u/T1DMamaJourney

Disclosure upfront: I'm not T1D myself — I've been researching T1D and pregnancy extensively and wanted to share what I've found, plus hear from people with real experience on this one.

One thing that comes up repeatedly in the research is how badly morning sickness disrupts normal bolus timing. The standard "dose before your meal based on what you plan to eat" logic completely breaks down when nausea is unpredictable — if you bolus for a meal and it comes back up, you've got insulin on board with nothing to match it, which is a genuinely dangerous situation on top of an already miserable one.

A few approaches that seem to come up as workarounds:

1.Dosing partway through or right after eating, once you're more confident the meal is staying down — rather than pre-bolusing

2.Smaller, more frequent doses rather than one larger bolus

3.Keeping fast carbs specifically staged for "I dosed and then got sick" scenarios, separate from general low treatment

4.Some people apparently switch to only eating foods they know their body tolerates during the worst weeks, just to make bolusing more predictable

But I'm genuinely curious what actually worked for people here, since research can only go so far on something this individual — did your care team give specific guidance, or did you figure out your own system?

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I've been researching T1D and pregnancy pretty deeply and figured I'd share a clear breakdown, since a lot of the info out there is scattered or overly clinical.

First trimester: Insulin sensitivity often increases for a lot of people — meaning the same dose that worked before pregnancy can suddenly run you lower than expected. This is part of why early pregnancy is a higher-risk window for unexpected lows, on top of morning sickness messing with normal bolus timing. It's not universal though — some people see the opposite (more resistance, higher numbers), especially if stress hormones are elevated.

Second trimester: This is usually when the shift flips — placental hormones (human placental lactogen especially) start driving up insulin resistance, often steadily increasing through the rest of pregnancy. Basal and bolus needs commonly climb noticeably from here on.

Third trimester: Insulin resistance typically peaks, sometimes requiring 2-3x pre-pregnancy doses by the end. Then right after delivery, insulin needs can drop fast — sometimes back toward pre-pregnancy levels within days, since the placenta (the source of a lot of that resistance) is gone.

The overall pattern is basically a U-shape for sensitivity — more sensitive early, progressively more resistant through the second and third trimester — but with real individual variation, especially in the first trimester.

Curious if this matches what people here have actually experienced, or if your pattern looked different.