Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
April 6, 2006
Question from USA:
I'm now four months pregnant and my endocrinologist told me to get my readings down into the 60 to 100 mg/dl [3.3 to 5.6 mmol/L] range. When I tried, my blood sugar would just continue to drop, mainly when I was sleeping. He didn't discuss any insulin changes or diet changes, nothing. He just told me that I was doing better than I had been, even when my readings were dropping down into the 30s mg/dl [1.7 to 2.2 mmol/L] and twice within a week I had dropped to below that and needed a glucagon shot. What should I do?
Your endocrinologist is being a bit overaggressive with your insulin management. To give you some perspective, in my practice, I recommend a fasting glucose of 70 to 90 mg/dl [3.9 to 5.0 mmol/L], a pre meal blood sugar less than 100 mg/dl [5.6 mmol/L] and one hour post meal less than 130 mg/dl [7.2 mmol/L]. I also tell my patients that they will not always achieve this and to not fret too much over an occasional high glucose value. It will not have a huge impact on the pregnancy. In fact, at this point in pregnancy, I would prefer some hyperglycemia (mild) over profound hypoglycemia (to the point of needing resuscitation). So, I would suggest that you raise your concerns with your obstetrician and endocrinologist to better adjust your glucose control. Changes in both insulin dosing and diet may help.