Now, at the halfway mark of my pregnancy, insulin resistance is becoming a bit of a thing, and is going to progress into an Actual Thing as the weeks go on, which happened last time and I’m prepared for but it still a bit whoa and this sentence is a run-on.
Which means that basal rates are creeping up ever-so-slightly (my pre-pregnancy basal total was around 13u and I’m now up to 16.2u) and my insulin:carb ratios starting to dance (pre-pregnacy was 1:10, am now 1:9 … except lunch is 1:12 because why would things be consistent?). When I first found out I was pregnant, my endocrinologist told me that post-prandials contribute most to macrosomia, so keeping my post-meal blood sugars as in-range as possible would help mitigate that risk. (But let’s take a look at the risk list … pre-existing diabetes? Check. Over 35? Check. Previous pregnancies? Check. Having a boy? Check. Cool.)
The plan? Actively and aggressively pre-bolusing the shit out of my meals.
This sounds like an excellent plan, in a perfect world. Pre-bolusing works well for me when the bolus is delivered at least 20 minutes before eating, the meal is properly carb-counted, and nothing delays the process of eating. But one monkey wrench in that process can muck the whole mess up.
Pre-bolusing can feel spooky, like I’m tempting fate and inviting a low. Not doing it is like opening the door for a high. The middle ground could use some xanax.
Over the last few weeks, my pre-boluses have been executed with precision. A few fistfuls of jellybeans have worked their way into rotation when I’ve bolused too early, but that’s to be expected. The temp basal option on the t:slim is stupidly easy to employ, so sometimes I use a temp basal to help back me out of a mild low, but overall, I’ve seen my post-prandials come down nicely and hopefully my ultrasounds continue to show a very boring, predictable pregnancy progression.
Makes meals interesting, though. They’ve become a game of roulette.
“Do you think we’ll get seated right away?” Or, “I forgot to pre-heat the oven and now dinner is going to be 15 minutes later than I thought.” Or, “Fuck. I forgot to eat!”
I’m pre-bolusing all over the place. Usually it works fine. Sometimes I end up wicked low. But every time, it’s in effort to keep my post-prandials from causing chaos in my kid.