In Which We Hit the Home Stretch
Kathryn enters the last few weeks of her pregnancy with pride and excitement.
By Kathryn Foss
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
April 2009 — What an amazing adventure being a pregnant diabetic has been! As I write this, I am entering the last four weeks of this pregnancy, and I have to admit, it was a lot easier than I thought it would be. At the beginning, I found myself constantly worried about blood sugar levels, A1Cs, and insulin amounts, but once I got into the groove of things, instinct seemed to take over and I found a great balance between medicine and my body.
That is, a great balance MOST of the time.
Before the pregnancy, I was a non-insulin dependant (and non-pregnant) diabetic, and as a result I never had to worry about scary low blood sugar. I never had any problems until I hit my 7th month. My insulin needs changed and I found myself injecting large amounts to keep my blood sugar levels stable. It felt like each mealtime was a gamble when it came to injecting my fast acting insulin. Most of the time, I was fine, but other times, my body simply got too much insulin and my blood sugar would plummet. This only happened a few times and usually right before dinner. I would get shaky and start having hot flashes. After testing and seeing a low number, I would panic and start eating anything I could get my hands on, from candy to cookies to chips. Anything high-carb. I was a poster child for what NOT to do when you have low blood sugar! I quickly learned to keep apple and orange juice on hand in the refrigerator, and when and if I had a low, a glass of juice would bring me up to a good level in about 5 to 10 minutes. However, at this point, I had yet to experience a low in the middle of the night. If this has not happened to you, I can assure you that you DO NOT want it to!
The evening leading up to the scary middle of the night low had been a tough one. I had pizza for dinner, which is one thing that really messes with my blood sugar. I had injected 40 units before dinner and then two hours later I was still crazy high, so I bolused with another 25 units. An hour later, I was still too high, so I injected another 10 units. That did it. I was fine and my blood sugar was at a good level. Shortly thereafter we went to bed and I injected another 17 units of long-acting insulin and went to sleep. A few hours later I woke up very confused. I was covered in sweat and shaking uncontrollably. Smart, sane Kathryn would have woken up her husband and asked for help. However, smart, sane Kathryn had been taken over by panicky, irrational Kathryn. In a daze, I made my way to the kitchen and tested my blood sugar and it was at 2.3. By this point, I had trained myself to drink juice, but for some reason, at 2 a.m., all training went out the window and a sugary, high-carb box of granola seemed like the best choice.
It was not. It was not the best choice when I ate the first bowl, nor was it the best choice when I had the 2nd thru 4th bowls either. I was like a cereal zombie and I just could not stop eating. I was eating out of sheer panic, which only kept me firmly strapped in the crazy blood sugar roller coaster, and predictably, four hours later, after some fitful sleep, my blood sugar was 16.5. I had to inject 20 more units of insulin and I finally stabilized my blood sugar about eight hours after the initial low. It was truly exhausting and I felt tired for days afterwards.
So, if this experience taught me anything, it is that I need a plan for every situation. The plan may not always be executed as intended, but I don't think I had ever even thought through the possibility of having a scary middle of the night low and what I should do if that happened. In hindsight, I think that lack of planning led to my reckless eating and my inability to stabilize my blood sugar. Effectively managing diabetes is an ongoing and constant process. It requires me to pay attention to, and cooperate with, my body. It's not always easy, but for me, the payoff has been huge. I am at the end of what has been a great pregnancy, despite being a pregnant diabetic. My doctors have constantly been amazed at my numbers and have, on more than one occasion, called me a "dream patient!" From all the tests, my little girl is perfectly healthy with no negative side effects of having a diabetic mommy. She is ready to make her debut into this world, and knowing that I was proactive and did my part to make that debut a strong and healthy one, is the most empowering thing I have ever done.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Lows are really nothing new to me. In the past (almost) 22 years, I've experienced every variety of low blood sugar. Two seizures, multiple black outs, the "I'm fine" at 32, the nauseating 85, and everything in between. That certainly doesn't mean that I'm used to them or that each low doesn't feel like a new and treacherous journey. They still scare me. They still annoy me. And they still overrun my life at times. Since I've hit the gym and the calorie counting on an aggressive...