Second Trimester: Diabetes Update

I haven’t talked specifically about diabetes for a while. That’s mostly because there isn’t a whole lot to say. Things are pretty much just plodding on. I do still have a strong focus on my blood sugars and overall control, and I still worry every day whether I’m doing enough, but a lot of diabetes control tasks are done on autopilot and I’m having success with suppressing some of the fears that I can do nothing about. It’s still hard work, but I guess I’m balancing it with the experiences of general pregnancy better than I was before. It helps that I’m probably at my most stable ever right now. The lows of the first trimester are gone and I’m shocked to be spending days at a time in range, with no in-your-face highs and lows to keep highlighting diabetes.

My insulin needs are still increasing on an almost daily basis, but I’ve become quite comfortable with adjusting them almost daily too and I feel pretty in tune with what I need to do. I’ve also somewhat moved past my issue of meal boluses sounding just too big to be possible, so I’ve eradicated some of the post meal highs I was seeing and feel much more confident with what I’m taking. Some of these doses are getting huge now though. I would never have taken 8 units, or more, for a single meal pre-pregnancy. I’m still craving carby foods, so the low carb resolution I made before I got pregnant has totally gone out the window. I don’t feel bad about that though, as I’m managing to stay on top of things and the sole reason for going low carb was improve the stability of my blood sugars. If I can have my carbs and my good blood sugars, then it’s a win-win! Cake? Don’t mind if I do!

I’m still very reliant on the CGM. I honestly don’t know where I would be without it. More stressed for sure. Likely with a higher A1c and experiencing more lows. Probably wanting to give up work sooner to have more time to focus on diabetes management. I’m not sure I could have allowed diabetes management to blend in to the rest of pregnancy so easily without it there to help me out. I’m in total awe of women who go through pregnancy without one, I really am. They are the vast majority of pregnant diabetics, so I know how lucky I am. People keep complimenting me on my excellent control and how hard I must be working, and it makes me feel like a bit of a fraud, to be honest, as it’s the technology that’s doing the lion’s share!

My growing belly is creating some diabetes management issues though. There is a bit of a shortage of real estate for pump infusion sites and CGM sensors. I know some women continue to use their bellies during pregnancy, but to be honest, everything feels so tight the idea of sticking a needle in there is something I can’t get my head around. I have a comedy image in my head of my belly popping like a balloon stuck with a pin. I’m also a bit limited with where I can place infusion sets around the back based on how far I can reach, which is now considerably less far than it was pre-pregnancy. Now it’s your turn for a comedy image of a woman-resembling-whale trying to reach the middle of her back! I also can’t get used to just how often I need to fill up the reservoir in my pump. Now that my total daily dose is pushing up above 70 units per day, I’m needing do it every other day. The good thing is that it reminds me to also change my infusion sets this often. I was frequently lackadaisical about this task pre-pregnancy, but it’s more important than ever to avoid infusion set issues, so I’m being pretty good with it.

What’s to come? Well obviously, there are no certainties. Each day is the most pregnant have ever been in my life! I am expecting my insulin needs to continue to rise. I’m probably expecting things to get a bit harder again too, as it seems almost too calm and easy right now (There we go… just jinxed myself!). I’m just hoping I can keep plugging away at it and doing what needs to be done. I do have the greatest motivation in the world ever though. And that growing belly is all the reminder I need.

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