insulin?

[jasminescent]

I was diagnosed with gestational diabetes early since diabetes is in my family.
I am now 30 weeks along. The last time I visited my endo, he seemed to be somewhat concerned that about 1 out of every 5 fasting blood sugar level is over 90 but under 95. He even asked me how I felt about taking a shot of NPH before bedtime. I said no because I thought he was being way too strict with the guidelines. He then suggested eating a little snack before bedtime... What are your experiences out there? Is this really too high?

 

[capel]

Well, here in the uk they want you to wake with less than 5.5 (99 in US). I don't always, normally I am around 5.7 (103). My doctot is not very concerned because my hba1c is very good. During the nigth my levels are good but I have a small dawn phenomenon, so there is nothing I can do apart from waking up at 5am to inject insulin. But the was giving me hypos. I rather be sligthly over that hypo every morning.

 

[spring_baby]

well i have just been diagnosed and due to my baby needing steroids and my blood sugar wasnt at the correct level before the steroids but since the intro to insulin and the night time one too my levels have tripled and i have started to eat only a proteing low gi fruit and salad to try and bring it down, high fibre cards made it sky rocket (but it could be due to the steroids every 12 hours as app yr blood sugar spikes when steroids are introduced will see the gd midwife again mon when i get rescanned to see if the steroids have made baby stronger and check on my fluid levels etc so wont know until then, feeling tired but that could be gd and then again it could be the fact that i havent slept properly since tues when i found out gd and less than 34% aminotic fluids..

 

[capel]

Insulin should make your levels drops. But steroids can make then VERY high. It is very hard to manage diabetes when taking steroids. I was told that if I needed then during pregnancy I would be admitted to hospital to have them. Then take intravenous insulin, not injections. But I have type 1 diabetes and can't produce any insulin on my own.

 

[Tanikit]

I agree with you that he is being too strict and you would probably find that if you take long acting insulin at night you are likely to go low in the middle of the night and then it is likely that you would wake with even higher sugar levels in the morning because your liver would have to fix the low. Just keep monitoring and if it does go up a lot you could reconsider.

Spring_baby that is very hard to deal with - I had to increase my insulin a huge amount just on a small dose of cortisone for asthma and I know they give you huge doses for babies lungs. Once they stop giving it though your sugars should be better (may take a few days though as the corticosteroids they use act over a few days) Don't starve yourself as your baby needs food too - it is probably better while on the steroids just to run a bit high while they sort out the insulin and the baby and still get some nutrition in - stay low GI though for sure. Thinking of you.

 

[spring_baby]

I agree with you that he is being too strict and you would probably find that if you take long acting insulin at night you are likely to go low in the middle of the night and then it is likely that you would wake with even higher sugar levels in the morning because your liver would have to fix the low. Just keep monitoring and if it does go up a lot you could reconsider.

Spring_baby that is very hard to deal with - I had to increase my insulin a huge amount just on a small dose of cortisone for asthma and I know they give you huge doses for babies lungs. Once they stop giving it though your sugars should be better (may take a few days though as the corticosteroids they use act over a few days) Don't starve yourself as your baby needs food too - it is probably better while on the steroids just to run a bit high while they sort out the insulin and the baby and still get some nutrition in - stay low GI though for sure. Thinking of you.

ty xxx been in and out of hospital for min 12 hour stints all weekend due to maternity panicking but no one experienced in gd to recommend what to do until mon, finally they got hold of my gd mw and she said no to insulin drip)again thankfully after being there since 8am the registrar wasnt awailable to 19.00 hours to put me on the drip and by then my gd mw said no mu insulin has been increased to 9, b4 each meal with another insulin tablet after even meal and breakfast and a different insulin just b4 bed also set at 9 my levels have been as high as 23.7 today but finally 4th steroid injection finished for bubs lungs.
Sje said same as you prob wont stabalize till thurs as not ill or anything to go home so registrar signed me off as he was unsure about gd and went with the advice of my gd mw, finally home exhausted, have to go back tomo at 10am to have scan bloods see gynae to check aminotic levels etc go to scu for observations for baby movement poss contractions etc the see my gd midwife for a brief consoltation but more to reassure me, then a proper appointment on Thurs when she thinks it will have calmed down and insulin can be adjusted etc, ty for explaining what the insulin does feeling much better now did google gd but it scared me more xx

 

[Tanikit]

Spring baby I am actually surprised that they have released you - while you may not need an insulin drip they are making things a bit hard on your body - anything over 15 is very very high and can lead to ketones - also especially with the low amniotic fluid I am sure you have been told to drink a lot of water - please drink really LOT - I mean litres and litres and litres every day of water (or anything sugar free but preferably just water)

I am not your midwife, but this is what I would have expected:

1. They need to give you a short acting insulin to inject before every meal and a long acting one at night and possibly in the mornings too.
2. You need to test sugars at least 6-8 times a day and possibly bolus the short acting after the meals if your post prandial readings are very high.
3. They need to keep a VERY close eye on you as the steroids wear off as your insulin needs should drop significantly and you don't want to go low.
4. It is possible they should have put you in touch with a diabetes specialist - physician or endocrinologist as levels of 23 are not normal even with the steroids.

