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I decided to write this since I had wanted to know what to expect while pregnant with diabetes and did not find a lot of information. I figure that there is probably someone out there that would like to know what can happen and what doctors will do.
I am a type II diabetic with PCOS.
I tried oral medications and still not enough improvement. Then the endo added Lantus at night and Humalog for meals (and 2000mg metformin ER) and finally got the right combination that was safe for pregnancy. It took about 1 year to get where they wanted me to be. I also was diagnosed with hypothyroidism and started taking thyroid pills.
I got pregnant within 2 months and after the 8 week check at the regular OBGYN I was sent to a high risk dr. I had regular ultrasounds every couple of months. I also had regular Endo visits as well. My a1c was running between 4.8 and 5.3. She had me back off a little after the 4.8 because I was losing the ability to feel lows.
Oh and they made me collect all my urine for 24 hours (every single drop while keeping the collection container on ice... yeah ewwww) to check for proteins in my urine (think this was around 18-20 weeks). I believe they said this was to help look for signs of Preeclampsia (high blood pressure induced by pregnancy) later... kind of finding out what is normal for me I think so they would notice a difference?
I chose not to go super low carb during the pregnancy and instead went with the carb recommendations for pregnant diabetics. I've already forgotten what they were, but I think it was 30 carbs for breakfast, 40-50 for each meal and 15 for snacks. I chose this because I did not want to take the chance that the baby would not have enough carbs to develop properly. This is what was most comfortable for me.
I had to check my blood 1 hour after each meal and two hours after each meal. They wanted my fasting to be below 90 in the morning and I think it was 120 at 1 hour mark and below 90-100 at 2 hour mark. I generally kept it around 70-80 for the most part at the 2 hour mark and in between meals.
Even though they advise you to wait 4 hours between giving insulin, I would do my corrections when I noticed it was not on target (often even at the 1 hour mark). Luckily I had practiced this a lot prior to pregnancy and knew what did and did not work for me.
Oh and do not let them give you a glucose tolerance test. This test is to check to see if you have diabetes and well, you already know!!!!
My insulin needs increased drastically throughout the pregnancy due to the hormones being given off by the placenta. what normally would have required maybe 3 units of insulin was requiring as much as 15 at some points. The endo let me decide when to increase insulin on my own. Other then checking me every 2 months she did not check on me at all besides that. I will not lie, this level of testing was very stressful in the beginning and hard to adjust to. I would get busy with work and miss the hour mark or the two hour mark or have trouble figuring out how much insulin to increase to. It took me at least a month or two before I started falling into a more comfortable habit. Oh and I had to request more test strips since I was testing 6-8 times a day (still didn't quite give me enough)
Toward the end of the pregnancy I had to go in for non-stress tests. Which is basically they have you sit in a recliner in a room with a TV and they hook you up to where you can hear the baby's heart beat and another monitor that could detect baby's movements. They wanted to see good activity of the baby's movements and heart beat.
They told me they would not let me go past 38 weeks and would induce (standard protocol for pregnant diabetics). At 37 weeks when I went in for my final ultrasound they told me my amniotic fluid was low and my blood pressure was a little too high and told me to head to the hospital to be induced.
They tried to induce me and at first not much. They broke my water and then it was hurting a lot and started the epidural. The baby's heart rate was dipping after contractions and they had to back off the pitocin and tried to let me body do it on its own. A nurse told me that my placenta was failing and causing the heart rate dip and said it was because of my diabetes. I never did figure out whether she knew what she was talking about or not. Eventually they cranked the pitocin back up.
After almost 28 hours and dilating to an 8 they said my contractions were just not regular enough and regular delivery was out of the question and wisked me in for emergency c-section (I have read that insufficient contractions are not uncommon in diabetics of both kinds). By this time either I was so tired I was getting dizzy or some of the meds they gave me were making me dizzy (I do not handle narcotics well at all), not sure. Last thing I remember was them saying I was going to feel pressure and I was saying OW OW OW because it felt like pain to me. I did not see the baby until I woke up in my room a couple of hours later. Still do not know if they knocked me out on purpose or if I passed out on my own. (hopefully this does not scare you too bad)
Thankfully baby was healthy and doing fine. She is almost 4 months old now and a joy and worth every effort (although until she got there I had a hard time grasping this).
