I don't know what's going on. But every three days, like clockwork, I keep having these extreme highs. Not coincidentally, these highs line up with my site changes, so I feel like there's some time that my body needs to get used to the new site area. The first meal that I have following a site change will have me soaring into the 300s like the insulin I gave was nothing. And I spend the next few hours either crying, frustrated, and rage bolusing or some combination of all three.
So I'm contemplating not changing my site immediately when I run out of insulin like I usually do. I'm thinking of changing the reservoir but keeping the site in my skin to avoid the time my body needs to get used to a new site. I know some people change their site every 3 days to avoid absorption issues, but I seem to be having the opposite effect. Pre-pregnancy, I could fill up my 180cc reservoir and make it last 5-6 days, and I've never had a problem with absorption on the last day. With my basal rates up to over 27 units a day and my insulin:carb ratio at 1:6, I'm barely making it three days. As for when I do change my site, I'm thinking I will switch to injections for the first 12 hours for meals because insulin always reacts more quickly to an injection. These are all just tentative plans. I have no idea if this will work.
I know that having rogue 300s now and then are not that dangerous in the long run, but rather the sustained highs for several hours. But it is so, SO hard not to feel emotional when I see that number staring back at me. It might as well have said, "You failed." The emotional aftermath of having type 1 diabetes and being pregnant was something I was not prepared to handle. Trey and I talked last night about spacing out our kids (if God-willing we're blessed with more), and I said I feel like I would need time to recover emotionally more than physically. The guilt, the shame, the frustration with each bad number has drained me. I can't help but feeling like each bad number is hurting her, and I want to fast-forward to getting her out of me.
In the meantime, I'm trying to keep my eye on the prize. I know she's in there because she kicks all the time! The nursery is prepared, and the car seat and stroller have been purchased. I want to know that she will be OK and that I will survive this emotional roller coaster.
So I'm contemplating not changing my site immediately when I run out of insulin like I usually do. I'm thinking of changing the reservoir but keeping the site in my skin to avoid the time my body needs to get used to a new site. I know some people change their site every 3 days to avoid absorption issues, but I seem to be having the opposite effect. Pre-pregnancy, I could fill up my 180cc reservoir and make it last 5-6 days, and I've never had a problem with absorption on the last day. With my basal rates up to over 27 units a day and my insulin:carb ratio at 1:6, I'm barely making it three days. As for when I do change my site, I'm thinking I will switch to injections for the first 12 hours for meals because insulin always reacts more quickly to an injection. These are all just tentative plans. I have no idea if this will work.
I know that having rogue 300s now and then are not that dangerous in the long run, but rather the sustained highs for several hours. But it is so, SO hard not to feel emotional when I see that number staring back at me. It might as well have said, "You failed." The emotional aftermath of having type 1 diabetes and being pregnant was something I was not prepared to handle. Trey and I talked last night about spacing out our kids (if God-willing we're blessed with more), and I said I feel like I would need time to recover emotionally more than physically. The guilt, the shame, the frustration with each bad number has drained me. I can't help but feeling like each bad number is hurting her, and I want to fast-forward to getting her out of me.
In the meantime, I'm trying to keep my eye on the prize. I know she's in there because she kicks all the time! The nursery is prepared, and the car seat and stroller have been purchased. I want to know that she will be OK and that I will survive this emotional roller coaster.
I'm ready to put her in here and run away!
I had to bump (no pun intended) up my site changes to every 2 days, and when I did, I always bolused a half-unit extra for the transition into the new site. It helped with the post-site change highs. Maybe give it a try and see?
ReplyDeleteI have that same issues (when not pregnant) with meals after site changes. I actually never change a site before a meal. I usually wait until after dinner and change the site before bed, even though that is not always recommended. That way I have several hours of non-meal basal bolusing to make sure the site works well before breakfast time. I do exactly what you are thinking, when I end up having to change a site before eating a meal, I usually bolus with injection instead to avoid a site related high! Sometimes I also do the same thing Sarah suggested. Good luck with the changes! You are doing a great job!
ReplyDeleteDear Holly, I have been folllowing your blog and sympathize with you completely.
ReplyDeleteI had a baby eight weeks ago and the whole pregnancy was a challenge for me. I was all the time testing and correcting (especially after breakfast), then having lows and feeling like I failed or that I was doing something wrong to my baby. But you are right, the prize is so huge that it will make all these moments of stress and frustration go away! And you'll feel so happy and proud that you have done your best for this little creature!! All the best!
I'm not sure what pump you use but I've had great luck with my medtronic by not removing the old site for about 8 hours. I put a cap on it and that way no insulin spills out once I remove it because it's had time to absorb. Viola! No site change highs
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Ressy
I have the same experience as Ressy, as long as I leave the old site in for several hours after I can avoid the post site-change highs. Good luck!
ReplyDeleteI do the same thing as Ressy and Alex and have never had a high with a site change. I pull it out a few hours after inserting the new one. Good luck with the rest of your pregnancy! You can do it and once your baby girl is here she will make you forget all about this current emotional roller coaster!
ReplyDeleteI would recommend that you do not opt for just refilling the resevoir, especially during pregnancy, the last thing you want is to run the risk of getting an infection. Instead I would recommend that you change the site in full, add a bit more insulin to the first bolus for whatever food you're going to eat and keep the old site in place for a couple hours. What's the harm? Just keep doing what you're doing...you're almost there!
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