Sorry if I am scaring you - I just worry about what such high levels are doing to YOU - even a once off like that makes me feel terrible, let alone a few of them. Your baby however should be ok as long as you are not going ketotic (did they do urine tests as those will pick it up)

Make sure you talk to the doctors and if they do not know what to do with the diabetes tell them to refer you to someone who knows - preferably a physician. You may also need an HbA1c - if it is close to normal then you will at least know that this is all from the steroids, but if it is high they will have to look again. (I am not sure the steroids should be doing what they are doing to your sugars - yes they can cause trouble, but this is a bit excessive - I could be wrong though)

Again try not to stress too much, a short time like that won't harm your baby, but this does need a bit more looking into.

 

[spring_baby]

Spring baby I am actually surprised that they have released you - while you may not need an insulin drip they are making things a bit hard on your body - anything over 15 is very very high and can lead to ketones - also especially with the low amniotic fluid I am sure you have been told to drink a lot of water - please drink really LOT - I mean litres and litres and litres every day of water (or anything sugar free but preferably just water)

I am not your midwife, but this is what I would have expected:

1. They need to give you a short acting insulin to inject before every meal and a long acting one at night and possibly in the mornings too.
2. You need to test sugars at least 6-8 times a day and possibly bolus the short acting after the meals if your post prandial readings are very high.
3. They need to keep a VERY close eye on you as the steroids wear off as your insulin needs should drop significantly and you don't want to go low.
4. It is possible they should have put you in touch with a diabetes specialist - physician or endocrinologist as levels of 23 are not normal even with the steroids.

Sorry if I am scaring you - I just worry about what such high levels are doing to YOU - even a once off like that makes me feel terrible, let alone a few of them. Your baby however should be ok as long as you are not going ketotic (did they do urine tests as those will pick it up)

Make sure you talk to the doctors and if they do not know what to do with the diabetes tell them to refer you to someone who knows - preferably a physician. You may also need an HbA1c - if it is close to normal then you will at least know that this is all from the steroids, but if it is high they will have to look again. (I am not sure the steroids should be doing what they are doing to your sugars - yes they can cause trouble, but this is a bit excessive - I could be wrong though)

Again try not to stress too much, a short time like that won't harm your baby, but this does need a bit more looking into.

Hi Tanikit,

Last night I did as you said no one had told me to drink loads of water i think they took it as pat that i would be being pregnant. I normally drink about 3 litres a day but last night i drank that again and my blood sugar this morning pre breakfast was down to 10 i ca taste pear drops i know this is keytones and after my blood sugar test shortly I will have an oat bar and an apple with some more water when i get to hospital, as I will still need lots for the scan i FORGET WHEN WE NO LONGER NEED TO DRINK FOR THE SCAN but lately my brain is concentrating on my gd and blood sugars.

For me I am just lucky that I have someone like you to talk to thank you soo much, I will ask about keytones whilst there today and other than maternity this weekend who didnt check my urine, it is checked everyday at scu so all of last week and again today, on Fri there was sugar in my urine and thats when i was put on insulin.

On to brighter things my poor neglected dog is sitting next to me dreaming of walkies back door is open sun is streamimg through but will he go outside, no..he senses I am leaving in 45 mins and thinks i have neglected him the last week
I will make it up to him tomo, ty again I will keep you posted xx

 

[Tanikit]

Glad the water seemed to help a bit - you need to keep drinking loads as by the sounds of things you are possibly dehydrating now which may also be an issue with your amniotic fluid.

Need to ask: have you ever been tested for diabetes when NOT pregnant. I think I read somewhere that you had had a level of 6.9 at some stage which is fairly acceptable if it was a reading after you had eaten something sweet. I would definitely ask them to do an HbA1c on you - there are a lot of complicating factors with the pregnancy and steroids and everything right now and that test measures the last three months and will give a much clearer idea of what is going on - if it is high however they would have to repeat it when you are no longer pregnant to see what is going on.

The ketones are a BIG problem so make sure you know - in pregnancy you can get them from eating too little and you arenot eating much by the sound of things so a trace of them should not be too much worry (you wouldn't know this so there would be no taste)- anything higher than that and they probably need you on a drip with insulin.

And finally again ask for a physician/endocrinologist - while the gd midwife is probably great for GD related issues normally your case is a little more complicated and while it may just be the steroids I think there is something else going on here too - you should find out once the steroids are out of your system - when did the levels over 10 start that you know of?

