Funny story. At last week's OB appointment I asked Dr.Best to prescribe a glucometer for me. I had been borrowing a friend's, but she needed it back. Sure, he said, no problem, which pharmacy do you use? And then he stopped to ask "But you are not testing like a diabetic would, are you?" I assured him that no, I was not. Just testing when I felt funny, and that I did indeed catch a few rather impressive reactive lows*. I think they are getting worse, I said. I think I am loosing sensitivity in my receptors, I said. (Hm, as I type this, it occurs to me that this sounds like a pretty terrible pick up line. Don't try this at home, ok?) Dr.Best nodded, sagely, in what I interpreted to be agreement with my deductive reasoning, but also a statement of there is nothing we can do but watch, a sentiment with which I heartily agreed.
So where's the funny part, you ask? Here it comes. I failed four tests in five days now. The 1 or 2 hour postprandial (after eating) measurements on both my friend's glucometer, and my own new shiny freshly calibrated one. The first one was the night last week when I felt too puky to eat anything but carbs, so I thought that was it. But I started watching after that, and measuring, and had a few much more worrisome setups since. I am taking insulin-sensitizing drugs already, although my dose is not maxed out. In fact, one area of discussion we left open at the appointment was whether I am staying on the drugs for the duration as per experimental protocol in agreement with a paper that is supposed to come out soon in a very respected journal, or whether I am dropping the drugs as per current widely-accepted protocol. I called today and left the message for Nurse Kind, throwing myself at their mercy. A triage nurse called me back, but I asked for Nurse Kind, so they will try to have that happen today. And we'll see where it goes from there.
This is how this happens, by the way, the transition from insulin resistance to diabetes-- your insulin receptors become more resistant to the actions of insulin, requiring more insulin to accomplish the same work in each cell, making your beta cells work harder to make more insulin, resulting in more insulin in the circulating blood, resulting in more and more profound reactive lows. Until, one day, the beta cells just give up from the overload and make less insulin. And then it's the glucose that stays too long in your blood. A textbook case, really. My nerdy little self has to admit that it's actually kinda cool to watch it happen in real time. It's just what it means for me that isn't so cool.
I am not shocked. I have had documented insulin resistance for a while (and obviously since well before then since I had those pesky PCOS symptoms for years before someone was smart enough to diagnose me definitively), so it was always a toss up as to whether I would get through any given pregnancy without dipping into gestational diabetes. I got away with it twice, and that, I believe, was pretty impressive in its own right. I have been watching my carbs for so long that it's really second nature to me, or maybe even first one by now. So I am not shocked. I am mildly annoyed that it appears to be happening so early on in this pregnancy. I am resigned to whatever I have to do for the duration, though. I am resigned to it happening every time, and early, in any pregnancy subsequent to this one. I am not panicking or freaking out because this is sort of expected and should be manageable.
The scary thing, the unknown, is whether my beta cells are just on strike or whether they have severed their relationship with this particular employer forever. I can handle the strike. I was just hoping not to become a real diabetic, for life, before the age of 35. Little things, you know. But I am not going to think about this for now. Most likely it's just gestational, and I can't know one way or the other until I am done gestating. So I am going to focus on doing what needs to be done now instead. That's my plan and I am sticking to it. La-la-la-la-la-la. Now if only the nurse would call so I would know what it is they want me to be doing...
*going hypoglycemic relatively soon after a meal due to too much insulin ending up in the blood, and so clearing out too much glucose too fast.