Overcompensation Nation

“It’s always safer to be on the high side than the low side.”

It was one of the first things my pediatric endocrinologist told me after my diagnosis in 1990, and it’s a refrain I’ve recited to myself dozens of times since then. I think a lot of us make a habit of cruising just a bit higher than ideal, whether it’s because we fear low blood sugars or we’re preparing for exercise or whatever. I’ve always felt further from the edge of the diabetes cliff when my numbers are closer to 120 (or higher) than 90-ish.

Of course, all of that has changed since I’ve started tweaking bolus rates and carbohydrate ratios to keep up with the insulin-resistant influence of the placenta I’m carrying around. (That sounds so gross. Sorry.) As my insulin needs creep ever-upward, and as the possibility of having to deliver a T-Rex-sized baby grows more immediate, I’ve started going out of my way to stay as low-ish as possible. Let’s put it this way: before, I was a moderate consumer of insulin, only bingeing on special occasions and always careful not to over do it. Now, I’m a junkie — a heavy user who’s growing less and less afraid of taking a few extra hits during the day.

It’s like I automatically add ten carbohydrates to any food item I’m counting, just in case. I’d rather have to eat a little more in an hour or so than watch the CGM graph on my pump jerk menacingly skyward. I think of it as preemptive rage bolusing. If I’m dealing with a sticky high, I’ve got no problem cranking my temporary basal up to 150% or higher until it comes down.*

I can’t tell if I’m making irresponsible and potentially dangerous decisions because I’m pregnant, or if this is the way I’m supposed to have been doing it all along.

After all, I haven’t passed out yet! I haven’t even had any crazy low blood sugars that I can attribute to this behavior. (The scary-as-hell 26 mg/dl I had a few months ago I attributed to unusually long periods of standing around.) And seeing that long, even CGM line over a 12- or 24-hour period brings me a sense of control and accomplishment that I haven’t felt since I found out I was pregnant.

For once in my life, fear and competition may actually be motivating me to take better care of myself. Each time I feel an extra-powerful head-butt from the inside of my belly, I imagine my baby growing to hulk-like proportions — feeding off of high blood sugars and lifting weights in her spare time. (She may be getting tattoos, too.) Then I see other Type 1 moms-to-be with A1c numbers in the low 5s. And although I know I shouldn’t compare myself to other diabetics (we’re all special snowflakes, after all), I want to be in the 5-point-something club, too.

I want to walk out of the hospital in September with a healthy, compact-sized baby and a birth story that reads like a fairy tale. I want to stand outside the sliding glass doors and give the finger to every doctor I’ve seen in the last 5 months who’s been lukewarm about my A1c or a fasting blood sugar number. I want to feel like a normal pregnant lady, and the only way I know how to get there is to keep taking a little more insulin than I might need. Pass the bottle.

*Special Disclaimer: DON’T DO ANY OF THIS STUFF. I am a crazy pregnant lady with no medical training.

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10 comments on “Overcompensation Nation

  1. Sara says:

    BABY HULK SMASH BREAK WATER BAG!

  2. lovehatediabetes says:

    On you are so cute.
    I know you’ll do wonderful during your pregnancy.
    And like you, I was always told its a bit better to be high than to be too low. I’m starting to not like that saying

  3. Heidi says:

    I certainly understand your wish to join the 5-point-something club, but just know that, even during pregnancy, it is not alway nice to be a member of that club 😉

    I wrote a bit about it here http://diabeticdane.blogspot.dk/2012/06/continuous-adjustments.html after reading your post today 🙂

  4. I’m obsessive about my numbers, so I sometimes lie to my bolus calculator too… and I’m not growing a tiny human like you are.

    I honestly didn’t know that medical professionals said that to people. But now I understand why my T2 mother-in-law freaks out when I have a blood sugar of 90 and won’t be eating for at least an hour.

  5. Auntly H says:

    I’m a weird one more afraid of highs, especially the stubborn ones, than lows.

    I LOVE your special disclaimer (and you).

  6. Your last paragraph, before the disclaimer, ME TOO!!! Although, I kind of already am giving the jerk face docs the lovely middle finger 🙂

  7. Karen says:

    I’m like Heather, always more afraid to be high than to be low. (And weird, apparently . . . ) I can’t even imagine trying to juggle all this blood sugar crap while growing another whole human!!

  8. Layne says:

    You know, I heard that as a kid and then the adult Endo always told me different. Turns out that Peds Endos say that as kids our developing bodies/brains need the fuel that being low robs us of. But as an adult, I’ve always erred on the side of lows rather than highs. I also didn’t know that was weird until I joined the DOC. I just hated the way highs felt and it seems like lows were easier and quicker to fix anyway! And after pregnancy I totally feel you on the “addiction” of wanting to see just how low I can cruise. I love testing in seeing 85 or 92 and am totally finding myself scoffing at 120s or 140s. But as far as addictions roll I think that’s a pretty good one to have! I think my eyes/feet/kidneys/nerves will thank me 20/30/40 years from now! So rock on!

  9. Layne says:

    Sorry! I re-read that and it sounded WAY confusing. To be more clear: what I heard as a kid was to be careful of lows and err on the higher side (A1Cs in the mid to low 7s). And what my adult Endo said was that highs were bad and to err on the lower side (A1Cs in the mid to low 6s).

    I hated that JUST when I thought I was doing well my new doc was pushing me even harder, which was why I questioned this and why the new doc told me the reason that peds Endo’s push A1Cs on the slightly higher side.

    /rant

  10. Amanda S. says:

    I just wanted to say that I am pregnant right now as well and I love love loved this post you wrote…it was so great to hear that someone else out there is doing & feeling the same as I am. I have been totally doing all of the things you mentioned re: insulin, blood sugar etc during this entire pregnancy (and may continue afterwards too because it’s comfortable for me).
    As well, cheers to your last paragraph…omg that’s exactly how I feel!!! Kudos to you for writing & sharing it!

    “I want to walk out of the hospital in September with a healthy, compact-sized baby and a birth story that reads like a fairy tale. I want to stand outside the sliding glass doors and give the finger to every doctor I’ve seen in the last 5 months who’s been lukewarm about my A1c or a fasting blood sugar number.”

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