Wednesday, May 18, 2016

Early Weeks

In my last pregnancy, I recorded each week rather diligently. This time, I sort of forgot to write about it, or even to think much about it. I also sort of wondered whether going week by week and publishing my thoughts publicly would encourage over-reflection and a rushing-to-judgment about diabetic pregnancy. My experience is almost certainly not universal to other diabetic women, and it's probably not even consistent from one pregnancy to the next. So to avoid overgeneralization about my own or anyone else's experiences in pregnancy, I'll simply make some observations here about the early weeks. If they jive with what you experienced in early pregnancy, too, let me know by commenting below! Perhaps we can make a pattern out of it and some day our doctors will listen to what the rest of us have noticed.

I knew very early, again, that I was expecting. This comes of natural family planning charting. I still have some difficulty identifying the day of ovulation - some months are easier than others - but I got it within a day this time. And for those who don't know, the day of ovulation is the one day of the month when a woman releases a prepared egg for fertilization. Some women have difficulty conceiving because they fail to ovulate, and some women have difficulty conceiving because the egg isn't released into the fallopian tube properly. (There are also any number of other difficulties with conceiving that a couple may experience, but these are two of them related to ovulation). Conception always takes place within a day or two of ovulation (if you release two eggs, this time is extended a bit), as the sperm cannot reach the egg until after its release, and the egg disintegrates rather quickly if it is not fertilized.

I had a few high BGs right around the time of implantation, but the phenomenon was not as noticeable this time as it has been in other pregnancies. I did notice that my blood sugars seemed a bit more even than at other times. Once I returned to baseline after a meal, my BG remained remarkably stable for hours, with the exception of about 45 minutes before my next meal. This was true whether my BG returned to a lower level (think 80) or a higher level (think 130). I'm not sure whether to attribute this difference to fact that I was measuring levels with the CGM rather then my blood. I do sometimes wonder if interstitial fluid glucose levels don't show the same changes that the blood does, and perhaps particularly so under the protective influence of the hormones progesterone or hCG. This is purely theory, though.

Immediately prior to the start of pregnancy, I had spoken to two certified diabetes educators (CDEs). Both of them suggested that I need to eat more frequently, both to relieve nausea in early pregnancy and to keep my blood sugars stable. I do go for a long time in the afternoon, between lunch and dinner, without eating. This period of fasting lasts about 6 hours. But in light of the above - that is, the general stability of my BGs following meals - I have not found eating continually to promote stability in my BGs. On the contrary, I have found that it promotes more frequent spikes, even when eating small amounts. Since about week 6, I have experienced nausea, and have also not found that eating frequently helps with nausea. The times when I notice nausea most are when my blood sugar is falling after a meal bolus, about 45 minutes after a meal. If I give insulin to account for the food that I eat, then I would likely experience this blood-sugar-falling nausea even more times per day. I am not anxious to do that.

So the early weeks dragged on rather uneventfully. Jenn, who has recently become a CDE (congratulations!), did suggest that I try to give insulin about 10-15 minutes prior to a meal. This has been a wonderful tip for my regimen, and I will use it whether I'm pregnant or not. My spikes after meals are not as high, which helps avoid the post-meal blood-sugar-falling nausea mentioned above.

1 comment:

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