Okay, brace yourselves because I had a bit of a bumpy ride about a week ago and I'm kinda ready to rant. Here it goes . . .
So my sugars have been driving me crazy lately. Recently, for my entire 32nd week of pregnancy, I saw way too many numbers in the 200s and even a couple in the 300s. At first, I thought no big deal. It keeps happening throughout my second and third trimester. I'll go along thinking I've got this whole pregancy-with-diabetes-and-stupid-insulin-resistance-thing down and then I'll have the week from hell. This is where my sugars suck no matter what I do. And since this whole insulin resistance thing seems to wax and wane a bit (ie what works one day won't work the next) I don't want to adjust too quickly and bottom out. Instead, I slowly tweak things here and there and eventually get everything under control again. But it's torture waiting until I see those numbers come down and all I can think is "I'm the worst mother/incubator ever and I'm frying my poor child with awful sugars!!!"
Can you tell this is making me a little manic? Anyway, this past week of bad sugars was probably the worst one yet. Not only were my blood sugars higher than they'd ever been but they were so resistant to anything I did and it made me want to scream. I was trying sooo hard and it was so frustrating that no matter what I did, nothing seemed to help. Recently, my biggest issue seems to be that I have trouble getting my numbers back down after meals. I can't help but to spike into the 180s or 200s (sometimes even mid-200s) after meals. But not right after meals, more like 2-3 hours later and then my sugars just won't come back down despite bolus after bolus. Then, randomly, 3 hours later I'll check and I'm 45. And I'm really careful about not stacking boluses so what gives?!?!
I've tweaked my basals and my sensitivity factor but it barely made a dent. And you might wonder why I didn't just up my carb ratio. Well, its easier said then done. I've always had a pretty high carb ratio and before pregnancy it was 1:5. Obviuosly, with a carb ratio that high (or low? depending on how you think about it) it's hard to tweak things. For example, the smallest increment I can go by is one, so my next move would be to 1:4. (Oh, how I wish I could do increments of 0.5 on my pump for my carb ratio!) Anyway, that's the smallest amount I can increase it and yet its a 20% change! That's a huge jump?!? So, I actually did end up going to a ratio of 1:4 a few weeks ago and I was very hesitant to bump it anymore because (again) the next jump would be going to 1:3 and now we're talking a 25% jump. It really blows having such a low carb ratios because they become really hard to tweak. Pretty soon I might have to give up on my bolus wizard and whip out a calculator so that I can do ridiculous carb ratios, like 1 unit of insuling for every 2.75 carbs.
Another thing that's making this whole insulin resistance thing even more frustrating is that some days my total daily dose is as high as 130 units!?! And since my reservoir only holds 200 units (really 180 after priming) I'm changing it CONSTANTLY and always at really inconvenient times (think middle of the night, at work or even better, during my own baby shower). Most days I'm only around 105 or so units per day but, again, every day is different. As it is, I can barely go 2 full days changing my cartridge which also means I'm changing my site with it. Ugh. Super annoying.
Anyway, I had such a meltdown the other day. I was up in the 200s, feeling like crap, couldn't get my sugar down, running out of insulin, my CGM was screaming at me and I just started to lose it. I started crying iin front of my husband and couldn't make myself stop. I think I totally freaked him out. I could tell Brad felt awful and totally didn't expect the meltdown. He kept telling me how good I was doing and how hard I was working and that he was so proud of me. But all I could think to myself (because I was too verklempt to speak) is that it doesn't matter how hard I try, if I can't get my blood sugars under control the baby and I both suffer. I can't tell my placenta that I'm trying hard, so can you please take it easy on me? No. All that matters are the numbers . . if they suck, bad things happen. Period.
And going into this pregnancy, I knew I'd have to stay on top of it and there would be a lot of hard work and changes, especially towards to end. What I didn't expect was to actually be super vigilant and on top of things, making adjustments constantly and still NOT see any response. To bolus and bolus and bolus and have my blood sugars just stare back at me, unmoving. Or even better . . . keep going up!
I feel like I'm trying so hard to be the "good diabetic" pregnant lady who has great blood sugars, great A1Cs and whose baby comes out weighing a normal amount and has no complications. It can be done. I know it can. And yet no matter how hard I try, I can't seem to keep up with my body. So it seems like even though I know it can be done, apparently I'm the schmuck who can't do it. And worst of all is that the baby could suffer because of it. It's infuriating! I hate feeling like I have no control, especially over something so important. And I really hate feeling so helpless!
Anyway, I finally bit the bullet and went to 1:3 for my carb ratio over a week ago. I was totally freaked that I would be low all the time but so far so good. In fact, the last several days my sugars have been pretty great. ::knock on wood:: I am actually having a few more lows now but I think those can be fixed by dialing my basals a bit since I was jacking them way up in a feable attempt to avoid messing with my carb ratio. I think things are getting better . . . slowly. But I'm not sure that I'll still have my sanity by the end of this pregnancy!
I hope that wasn't too much venting. And I hope that I'm not the only freak out there who feels this way, or worse, has this much trouble with her sugars. I think my biggest fear is that it's ME, not the DIABETES that is doing this to myself and my baby. That it's my fault and that I'm missing something or doing something wrong. I know this disease can totally psych a person out and make them feel guilty for stuff that they can't control so I'm hoping that's what this is . . . and not just an excuse.
strawberry graham icebox cake
3 days ago