“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.