I am a type II diabetic with PCOS.
I tried oral medications and still not enough improvement. Then the endo added Lantus at night and Humalog for meals (and 2000mg metformin ER) and finally got the right combination that was safe for pregnancy. It took about 1 year to get where they wanted me to be. I also was diagnosed with hypothyroidism and started taking thyroid pills.
I got pregnant within 2 months and after the 8 week check at the regular OBGYN I was sent to a high risk dr. I had regular ultrasounds every couple of months. I also had regular Endo visits as well. My a1c was running between 4.8 and 5.3. She had me back off a little after the 4.8 because I was losing the ability to feel lows.
Oh and they made me collect all my urine for 24 hours (every single drop while keeping the collection container on ice... yeah ewwww) to check for proteins in my urine (think this was around 18-20 weeks). I believe they said this was to help look for signs of Preeclampsia (high blood pressure induced by pregnancy) later... kind of finding out what is normal for me I think so they would notice a difference?
I chose not to go super low carb during the pregnancy and instead went with the carb recommendations for pregnant diabetics. I've already forgotten what they were, but I think it was 30 carbs for breakfast, 40-50 for each meal and 15 for snacks. I chose this because I did not want to take the chance that the baby would not have enough carbs to develop properly. This is what was most comfortable for me.
I had to check my blood 1 hour after each meal and two hours after each meal. They wanted my fasting to be below 90 in the morning and I think it was 120 at 1 hour mark and below 90-100 at 2 hour mark. I generally kept it around 70-80 for the most part at the 2 hour mark and in between meals.
Even though they advise you to wait 4 hours between giving insulin, I would do my corrections when I noticed it was not on target (often even at the 1 hour mark). Luckily I had practiced this a lot prior to pregnancy and knew what did and did not work for me.
Oh and do not let them give you a glucose tolerance test. This test is to check to see if you have diabetes and well, you already know!!!!
My insulin needs increased drastically throughout the pregnancy due to the hormones being given off by the placenta. what normally would have required maybe 3 units of insulin was requiring as much as 15 at some points. The endo let me decide when to increase insulin on my own. Other then checking me every 2 months she did not check on me at all besides that. I will not lie, this level of testing was very stressful in the beginning and hard to adjust to. I would get busy with work and miss the hour mark or the two hour mark or have trouble figuring out how much insulin to increase to. It took me at least a month or two before I started falling into a more comfortable habit. Oh and I had to request more test strips since I was testing 6-8 times a day (still didn't quite give me enough)
Toward the end of the pregnancy I had to go in for non-stress tests. Which is basically they have you sit in a recliner in a room with a TV and they hook you up to where you can hear the baby's heart beat and another monitor that could detect baby's movements. They wanted to see good activity of the baby's movements and heart beat.
They told me they would not let me go past 38 weeks and would induce (standard protocol for pregnant diabetics). At 37 weeks when I went in for my final ultrasound they told me my amniotic fluid was low and my blood pressure was a little too high and told me to head to the hospital to be induced.
They tried to induce me and at first not much. They broke my water and then it was hurting a lot and started the epidural. The baby's heart rate was dipping after contractions and they had to back off the pitocin and tried to let me body do it on its own. A nurse told me that my placenta was failing and causing the heart rate dip and said it was because of my diabetes. I never did figure out whether she knew what she was talking about or not. Eventually they cranked the pitocin back up.
After almost 28 hours and dilating to an 8 they said my contractions were just not regular enough and regular delivery was out of the question and wisked me in for emergency c-section (I have read that insufficient contractions are not uncommon in diabetics of both kinds). By this time either I was so tired I was getting dizzy or some of the meds they gave me were making me dizzy (I do not handle narcotics well at all), not sure. Last thing I remember was them saying I was going to feel pressure and I was saying OW OW OW because it felt like pain to me. I did not see the baby until I woke up in my room a couple of hours later. Still do not know if they knocked me out on purpose or if I passed out on my own. (hopefully this does not scare you too bad)
Thankfully baby was healthy and doing fine. She is almost 4 months old now and a joy and worth every effort (although until she got there I had a hard time grasping this).
