Help and advice please

Hi Everybody
I completed DAFNE over a year ago now and have sort of gone onto autopilot so need a bit of support please.
I am on an insulin pump and planning for pregnancy.
My last HBA 1c was 7.4%/57 as things have gone off track the last 6 months due to having a miscarriage.
My pregnancy blood glucose targets are pre meal 3.5-5.5 and post meal less than 7.5 mmols.
I am finding the post meal targets difficult,
I can see that my morning readings are not in any sort of pattern and I am going to do an overnight basal check this weekend.
I would be really grateful for any advice you can all give me please. I have attached my readings for this week so far for comment.
Any advice or tips welcomed
Many thanks
x

From what I can see you results are really quite good, so well done.......

I would agree that an overnight basal test should be done, but also maybe some basal tests at other times, as fine tuning the basal throughout the whole day could help lower the mid meal readings.......

Another tool in the fight against high mid meal spikes is to consider dose timing, so giving your bolus before you eat, specifically 15 minutes or more....

I am aware there are different bolus option on a pump like dual wave etc.....I am not completely familiar with them as I am not on a pump YET!!.....

I would have a play around with the timing first, then speak with your pump team in order to come up with some ways of fully using the pump features to help get your mid meal reading down....

I see you made a comment about eggs having carbs, I would say NO, DAFNE would say NO, but I have heard other pumpers saying that they need to count their eggs and some vegetables too......It was theorized that because pumpers dont have an engineered slower acting insulin on board to mop up the very slowly digested foods [proteins, fats] that these items can effect blood sugar, all be it small amounts........it makes sense to me, but as I say I dont know first hand.....

I would assume your basal may need tweaked here.........

Well done again, your BG is looking good, I hope another pregnancy comes soon for you, good luck.....

Thanks very much for your reply.
I agree about the basal checks throughout the day. I am getting round to it. I did the breakfast one but I am too hungry at other times of the day ha ha!
That is a great tip about taking the insulin 15 mins before eating, I have been trying to do it but often its difficult because I do not know what portion size I am going to give myself until the last minute or nightmare if eating out. At least if I can try it MOST of the time then it should help things.
I do find it very hard to get the readings down though, the difference when I eat a meal with a tiny portion of carbs to a normal sized dinner is shocking. It just keeps highlighting to me that its me who is making my blood high because of what I am eating but I have been advised not to low carb because of wanting to become pregnant and also I do enjoy my food and don't want to cut out carbs.
Another problem I have is with snacking in between meals because then I can not get an accurate result of what is happening with the pre evening meal dosage. I tend to eat my dinner and then want something about an hour afterwards like crisps or chocolate so feel I can't see accurate patterns of what is happening.
That is also a great idea about looking into pump features, I have never had any extended training so maybe I should look into this myself. I have just moved house and my new hospitals approach is very much "what do you think?", "what do you want from us?" which is really not good for somebody in my position who needs a push and some support because I have got to the stage where I am fed up of being diabetic.
That is interesting about eggs and veg, I think I am going to have to do the same.
I did an overnight basal check and the readings were very erratic. I have increased my basal rates and things are looking better but I suppose I am going to have to do it again to confirm.
That's terrible that you are not on a pump, its unfair that some people can have it and others not. I have just seen that Medtronic have a new machine out that constantly monitors your blood sugar which works along side the pump, I really want it but doubt I will be allowed. I don't think it will be long before they have the artificial pancreas but then none of us will be allowed
Whilst I am having a little rant, since I have been on the pump my readings are a lot lower than pre-pump, I have had my driving licence restricted to 1 year!!! It's crazy, my control is better yet I am penalised for it.
Ok, so I will try today with taking my insulin 15 minutes before eating and see what happens.
Thanks very much for your support, I really do need some help at the minute!

You can have carb free meals, like meat, cheese, eggs etc for basal test during the day remember, even on the pump it should give good enough results to make a dose adjustment decision....

I am going live with the pump on the 21st of January, so not on one yet, but very soon, good timing I say, lets me go mental st Christmas.....

How many basal rates do you have out of curiosity.......?

Oh yes, I had forgotten that I can still eat the carb free things! That will make it easier.
That's good that you are getting the pump, I think you will adjust to it really quickly, yes enjoy your Christmas! I got mine just before a holiday and could only swim (well bob about in the water ) for an hour a day, that was a shock!
I have 15 basal rates at the minute.
For the past 6 months I have not made any adjustments, I have just carried on using my bolus wizard as it was set and left the basal as it was. The past few weeks where I have tried to get back on track I have already added an extra basal rate and adjusted 6 times so it clearly shows why my hba1c has been rising.

15 is not a lot for ME, it's come from trying to get very tight control and working with my diabetes team.
I am planning for a pregnancy and need to get very tight control which means having as many basal rates as my body needs. Every person is different and have different things which affect their sugar levels, I have extra things which affect me such as stress, driving times, hormones etc etc.
Since having 15 basal rates I got my HBA1c down from 9.3% to 6.4%!