Saturday, September 8, 2012

Ridiculous!

What you hear me say out loud: "Huh."

What you'd hear if you were in my head:  "What the bleep do you bleeping mean you bleeping stupid meter! Why the bleep is my bleeping blood sugar so bleepity-bleep-bleep-bleep-bleeping high?!"

The past three days have been absolute blood sugar hell.  I haven't been on track with my blood sugars nearly as often as my mental commentary has been inappropriately explicit in my opinion of them.  The last two nights in a row I've shot up into the 260s and even with active insulin in my system my body isn't responding to the "excess insulin" I'm rage bolusing to cover down on it.

Take last night as an example, I made this amazing poulet au porto rissoto a la Julia Child (yum) and I measured out my serving so as to bolus appropriately. Two hours later as my pump is reminding me to check my sugars, I see the numbers 186 mg/dl come on the screen of my meter.  Knowing that is high but will typically come down with the remaining active insulin, I let the high slide and decided to check again an hour later to make sure things were headed in the right direction.  So an hour later my meter reads 262 mg/dl and my jaw just hits the floor (probably making room for the commentary in my head to fall out my mouth).  The active insulin did nothing to fight off that high! So I rage bolused an additional 2.0 units of insulin to force my sugars lower sooner rather than later and set my alarm clock to wake me up in another hour to check on the progress... So off goes my alarm clock and I check my sugars again and they've barely moved down to 216 mg/dl. Frustrated beyond belief I bolus an additional 1.0 unit and set my alarm clock again, which I admittedly slept through until morning.  But when I woke up, my sugars were still above 100 mg/dl and my morning target numbers are between 60 and 90 mg/dl...


BOO HISS!!

As I've discussed before, such numbers are either indicative of carb miscalculations or insulin resistance as a result of pregnancy.  I've been really careful about my carb counting, so that means that the insulin resistance I've been expecting is off to an aggressive start... to fix this, I've decreased my carb ratios for almost all of my meals.  Pre-pregnancy my bolus ratios were roughly 22 grams of carbs per 1 unit of insulin, but now I'm down to 12 grams of carbs per 1 unit of insulin.  I've also increased my all of basal rates (the body doesn't need the same amount of basal insulin all the time for various reasons such as the dawn phenomenon) by several many tenths of a unit which has added up.  Pre-pregnancy my basal rates amounted to a daily total of 8 units of insulin and now I'm up to 11 units of insulin.

For those of you who aren't diabetic and aren't hypersensitive to the daily statistics of your life, such increases in insulin dependence are overwhelming (insulin:diabetics :: gold:pan miners).  The scary part is that I have somewhere between 8 and 12 more weeks of insulin resistance to work through, so these abnormally high glucose readings will persist and my increasing usage of insulin will continue until the placenta is delivered. 

Again, say it with me now: BOO HISS!!

The good news is that as of the appointment I had earlier in the week, I've been cleared to "exercise" again and that is another tool I can use to combat high glucose readings.  By hopping on the stair stepper and creeping along at a slow enough rate to keep my pulse at 140 beats per minute or lower, I can slowly but surely drop my blood glucose over the course of a half an hour from "exertion."  Unfortunately, with such high readings as the 260s, the risk is that I am spilling ketones and at that point exercise will only make my sugars go higher rather than helping me to correct.  So this additional solution is only helpful if I am at a lower high than the excessive numbers I've seen lately...

I am extremely relieved that I have another endocrinology appointment this next week to get some professional help to fix these issues.  From my understanding, I can pretty much expect my insulin requirements and bg numbers to be changing on a daily (or even hourly) basis, so at least one day this week I'll have exactly-exactly what the doctor prescribes. 

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