# 1st Trimester hypos



## MrsMushroom (Oct 15, 2012)

I am struggling with quite a lot of these, at least one a day 

I have done a DAFNE course and carb count and use a ratio of 1:10 of novorapid which on the whole works great for me, but a few times a day i'm still having hypos.

I'm trying to be really tight with my blood control so i'm pretty sure this is playing a part in it but could hormones also be contributing?

Should i cut back my Novorapid a little?


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## Lizzzie (Oct 15, 2012)

Hi Mrs Mushroom just found this post.

If you're consistently going low, it might be that you need a lower insulin:Carb ratio than you're currently on or it could be you need to reduce your long acting - if always within 4 hours of injecting for food I would blame the first.

I'm suddenly needing much higher amounts of insulin than I did before, which seems odd to me because last rime round I was like you and ended up on tiny insulin doses, I think my Levimir and novorapid doses halved.

Think the key is writing it all down then looking for consistent patterns like in the Daphne workbook.  Tedious but worth it. Also be very kind to yourself when the patterns seem to go completely 'random' and you're not sure why: I think you're right about hormones playing a part and complicating the picture beyond followable logic sometimes: that's biology!

Are you feeling ice yet? I keep having massive swings and am sure it makes it worse.....
G luck!

Lizzzie


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## MrsMushroom (Oct 15, 2012)

It generally is within 4 hours of injecting for food. 

I take 18 units of Lantus at around 8pm every night and my fasting sugars are around 5-6 which is quite good so I thought this would be the right amount of long lasting?

Maybe i'll cut back a little on my Novorapid for a few days and see.

Its just so hard to know what to do, yesterday I had a BS of 10.4 at 5pm so I had a packet of crisps and took 2.5 units of Novorapid which should have covered the crisps with enough left over to correct down to about 7/8ish ...... Nope, Hypo 2 hours later 

I have a food diary which i am writing EVERYTHING into and am also keeping note of all my BS readings in a little book from the hospital ...... its a pain in the ass but it is good for seeing patterns


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## Lizzzie (Oct 15, 2012)

Your logic sounds faultless to me. Good luck, let us know how it goes.....


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## Monkey (Oct 15, 2012)

I can't really add anything, but it does get better. First tri both times has been hypo central here, often without reason.

The only thing I'd have tried with the 10.4 would be to correct it, recheck an hour later and then eat plus inject for the food. BUT I know the need to eat now is completely overwhelming in early pregnancy, so in reality  I'd have done what you did!


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## trophywench (Oct 15, 2012)

LOL - I think it's absolutely true isn't it?  Diabetic or not - no 2 pregnancies are ever the same !

Do whatever you need to do - be that less or more insulin.  DAFNE's great when you ain't preg - but she doesn't really cater for preg hormones!  - apart from the write it all down and try and fathom it bit, but even that only works for comparatively short periods during preg.


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## MrsMushroom (Oct 16, 2012)

When I was on the DAFNE course we were told never to take insulin without food which is why I had the crisps 

2 more hypos this morning already ........


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## Monkey (Oct 16, 2012)

MrsMushroom said:


> When I was on the DAFNE course we were told never to take insulin without food which is why I had the crisps
> 
> 2 more hypos this morning already ........



Hmm, I've never been told that, DSFNE or otherwise. Surely to correct a high BG you'd just inject and not eat?! 

It's relaly trial and error (I know you'll know that!) - have you got a DSMW who can have a look with fresh eyes and suggest anything? If 2 hypos this morn already, I'd be tempted to try reducing basal, but I'm not a medic!


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## trophywench (Oct 16, 2012)

Well the other option to cutting down on basal of course is to test 2 hourly and snack when you see your BG coming down too much and you still have active fast-acting, and you took that amount to avoid a spike.  

Now I know you'd never do this 'for the rest of your life' but Hell! - you are fire-fighting for 9 months when you are preg so you DO whatever you NEED to do and hang DAFNE.

I also don't need carbs with a correction dose.  The idea of the correction is to reduce your BG over 4-ish hours, not in 30 minutes.  If you take enough insulin to reduce it before the active period for that insulin is done, then the correction rate is too high!  And anything re ratios that used to be right before you were preg, stick it on a shelf in a cupbaord until you've had your baby and then get it out again after, along with the 'normal' jeans !


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## Kerry Type 1 (Oct 16, 2012)

I have been having a daily hypo in my first trimester .... and now into the second i find its starting to settle a bit... I had alot of un explained hypos where i thought i had not maybe taken enough novorapid ... but went hypo . I think its down to hormones and your body changing .... now im in the second im not having as many hypos but still hard keeping things settled. 

ive been told to inject if i have high sugar but to eat along with it also.... but have also been told to take correction dose. I correct 1 : 2 but in fact when correcting i could come down by 5 or 6 with just 1 unit... 

Pregnancy is certainly hard work but worth it

I have never had control of diabetes until now ... i suppose im more determind than ever !!


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## MrsMushroom (Oct 17, 2012)

This is the problem I have with correcting too. I never know how much I am going to come down by. Sometimes half a unit is too much, sometimes not enough. Maybe this is why I was told to eat when correcting?

Can I ask, how much do you think I should change my ratio by? I'm happy that my 18 units of Lantus is just right (for now) as my fasting sugars are good, it's the carb ratios that seem to be causing me problems 

I'm currently 1:10, maybe change it to 1:15?


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## Kerry Type 1 (Oct 17, 2012)

when ive had my ratios changed the doctor only changed it by one or two to see how it goes . i would suggest increasing only slightly as you could go from from extreme to another . Give them a call and run it by them ? 

I sometimes find that i can be slightly high 2 hours after but crash at 3 hours after meal ... now im in the second trimester things are calming down but docs are still a bit baffled with some readings and they are going to monitor over 24 hours soon to see what they are missing .... I think its just pregnancy to blame for the unexplained


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## Kerry Type 1 (Oct 17, 2012)

my levimere has more than halfed the dosage since becoming pregnant !i used to be on 28units and now take 12 units ! ive found it takes alot of tweaking to get things on a good slate then something changes and back to square one !


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## SweetAmerican (Oct 17, 2012)

It's common to have lots of lows during first trimester-I think this is when I gain the most weight because I'm eating all of the time lol!

From about 23ish weeks is when you start to get the insulin resistance. By the end of my last two my ratios were like 1 unit of insulin to 3 grams of carb plus 1 or 2 units. and I was on 3-4 units per hour!! (I'm on a pump) it was crazy! 

I have never, ever heard the advice to eat when correcting for a high and in pregnancy this is just crazy advice since highs are dangerous, especially in the first trimester when the baby is developing his/her organs. I usually drink water and go for a walk when correcting for a high during pregnancy and wait  until i have a normal reading to eat. My doctors told me to avoid correcting the blood sugars until at least two hours after a meal as the stacking up of insulin leads to more lows. Usually I test 1.5 hours, try the water and walk if high then recheck at 2 hours post meal and correct if I'm still high.


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