors want me to "take it easy" and not exercise or be too active. Exercise used to be my best friend when trying to bring down a pesky high. When a correction bolus would not bring me down fast enough, I used to take my big pregnant belly down to the stationary bike and ride until my sugars started to come down, even in the middle of the night! I guess this time I'll have to be extra careful about what I eat to avoid the highs in the first place, since I won't be able to use the bike or a brisk walk to help me come down. But still, I desperately miss exercising. I've been going to the gym and exercising regularly even since before coming a diabetic, and love how it makes me feel more energetic and uplifts my mood and all that good stuff. Going to the gym also gave me that glorious "me time" that I don't get any more, and it gave Little Man a few hours a week of socializing with other kids. The way things are going, I have a feeling that even if the bleeding stops for good, I will still have to avoid the gym. Just one more thing to give up during this high risk, diabetic pregnancy. And to think that things were so much easier last time around, even with the "high risk" label! For the health of this pregnancy, I'll have to deal with my decreasing muscle tone, waning flexibility and mushy thighs after the baby is born. That is of course, if I can find the time!