Diabetes and Pregnancy: And So We Enter the Third Trimester

A couple of months ago, I wrote about my awful night of hyperglycemia. At the time, I was unsure what the precise reason for a persistent high blood sugar was, with the most likely culprits being bad insulin and my ongoing pregnancy. After that night, I switched insulin bottles, and my daily insulin requirements dropped right down to where they had been a week prior. I concluded: the insulin was bad.

Over the couple of days, I have again seen a sharp spike in my insulin requirements. Pre-pregnancy, I would take 12 – 15 units of insulin on an average day. Requirements have been slowly climbing for the past two months, and in the last few days I have reached double that original level, requiring 24 to 30 units for a normal day.

This time, though, I don’t suspect the insulin. Tomorrow marks three months left in my pregnancy. In other words, third trimester insulin resistance is upon us.

Right now, it is 8:20 AM. First thing when I woke up, my blood glucose was 69 mg/dL with a slight downward trend, and I had not suspended my basal or anything. I have worked out for 45 minutes on the elliptical machine at the gym, and eaten a total of about 3 grams of carbs. I have taken a whopping 5.3 units of insulin over the past hour and a half, and am finally leveling out at 94 mg/dL.

Pre-pregnancy, I might take 0.6 units of insulin for a similar waking blood sugar plus (albeit slightly more intense) workout, plus about 20 grams of carbs. So the idea of pumping more than five units of insulin into myself before the day has even begun is a little bit shocking.

The other night, I went down to 34 mg/dL in the night because I had stacked and stacked boluses waiting to go down, thinking, insulin does nothing anymore! The trick of it seems to be that the insulin does less, but also takes longer to do it, which I am not used to. So total efficiency is greater than I perceive, just over a longer period of time. Delayed responses really complicate bolusing strategies; how do I know if I haven’t taken enough insulin, or if it’s just going to hit me in two hours?

And the third trimester has yet to officially begin. My strategy? Low carb. Or rather, lower carb — I have been anticipating needing to reduce my carb intake for a while, and so began in the second trimester, but only a little. But based on how much insulin it’s taking just to defeat my hormones, I’m thinking the third trimester is going to involve a lot of string cheese.

But, hey! I’ve made it this far, and thank God it has been easier than expected so far. The little tummy-dweller has stayed put, despite what seem like concerted efforts to kick a path out of me. So, one more trimester? We can do that. Onwards!

Karmel Allison

Karmel was born in Southern California, diagnosed with Type 1 Diabetes at the age of nine, and educated at UC Berkeley. Karmel now lives in San Diego with her husband, where she is loving the sunshine, working in computational biology at the University of California, San Diego, and learning to use the active voice when talking about her diabetes.

Karmel Allison

Karmel was born in Southern California, diagnosed with Type 1 Diabetes at the age of nine, and educated at UC Berkeley. Karmel now lives in San Diego with her husband, where she is loving the sunshine, working in computational biology at the University of California, San Diego, and learning to use the active voice when talking about her diabetes.