Everyone is different. We may share diabetes in common, but how we manage diabetes might be completely different.
Not only that, but our bodies are completely different. This post is not to imitate, but more to view as a look inside what my settings are during pregnancy so you can see it as a possibility for what could be in store for you! I am using the Tandem Tx2 slim insulin pump paired with Dexcom.
Pre-pregnancy, my insulin duration was set at 4hrs, and my insulin: carb ratio at certain times of the day (usually later in the day was 1:15). My target BG was 100. And, obviously, my basal was much lower. I think pre-pregnancy my total daily basal was between 12-14 units. Also, my correction factor pre-pregnancy was 1:56.Pre-pregnancy I kept sleep mode on 24/7 however, during pregnancy, it’s not recommended to use control IQ and instead, switch back to manual mode. This is because control IQ keeps your target BG at 110mg/DL which is too high of a target during pregnancy. My increase in basal started a month after finding out I was pregnant. Usually, in the first few weeks you may notice that your sugars are much lower and then, they start to increase. During the first month of pregnancy in March 2023, I was using MDI and then in April 2023, I started using my insulin pump again. As you can see from my overall basal settings, my basal is higher in the middle of the day. This is usually when I am least active. I usually work out either in the morning or the evening or do strength training in the morning and cardio in the evening.Total daily insulin has increased from 14 to 22.15 during the entire 1st trimester.The biggest thing I have noticed so far in the second trimester (I am currently almost 25 weeks pregnant), is that my insulin: carb ratios have increased A LOT. One of the first signs was my morning coffee. I am usually a lot more insulin resistant at breakfast time, so pre-pregnancy I would bolus 1 unit for my morning coffee which usually had some almond milk or 1/2 & 1/2 and zero sweetener. In the 2nd trimester, I find I am giving myself enough insulin to cover about 30g of carbs just for my morning cup of coffee. Now, at 24 weeks, I am finding that I am more insulin resistant post meals and require more insulin for my meals at any time of the day. One thing you can see here is that at the 24-week and 4-day mark, I lowered my insulin: carb ratio from 1:10 to 1:5. (Personally, I don’t always use my insulin: carb ratio on my pump, mostly because I found I still needed more insulin, but I am trying to fine-tune my settings so it takes less mental strength throughout the day.Overall, there is a slight increase in basal throughout the day from morning to evening.Looking at my Dexcom log, even despite the slight increase in basal, I am noticing a spike in glucose at 1 pm and 5 pm, I may need to increase my basal during these times. The goal right now is to test my basal by not eating anything in between meals for 4-5 hours to see what my glucose levels do. I am, however, feeling like it could be more of an insulin: carb issue not an overall basal issue. This is because I have been traveling and guesstimating on my carb intake versus being in a solid routine and using my food scale which helps me be 100% accurate with getting the exact number of carbs/protein and fat in meals. Also, my exercise routine has been a little less consistent the last 2-weeks as I am on a road trip. Overall, from the 1st to 2nd trimester, my basal has increased a total of 1.89. I have one more month to go in the 2nd trimester, so this could change, and if it does, I will keep you posted as to what you might expect entering the 3rd tri.
This is just data from my own experience and your experience may be different!
If your experience is much different, know that is okay and totally normal. Our bodies are, after all, not the same even though we both experience diabetes. I would love to hear how things change(d) for you during each trimester. I hope this gives you some insight into what you might expect during the 1st and 2nd trimesters of pregnancy.