My second trimester of pregnancy (roughly week 13-28) has officially come and gone! I can’t believe I only have one more to go until we meet our baby boy. During my second trimester, I got a lot of my energy back, felt a lot more like myself than I had the first few months, and we enjoyed our babymoon in Nantucket! Diabetes has definitely kept me on my toes this trimester, but of course it was nothing that I couldn’t handle with a little focus, patience, and of course: pre-bolusing. Don’t forget to check out my first trimester with type 1 diabetes blog post for more details about how I prepared for pregnancy with T1D, how I managed my blood sugars off the bat, and how I avoided spikes during those first few months.
Diabetes Management During My Second Trimester
During my second trimester, I was able to maintain an A1C of 5.4 and keep my blood sugars in range (between 60mg/dL and 140 mg/dL) 84% of the time. This management came with a lot of flexibility (with my schedule), long wait times before eating, constant focus on my patterns, and ongoing adjustments whenever I consistently was having issues staying in range.
Hypoglycemia
Between weeks 13 and 16, I noticed that my insulin would work a little too quickly. I had quite a few hypoglycemic episodes (low blood sugar) during those weeks, and also started to notice that my tongue would go numb if my blood sugar was dropping low very quickly. Low blood sugar episodes in this trimester started to make me feel a lot more lightheaded than ever before.
Insulin Resistance
Pregnancy insulin resistance finally roared her ugly head during this trimester, and I started to see my insulin needs change around 20 weeks. My resistance started in the mornings, and by 21 weeks I was needing to adjust both my insulin to carb ratios at all meal times as well as my basal settings throughout the day and night. I started to wait anywhere from 30-40 minutes after taking insulin to eat starting around 21 weeks to cut down on post-meal spikes. I refer to this wait time as a “pre-bolus”.
I saw a similar wave of insulin resistance kick in during our babymoon when I was 24 weeks. For me this looked like higher numbers no matter how much insulin I seemed to take. My high blood sugars started to feel “sticky” and took a lot more than a correction dose to come down back into the range I was looking for.
Lowering Fasting Blood Sugar
Toward the end of my second trimester, my doctor recommended I switch from using auto mode on my Omnipod insulin pump, to manual mode just for overnights. I was waking up in the 115 to 130mg/dL range, which is a higher fasting blood sugar than what my doctor wanted to see. By switching to manual mode, we were able to fine tune my overnight basal rates and I was able to finally start waking up in the 75-90mg/dL range, which is a more ideal fasting blood sugar.
Staying in Range
What has helped me the most over the course of this pregnancy to stay in range has been staying consistent with pre-bolusing before all meals, trying my best to count my carbohydrates properly, and to always incorporate protein into my meals and snacks (vs. only having carbohydrates). When I did make adjustments to my ratios and rates, it was always a very small adjustment (mostly suggested by my doctor first), and then fine-tuned accordingly depending on how the outcome looked after a few days.
Second Trimester Symptoms
I started to feel a lot more like myself this trimester, which I hear is common. There’s a reason it’s recommended to schedule your babymoon around this time! I went back to consistent strength training classes (with modifications to avoid core) during my second trimester to pair with reformer pilates and cycling workouts since I had a nice burst of energy throughout these weeks.
I got to feel baby kick for the first time in week 13! It felt like small flutters or a muscle spasm at first, and turned into more consistent kicks in week 19. My belly felt much more pronounced in week 17 and I felt like it “popped” in week 24/25 when I really started to see and feel how round it was.
We took our babymoon to Nantucket during week 24, which I was happy to have planned it that way because my exhaustion came back with a vengeance in week 25-26.
Second Trimester Thoughts and Feelings
I would be lying if I said pregnancy has been a walk in the park mentally. It’s been a lot more difficult for me to witness my body change the way it has during this time. The baby growing inside me part has been nothing less than absolutely magical, but watching myself put on the extra weight was a bit harder to experience than I expected it to be. I’ve felt a lot of “I don’t recognize myself in the mirror” moments, lots of emotions stemming from hormonal changes, and the slow process of saying “goodbye” (in a sense) to the person I once was, in order to transform into the mother, caregiver, and protector that I am becoming.
Of course, I am consistently so amazed to watch my body do this all on its own and feel so blessed to be able to experience this miracle, I mean can you believe our bodies just know what to do?! I do think it’s important to share about these feelings though, since I never really heard anyone talk about this topic before getting pregnant.
Mental Health + Managing T1D
The mental load of managing my type 1 diabetes has also felt heavy at some parts of my second trimester, however, I was surprised at how slowly these insulin changes happen and how mentally “okay” I was to make these adjustments. Seeing a much lower insulin to carb ratio when you’re used to a certain number can be jarring out of context, but in the trenches of pregnancy, when you start to realize that your body just needs more insulin, it’s a lot easier to confirm bolus on an amount of insulin that’s higher than your non-pregnant self was used to.
I’m sharing more about my second trimester diabetes management, symptoms, and more over on youtube! I asked my community on Instagram for any second trimester questions they had for me and answered them in the video above. Enjoy 🙂
Pregnancy Favorites
Find everything that has helped me through my pregnancy here!
Only one trimester to go until we finally meet our baby boy! Stay tuned for my third trimester update coming soon. In the meantime, I’m sharing weekly pregnancy and type 1 diabetes updates over on Instagram.
Don’t forget to check out my second trimester recap over on youtube, where I answer a bunch of questions I received about navigating T1D during my second trimester. Talk to you soon!
