Hi everyone! I’m poking my head back here.
I’m 25 weeks pregnant with boy/girl twins! And hitting major insulin resistance (also have 2 placentas).
Dexcom/MDI. Pre-pregnancy a1c ~5.8 (lazy management). Approx 15u lantus and ratios 1:12-1:15.
My a1c at 16 weeks was 5.1. I’ll get another done at 28w but that will be artificially low due to pregnancy… Now at 25u lantus morning + night (50/day). Humalog Ratios 1:3-1:5.5. And still running a touch high despite daily (albeit too conservative) adjustments.
Carb cravings have been insane. I’ve eaten meals with 200+ carbs. My appetite is finally slowing down since my uterus is starting to invade my stomach space. There is not much pre-bolusing. Pregnancy hangry is just too much to resist. Immediate walk after instead gets the job done. IMHO even better.
I haven’t really run since about 10 weeks but its been extremely helpful to walk approx 2mi after nearly every meal. Until resistance really hit hard about 2 weeks ago, I rarely spiked above 150 and if I did it was very brief (minimizing the area under the curve is my goal).
The poster’s own insulin requirements here have more closely mirrored mine than the theoretical numbers: https://www.reddit.com/r/BumpersWhoBolus/comments/d28eg6/pregnancy_and_insulin_requirements_a_guide/
I read another guide which indicated a “rule of thumb” is double insulin at 20 weeks and triple at 30 weeks compared to pre-pregnancy numbers. I’ll be even higher than that. Mostly due to 2 placentas I think.
I’ve been having virtual appts with my endo monthly but really its all self-managed. I like her and she just notes my ratios, gives me a few pointed about specific days where I screwed up, and lets me do my own thing. I’ve refused diabetes management from anyone else (mfm/ob). The first mfm appointment left me nearly in tears because she just gave me a lecture on how I’d kill my babies if I ever went above 120. The stress from that alone had me in the 170’s. I’ve just shut them down if they even bring it up every since and say my endo is happy, talk to her.
Pre-pregnancy I read on a t1 and pregnancy facebook group about hitting ratios of 1:1 or even 1:0.5 with over a hundred units basal/day and it just seemed mind-boggling and impossible. Now, not so much.