I'm hoping someone can explain what is going on right now...

I am currently 32 weeks pregnant with my first child and have had Type 1 Diabetes since October of 2009. My A1C throughout the pregnancy has been between 5.7 and 6.5 so I have tight control of my sugars. I see my Endo every three weeks and communicate with him often through e-mail/phone. Lately, we have been changing my insulin doses every few days it seems. My scale without pregnancy was 1 unit of insulin for everyone 10 carbs I eat. With pregnancy I am currently at a scale of 1 unit for every 2 carbs. It has changed DRAMATICALLY but I have been told over and over that this is normal in pregnancy and once I have my son I will go right back to my old scale.

My problem now is that for the past 3 days I have barely taken any of my fast acting insulin (novolog) .. just my long lasting (lantus). It's like I all of a sudden don't need insulin or something and I keep having lows. I am very concerned and confused. My diet has not changed at all. For a meal that I usually would take 30 units for I'm taking none and my blood sugar is 78 two hours later.

What is going on?!?! Is anything wrong with my pregnancy?? Should I be concerned?? Has any one every experienced this before?!?!

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Hi Amy,

I can't answer the question but I think it's important enough to check in with your endo and ob/gyn. If something is going on, you don't want to be weighing message board responses rather getting medical help. If what you're seeing isn't uncommon, I'm sure your docs will tell you.

Take care and best of luck,

Maurie

I have a doctors appointments tomorrow with my OB and my ENDO so I'm definitely going to bring this up .. I just really wanted to see if another woman has had a similar experience.

Amy, I had the same experience, years ago and my insulin requirements changed daily and there seemed to be no rhyme or reason. I became very deligient in testing, monitoring, rechecking and changing dosages. everything worked out well for me, both my children were under 7lbs, which in my day, was considered underweight when I was diabetic.

For sure take your questions to your health care provider, and get the answers so you can ease your worries.
Best of luck and hope all goes well with the birth.

Amy, Im Type 1 as well, and my BG was so low darn near the whole pregnancy, only the last few weeks did I really notice an increase in my insulin needs. After delivery you may notice as well your insulin needs drop really low as your body adjusts. BUT I'd also bring it up to your OB/Gyn and Endo as well, as BG is nothing to play around with pregnant or not.

If you keep having lows you have to lower lantus too.
Lantus, even only 1U in excess, can really let your BG down all day long.
Keep in touch with your endo: during pregnancy things change really fast.
It's due to hormones, and you being two being now (I don't know if it's correct english, but I like it).

Hi Amy. This just happened to me recently - I had read that the drop would happen closer to 36 weeks and was surprised when it happened around 32/33 weeks. I also started getting sick and dehydrated at the same time so endo, OB and perinatologist all felt that I must just be stressed and I was put on bed rest. I'm Type 1 diagnosed last year.

I don't want to scare you at all, but please don't hesitate to question your doctors and get the answers you need. I lost my son 2 weeks ago at 37 weeks and it must have happened quickly. I was getting non stress tests weekly as well as high level ultrasounds, and the final NST took a lot longer than usual, but the OB "passed" him. I was scheduled to deliver at 38 weeks, but felt him moving less on Sunday and an ultrasound on Monday confirmed he was gone. In the end, they feel it was a quick onset of preeclampsia, which is a risk for diabetics. (this was going to be our 2nd son, our first was born in 2008 at 30 weeks via emergency c section b/c of a placental blood flow issue, still not sure why)

I wish I had spoke up about many things instead of just trusting the doctors. Trust your instincts and do your kick counts and you should be fine. :)

-Amy

Hi Amy - Congratulations on your pregnancy! It sounds like your pregnancy is similar to mine. My son was born at 37 weeks back in February. Like you, I started seeing lows around week 34. My perinatologist and endo were in close communication regarding this. I think that they were most concerned that the placenta was deteriorating. They assured me that it wouldn't "go all at once" but would be a slow process. That's why I saw them weekly at the end. Checking in with your doctors and making sure your little one is okay is the best bet. But it sounds very similar to my (T1) pregnancy.

I hope your dr's appt goes well!

(side note: have you checked out the Oh! Baby! group? You can chat with a lot of people dealing with all the issues of pregnancy and diabetes)

Hi Amy!
I am a type I also and out of my five children I have had 4 diabetic pregnancies. (I was diagnosed after the first was born. I had no complications. I ran low all the time too. With such tight control, it doesn't take much to drop low. After birth my insulin needs sharply decreased. In the hospital after the birth they were great about letting me control my insulin and testing and not the nurses. Afterwards if you are nursing, that can burn through the blood sugar too but for me it was worth it and it evens out after a while. It's good your endo communicates with you regularly over the phone and e-mail. I wouldn't hesitate to call your OB office and ask questions or voice concerns too at any time either whether your appt is soon or not. I called a lot and I was lucky to have an OB who knew a lot about blood sugar control. Congratulations and I wish you all the best!!

Thank you everyone for all of your responses. My OB seemed clueless (I do have to go to a clinic which gives me a diff resident every time so I don't trust them very much) My endo however seemed concerned. She told me that this is a sign of early labor, and like you said T1mommy, shouldn't happen until at least 36 weeks. She changed my doses and told me to call her within a few days to see how its goes. To be honest, I am terrified right now. I have searched the internet for hours and am finding nothing about placental problems, which is what I think is going on right now. I don't know, I guess I'm a worry wart but I very very scared at this point. I can't imagine what it would be like to loose a child. I'm sooo sorry for your loss T1mommy. Thanks for sharing your story and making me more aware though. I'm going to contact the high risk OB that I saw the beginning of April. He gave my son an echo and a thorough ultrasound so I'm guessing he's the best person right now to get a second opinion from. I almost want them to induce me .. like now!!

I really didn't intend to cause you anymore worry, but I think you are doing the right thing by trying to find more answers (especially with the doctors). I did the same thing as you and tried to research as much as I could online. Just remember, much of what you see via google is not from doctors and can be a little skewed (or even alarming!).

Enjoy your pregnancy!! Too much worry will stress you out and it sounds like your endo is on your side to help you through this. The high risk OB is a good one to contact - not sure if you see a perinatologist, I saw one weekly toward the end and he was assigned to caring for the baby, whereas the OB was taking care of me. In hindsight, I should have contacted the perinatologist earlier, but instead, waited it out until my next scheduled appointment, which I think was a day too late.

One thing I would recommend is to get your blood pressure checked regularly - many grocery stores have a free check stand by their pharmacy. They may or may not be calibrated to super accuracy, but that may give you an indication of any drastic changes (shows risk/onset of preeclampsia) and then you can let your doctors know.

Like you, I had my diabetes under great control through the pregnancy with my last A1C at 5.4 (A1C at diagnosis was 13.6! - got to 5.4 nine months later). Keep up the great work and let us know how it goes!

-Amy(T1mommy)

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