Back at the Diabetes 2.0 conference in Florida in November, I was talking to Manny Hernandez about how evenly my numbers were running due to the pregnancy.
"Dude, it's like a cure. It's creeping me right out, but I am NOT complaining. Whatever keeps this baby safest!"
Oh how I wish that was still the case.
The lows chased me all around the house for about five months, helping my A1C drop like a rock and keeping highs out of the rotation for approximately twenty weeks. A blood sugar of 150 mg/dl felt HIGH (which was a far cry from the 250's I was sadly bonding with this time last year) and my low symptoms weren't kicking in at all (see also: the 29 mg/dl without a whisper of a hint).
Tomorrow I'll be in the 23rd week of my pregnancy, and the highs are back. With a freaking vengeance.
It started innocently enough - with some spiky numbers in the middle of the night. Nothing chaotic, but 120's where there were 80's the day before, and they continued to climb a bit every day. For about four days straight, I was waking up at 4:30 in the morning between 120 - 140 mg/dl, correcting back down to 100 mg/dl, and then the creeping would start again around 10 am. It was like my body wanted to incubate BSparl at a steady blood sugar of ... 180? NO WAY.
After a quick chat with my endocrinologist (who told me, in no uncertain terms: "Pregnancy is completely different. Two days is a pattern now. You know what you're doing - adjust your basals as often as needed."), I starting hiking up my basal rates. Before I got pregnant, my total daily dosage was around 24u per day, thanks to a low basal rate and a lower-carbohydrate diet. Now? Five months and 3 weeks into my pregnancy and 17 lbs heavier? My TDD is 45u and climbing.
I am wearing my Dexcom and testing very regularly, but it seems like full-out stalking is necessary for the next four months. I'm also changing my insulin pump infusion set every three days, like clockwork, to keep absorption issues from adding to the pile of variables. What's becoming challenging is avoiding basal stacking. As in, if I'm 140 mg/dl and I bolus it down, I need to be patient and let the insulin do its work. I can't freak out and take another bolus 35 minutes later just because I'm nervous. Bolus stacking (and rage bolusing, too) are totally counterproductive when they result in a nasty low blood sugar that leaves me spinning.
So what's the moral of this story? ... honestly, I have no idea. All I know is that blood sugar management during pregnancy just went from literal cakewalk (as in, I'd take a step and would require cake to take another step) to a struggle that has me acting like an emotional wreck. My last A1C came in a little higher than the one the month before (went from 6.1% back up to 6.3%), and I know this is because the lows are tapering. But I don't want to crest back up towards 7% because I'm unable to wrangle in these stupid highs.
There's a lot of guilt when it comes to diabetes. I knew that before. But what I didn't realize before becoming pregnant is how much I worry about this little baby while she's growing inside of me. Every time I test and see a number above 130 mg/dl, I feel so sad and frustrated. My hands immediately go to my belly and I want to feel her kicking, because that at least soothes my heart, knowing she's still okay in there.
Actually, she's rolling around in there as I type this. My blood sugar is 96 mg/dl and holding, I hope. I have every confidence that I can do this and that she and I will be okay, but these last few days have been really emotionally tough, and I've found myself praying more now than I ever have before.
(Thank goodness for cute baby girl clip art.)