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Re: [IP] Needing words of wisdom

Nancy -- no one else has responded yet about their experience during
pregnancy with the pump. This is pretty long, and I still probably left out
something you want to know. Just ask!  (I am still planning to write a faq
when I have more free time.) 

I had had a minimed 506 for 15 months when I got pregnant, but was only
very loosely counting carbs. I quickly learned to be much more diligent! (I
had to keep accurate food and bg diaries while I was pregnant anyway.)

I didn't realize I was pregnant till I was "6" weeks (or 4 weeks past
fertilization). I had all the symptoms of getting my period, except no
period. But I had had what felt like menstrual cramps for close to 2 weeks,
and they continued most of the first trimester.  I had also been running
lots of 200s and 300s (as well as some normal bgs) and felt so tired and
rundown that I thought I was getting the flu. It was a relief to find a
good explanation for my exhaustion! If you're feeling crampy now, it may
just be your uterus stretching itself, and not a miscarriage at all.

My blood sugar goals were 60-90 fasting and before meals, and <130 1 hour
after beginning to eat each meal. (About what Barbara said.) I was using
Velosulin (Humalog wasn't yet available in the US). To achieve the <130, I
generally had to take more Velosulin than would cover the meal, and then
eat a (15g CHO) snack at 2-2.5 hours postprandial. I had a lot of lows from
mis-timed snacks in the first trimester. :-( After that, it got easier.
Also, I usually ate more than 15g for my snacks -- more like 30-40g. I
would bolus for any amount over 15g. And my "meals" were rarely over 45g
CHO, so that if I made a mistake, it wouldn't be too hard to correct. I
tested every postprandial -- I had to buy a watch with an alarm so that I
would remember. 

About my basal rates: I'll give you my specific details so you can infer
what you want from them. Basically, I went up, then down, then up and up to
about double my pre-preg rates.  I started with 0.5 12am-2am, 0.7 2am-8am,
0.5 8am-mid. As soon as I discovered I was pregnant, my endo raised them
all by 0.1, and my blood sugars quickly regulated themselves and were
pretty good overnight for 1-2 weeks. Then I started to wake up at 3, 4, or
5am with lows. We backed my basals down to their originals, then the 0.7
became 0.6. I stayed with 0.5, 0.6, 0.5 (and the same time intervals) until
week 16 or so. From weeks 16-34, we slowly had to increase my basal rates,
all in 0.1 increments. They ended up at 1.0, 0.9, 1.1 -- notice that they
started with the highest rate during the night, and ended with the lowest
rate during the night. I don't know why, but that seems to be common during
pregnancy. From weeks 34-39, my basals stayed stable. I delivered at 39.5

My bolus ratios also changed. They went from 1:15, to 1:20, down to 1:4 !!
And the breakfast ratio was usually a little more insulin than for other
meals.  The lead time for meals changed, too. I started out waiting 30 min
to eat meals. By the end, it was 45-60 min for breakfast, and 30-45 min for
other meals.  About week 26, I got to be so insulin resistent that I had to
stop eating a real breakfast. Instead, I had a "snack" when I got up, with
about an hour lead time between the bolus and the snack (usually a glass of
milk).  Then I'd eat an early lunch 2 hours later.

What I didn't do: I didn't keep a strict meal schedule. :-) Breakfast could
be at 8am or 10am, dinner varied from 6pm to 10pm to sometimes 1am. The
only strict correlation was between each meal and its corresponding snack. 
Oh, and I exercised 5-6 days a week till the third trimester, and then 4-5x
a week. (Yes, pregnancy consumed a LOT of my time. I stopped working at 26
weeks because I was getting too stressed, or so said my endo.)

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