Okay, this is something that I could have gone into on my most recent rant but I was getting ramble-y already and, it really is a separate issue. I'm not sure if this is a common problem in diabetic pregnancies but it's been pretty frustrating for me so I thought I'd put it out there and see what others' experiences were. . .
Over the past few months as the doctors appointments have really ramped up, I've been getting more and more frustrated with all these crazy doctors! Individually, I actually really like all the MDs that I see. But all together, they seem to be one of my biggest hurdles right now. Mostly emotionally. For instance, it doesn't help certain bloodsugar-related matters that my Endo is freaking out over every single low blood sugar. And, of course, I'm super worried about the highs. But I feel like I have to go super slow with any adjustments I make for fear of being lectured again about over-doing it. ("You don't want to have a seizure, do you? You know, that wouldn't be good for the baby either, would it?") And it seems like going so slow just means my numbers stay out-of-whack for longer.
Meanwhile, my OB and perinatologist freak out anytime my fasting sugars are over 95. Even a morning blood-sugar of 105 draws sideways glances from them. Seriously? My Endo says that the OB's just don't get diabetes and aren't realistic but my OB's say that pregnancy is a totally different animal that just can't follow the same rules. No one can agree and in the mean time, it seems like no one cares what I think. Which is especially frustrating because not only have I been diabetic for 20 years but I'm medical and work in the NICU and deal with pregnant ladies and babies all the time. I kinda know what I'm talking about here and wish everyone would stop patronizing me and just listen! Add to it that I have to hear these opinions multiple times a week because that's how often I'm seeing random doctors, and I feel like my head is going to explode.
On a brighter note, the tweaks to my carb ratio made a huge difference in my sugars. The week of bad sugars that I was talking about in my recent rant happened a while ago and things have definitely made a turn for the better since then. Also, my Endo said something to me that (::gasp::) actually helped. He explained that as pregnancy progresses, gastric emptying time increases. Meaning that as I get further along, the food I eat doesn't exit my stomach and actually start getting absorbed until more and more time has elapsed. This really helps explain why I'm not spiking until 2-3 hours after I eat. It was so annoying to see my blood sugars stay pretty steady initially after a meal and actually think that I'd actually managed to bolus correctly . . . until 3 hours later, when I'd randomly spike into the 250s. He also suggested since I'm having to go up so much on my car ratio that maybe I should try grazing throughout the day rather than eating 3 larger meals.
I'm not really a fan of grazing because I feel like I end up eating a lot more. At a meal, I plan out what I eat, sit down, eat it and when it's gone, I'm done. But if I have to graze and eat more often, I feel like I lose the regimen and the willpower and overeat. But I'm trying it anyway. The plan is no more than 30-35 carbs at a time, with lots of protein (hard for me because I'm more of a fruit and veggie girl than a meat-eater) and eating every 3-ish hours. So far, combining these two things (grazing and taking the slower gastric emptying time into account) with increasing my carb ratio has proved very helpful in reigning in my numbers!!! I haven't seen anything in the 200s in several days!! :-D And even the 170s and 180s have only cropped up a couple of times.
Anyway, I know that each doctor has me and the baby in mind but my Endo's tend to put a lot of focus on me and my OB's/perinatologists put way more focus on the baby. I tend to be somewhere in the middle but, truthfully, lean more toward my OBs way of thinking. Mostly because I've been lucky enough (::knocking on wood::) that I haven't ever had lows that were scary. No passing out. No inability to think straight. I've always been with it enough to eat and check my sugar if I need to. And no issues with hypoglycemia unawareness. So I'm not really afraid of lows. I'd rather just air on the lower side and protect the little girl rather than air on the higher end of the spectrum.
But that's just me. And I really do get both sides of the argument.
I spoke with my Endo's nurse today because I'm still waiting on the labs from my last appointment. My fructosamine 207) and my microalbumin (7) look great (YAY!) but still no word on the A1C. Anyway, I told her a little bit about the tug-of-war that I feel like I'm in the middle of and she said that this was very common in their Type 1 pregnant patients. She said that most OB's just don't understand that there is a difference between Type 1's and Type 2's/Gestational diabetics. I get that and I tend to agree. Mostly I was just glad to hear that this is something other patients had to deal with and not just me.
Anyone else out there having this issue? Just curious.
4 days ago