Question from Surrey, United Kingdom:

I am a 33 year woman with diabetes and coeliac and have been pregnant for five weeks. I am on insulin injections, taking Humalog before my main meals and Humulin I before bedtime. Now that I am pregnant, I have to reach a tight sugar control, maximum 5.5 mmol/L [99 mg/dl] before meals and maximum 7.5 mmol/L [135 mg/dl] one hour after main meals. The problem is when my sugar level is 5 to 6 mmol/L [90 to 108 mg/dl] one hour after my main meals. I become hypoglycemic for two hours. The only way to avoid this is try to reach the 7.5 mmol/L [134 mg/dl] target for an hour or eat extra foods when my glucose level is 5 or 6 mmol/L [90 to 108 mg/dl] for an hour.

I was also advised to introduce slow acting foods into my diet. Unfortunately, apart from basmati rice or new potatoes, I could not introduce anything else because most of these items contain gluten, which I cannot have as a coeliac. I think Humalog is not suitable for me, as I would need an insulin where the one and two hour results could both be kept between 4 and 7 mmol/L [72 and 126 mg/dl]. I had the one hour high peaks before pregnancy, but on check-ups, I was only asked to show two hour results. Because these were within the target and my A1c was normally between 6.2 and 6.5, my specialists were satisfied with my results. I also do not want to put extra weight on by eating extra after every one hour injections on top of my six meals/day. Could you please advise me?