Take care thinking of you and glad they did go down a lot this morning - the insulin is probably also kicking in better now to get you down like that (water alone will not do that, but it definitely helps)

 

[spring_baby]

Hi I will ask on Thursday about the HbA1c today my levels reduced in the main again 7.3 pre breakfast. 7.8 after breakfast but felt really whoozy and ill 8.3 after lunch again felt really ill, and 8.9 after dinner finally felt well.
Am presently on 9 plus a tablet breakfast and dinner and was told yesterday as i felt ill with the lower readings yesterday and today then to lower my insulin to 8& 1 tablet breakfast and dinner wed but to leave the bedtime dose at 9, she also said not to expect to feel normal whatever that is by Thursday fx that happens hate feeling so washed out.
Cant wait till 24/2 when i see the dietican, yr right I dont eat much this morning i had gf seeded bread with sauted mushrooms and a cup of tea and a snack of a flapjack late morning lunch was 2 poached eggs in gf seeded toast 100g cherries as low gi too cup of tea felt really ill after this so actually drank a bottle of water and slept for a couple of hours then had a late dinner of 1/4 piece spit roat bbq chicken with a small handful of chips approx 10, coleslaw and a banana split for dessert, again felt ill but ate a small snickers bar (dread to think what it will do to me blood sugar) but actually made me feel human again and a cup of tea, will continue drinking the water bubs is moving all the time at the moment which is good and my bump seems harder and bigger more like an egg according to my son me a football before gd my diet consisted mainly of salad protein rice cakes (low gi but not full of fibre so am cutting these out at the moment until i know for sure its ok to eat them) i normally had either pilchards or other fish in tomato sause or a sandwich filler on top of them followed by fruit for lunch anda more a more balanced meat and potato and 2 veg for dinner with my children, dessert was normally sorbet and meringue or vanilla icecream and sliced fruit or an occaisional gf brownie made rarely by my oh, as I am allergic to wheat it already made eating difficult, but on the plus side i lost 8 stone before getting pregnant with another 3 to go, but now I am struggling to introduce the correct carbs into my already limited diet along with the restrictions of not being allowed to eat certain foods whilst pregnant, before i got pregnant I ate a yoghurt and banana for breakfast goats cheese wrapped in parma ham dry fried till goats cheese all gooey inside on a bed of salad with anchovies and french dressing for lunch and gf pasta gf lasagne homemade or stews etc since being pregnant just cooking makes me want to be sick so its the quickest easiest option..sorry for rambling xx

 

[babybambi2011]

im type 1 diabetic, have been since i was 11. im now 20 weeks pregnant. this baby was a bit of a shock, and my hba1c was, lets put it honestly, rediculously high. since ive found out at 5 weeks, ive worked my (now huge) butt off to get it down. they say that a hba1c of 7 or below is acceptable during pregnancy, mine was 10 when i found out. ive just had another blood test to make sure its goin down. my one last month showed i was 9, so atleast im heading in the right direction. its horrible as my insulin requirements keep changing. at first i was having hypos every morning at 5am, which was a pain when i had to get up at 6 to go to work. thankfully now theyve stopped.
ive got my anomaly scan in 2 days, and i just hope that baby is healthy and everything is as it should be. the doctors are quite brutal when i go to clinic, repeating all the risks.
this is definately not easy, but will all be worth it in the end when i see my baby for the 1st time

 

[capel]

babybambi2011 I know it is hard work but worth it in the end. At the moment I am taking 3 times more insulin than before in the mornings and still going high. Lunchtime I take now less than before but the I have to eat the whole afternoon to keep me not going hypo. Today was the first day in the last two weeks that my levels were ok. It is driving me mad. I was very good controlled before I could tell most of the time what was happening with my body. Since pregnancy I lost my hypo awareness and can't keep on top of it. It's so frustating...

 

[babybambi2011]

it scares me the amount i take now.... my body obviously needs more, but my head thinks i cant possibly take this much! i find i have to eat a lot now at night time to stop my 6am hypos, but this morning i had one. i have to take twice as much of my long actiing in the morning than i do at night time, and my short acting is slightly less at night time than in the day.... soo strange, but atleast this is the pattern that seems to have stuck.
my hypos are really strange now.... i dont feel them now, i can tell cuz when i watch tv or am doing something, my eyes go all weird and blurry... so strange what pregnancy can do to your body!

 

[capel]

The hypo thing is very scary. Sometimes my husband just tell me that I should test, when I do I am very low and did not even notice. One day I just notice when I could not move my legs anymore. I miss my old body...

 

[babybambi2011]

yea, im like that. when i do have a hypo, i test cuz i dont feel right, its just something i cant put my finger on and then im like 2! like now im 3.9. i dont feel hypo, just something thats just a bit strange! and ive had to up my night time insulin 4 units in the past week. went to bed with a bm of 5.1 and woke up with 11.8.... things just never settle either you find the perfect insulin doses, then 3 days later.... nope! oh well, just one of the many "so called" joys of pregnancy lol

 

[capel]

I know what you mean. In the mornings I take HUGE amount of insulin (about 4 times more than before) and I am still a bit high one hour after. Then I am battling the hypos in the afternoon. I never nknow exactly how much to take because it is changing faster than I can adjust...

 

[babybambi2011]

fighting a losing battle! lol but atleast its worth it in the end when we get a perfect, healthy baby its hard to keep ontop of it, but ill gladly suffer thru my pregnancy for my baby x