Unintentional Ketosis

So this weekend was a productive one. We are damn near finishing the nursery, with just a few minor things to complete.

I also started pulling out the old baby supplies and newborn clothes and blankets to start stocking the necessary supplies. First of all, holy crap, my son had a ton of baby clothes. Definitely good news if new baby is a boy.

Second, I seem to have forgotten how high maintenance a new baby is, and how much stuff they need. I mean, I have a full storage tub of bottles and feeding supplies! And I have to clean all those! I quickly got overwhelmed by the sheer amount of stuff I need to go through and find a place for, so that’s a work in progress.

I have a couple projects that I need to finish up for the baby’s room, which I’m hoping I will have the energy for in the next week or two. Time is running out and I have set a goal of having everything done by 32 weeks. I have slight guilt because with Little Man’s room, I painted four paintings for his room, hand-crafted a mobile, and made a name decor. Oh, and not only did I help paint his room, I also painted a mural on a wall. Perhaps a little over the top, but still.

Fast forward to this baby, and the most I did was help tape up some trim. I happened to have a couple paintings that I did previously that I am using in this room. I do have one that I specifically want to paint to go with the star/constellation theme. I am about 40% done with the mobile and that’s it….it’s truly amazing how different one pregnancy is from another and how little time and energy you have once you already have a kid.

Speaking of, let’s talk about pregnancy with diabetes. One of the fun things doctors tell you to do when you are type 1 and pregnant is to check your ketone levels first thing in the morning. You pee on a stick and 15 seconds later match the color of the test strip to the bottle. It ranges from negative (a nice tan/peach color) to large (which is a scary deep burgundy). I’ve been diabetic for almost 24 years and have never received a ketone reading higher than a trace amount.

The reason for this recommendation is that pregnant women can slip quickly into diabetic ketoacidosis (DKA) without much warning. This is due to the increased insulin resistance in pregnancy – thanks hormones! Having ketones in your urine typically means your body is trying to rid itself of excess sugar. This would be accompanied by high blood sugar levels (diabetics should check for ketones anytime their sugar is over 250). DKA is nasty and basically shuts down your body and can kill you if not treated. Good stuff to think about when you are pregnant.

I admittedly have not been checking my urine every morning. My blood sugars have been stellar and just never felt compelled to. For whatever reason, I felt compelled to check this weekend. Saturday afternoon I was just kind of sleepy and a little nauseated. And my endocrinologist’s voice rang out in my head, “DKA can come on suddenly, so if you aren’t feeling well, you should check your ketones.” My blood sugar had been hanging around 150 after lunch, which isn’t necessarily high, but higher than in the range of <120 two hours post meal we would like it to be.

So I peed on the stick and it came back with a reading of “small” (a light rosy color if you’re interested). Oh shit. My anxiety-riddled brain immediately jumped to the worst cast scenario that I was going to slip into a coma at any moment and needed to be rushed to the ER.

Then I remembered that I hadn’t drank much water all day, maybe a glass. I gave myself a correction bolus to bring down my blood sugar and chugged a couple tall glasses of water. It wasn’t long before I started feeling better. I rechecked my ketones about an hour later and it was down to a trace amount. Phew.

Nonetheless, that scared me into actually following my doctor’s recommendation and start checking my pee first thing in the morning.

Here’s the thing, the past two days I have woken up to small ketones even though my blood sugars have been well within range the entire night before – waking up to 90 and 120, respectively.

Here’s the twist: not eating enough carbs actually sends your body into starvation mode, meaning your body will start breaking down fat to use for energy, instead of carbs or sugar you get from food. Heard of the Keto Diet? This is essentially what people are trying to reach by eating low/no carbs and high fat/protein. I am definitely not attempting a keto diet, as it can actually be dangerous for diabetics.

So it’s a double-edged sword. Eat too many carbs and your blood sugars are hard to control = bad for you and baby. Eat too few carbs and your body starts to starve itself. Ugh. It’s exhausting.

I have about 9 weeks to go and am so ready for this to be over. If baby is healthy and wants to make a debut a week ahead of schedule, I would gladly welcome that. Until then, the majority of my day will be consumed by making sure I am eating enough and that my insulin is keeping pace with my carb intake.

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