Saturday, January 22, 2011

Three Months

Wow, is my little baby boy already three months old? That flew by fast. My little man is cute as a button and I now see how it's possible to be addicted to babies.

I have recently started to turn my attention back to my blood sugars. It's amazing how a little person so small can so totally change your priorities that your own health begins to take a back seat.

It took a couple weeks for my blood sugars to return to pre-pregnancy levels. I recall it was a similar time frame with my first son. I had thought the insulin needs might drop immediately, since that's what my OB warned. But instead I found myself gradually adjusting bolus ratios, basal rates and insulin sensitivities down every 2-4 days. And, instead of leveling off at pre-pregnancy levels after 2 weeks, they continued to drop. For about 6-8 weeks, I was giving quite a bit less insulin than I had pre-pregnancy (30 units instead of 40 units per day). I suppose this may be attributable to breastfeeding, but...

A few weeks ago, right about when my son was 2 1/2 months old, I began to need more insulin again. I am now giving slightly more insulin per day than I did before my second pregnancy (40-50 units). I am still breastfeeding exclusively, so I can't explain the second shift.

Now that things are relatively stable, I am really trying to get a handle on my blood sugars once again. After all, as everyone can probably guess, I would love more children (it actually makes me sad to think that I really should wait a little longer before conceiving). So it's worth getting in the habit now. And if there's anything I've learned over the last three months, it's that you can't do everything, so put the most important things first!

In assessing my problem, I've realize that the biggest thing that keeps me from good blood sugar control is not all the holiday treats (although that can be a problem), and it's not irregular patterns/habits (although that can also be a problem). It's just a failure to check my blood sugar.

How does this happen? It starts with the lows. I start to feel a little wonky, and since I'm running low on time, and the baby is asleep on my chest, my toddler just woke up from his nap...I'll just grab some juice, because I'm pretty sure that's why I don't feel good. Of course I intend to check my blood sugar when I come back upstairs after getting my toddler from his nap, but then he asks for a snack and by the time I'm finished sitting him down to eat it and instructing him on how to keep his milk from spilling everywhere, I've completely forgotten about my blood sugar (because I'm feeling better by then).

Then, after a few days or a week of this bad habit, I notice that I'm having some "unexplained highs." So if I start to feel high, I just give a small bolus, without checking my blood sugar, thinking that I know pretty well what's up. These "unexplained highs" aren't so inexplicable: they're usually because I ate something (or too much) when I perceived my blood sugar to be low, but it wasn't. And then, of course, after these haphazard boluses, I'm either too low or my blood sugar is still high (perhaps slightly lower) an hour or two later.

I like to think that I know my body pretty well, and I'd say I guess correctly about 75% of the time when my blood sugar is out of the range where it's supposed to be. But nobody's perfect, and especially the first three months of my baby's life, I'm likely to feel a level of fatigue and wonkiness that I've never felt before. So, as I told a friend the other day, I'm emerging from "baby fog" and really trying to tighten up my blood sugars, partly for me and partly for my future babies.

Oh, and Jenn, if 7.3 is your worst A1C ever, you should just keep it to yourself. Because the rest of us have you handily beat!

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