Hey! I'm 36 weeks and 5 days...Lucy will be arriving next week, because I'm being induced next Thursday. :) However, I'm wondering if she is wanting to come on her own before that.
Therefore, I have some questions for my Type 1 friends:
1. Did anyone notice changes in blood sugar right before labor started? 2. How quickly did your insulin needs change after delivery?
3. Did you go on a drip during labor or continue to use your pump (if you're on a pump)?
4. How often do they check the baby's blood sugar after birth?
Thanks for your help! I really appreciate it...I just don't like the "unknown" and this is my first baby!
I had a scheduled c-section at 38w1d, but I actually went into labor the morning of my c-section and got to have contractions for a few hours before the c-section. My blood sugars and insulin needs both dropped dramatically from 33 weeks on, but particularly in the last few days.
My insulin needs decreased immediately after the c-section. I turned my pump down to 70% of my pre-pregnancy basal right away. I also brought big bottles of juice with me and need to use a lot of it while breastfeeding (should have brought more).
I used the pump in the c-section, but would have in labor too.
I'm not sure how often it was, but in the first day, they checked 3 times and since it didn't drop, then they stopped checking it. The first time was about 45 minutes after the birth. I don't know about the others.
1. I started needing less insulin as I got closer to my due date, but I didn't have anything like an immediate change the day of labor starting. 2. My insulin needs dropped very early DURING labor, and I ended up having to turn my pump OFF for most of my labor! I ate a lot of popsicles... My insulin needs stayed VERY low for about two weeks after giving birth, then they slowly started going back up to something similar to my pre-pregnancy rates. (I took those two weeks as a chance to indulge in things I normally couldn't, like milkshakes and delivery pizza!)
3. I stayed on my pump, and my OB said she wanted me to remain in charge of my blood sugar unless I was incapacitated somehow. Her comment was, "No one knows how to manage your diabetes better than you." I DID go on a DEXTROSE drip twice (once during labor, then once during the night after my C-section) because my blood sugar was low and the pitocin was making me throw up repeatedly. Both were short-term, though.
4. I don't know how often, but vaguely remember they stopped testing him sooner than I expected. His never went low at all though, so maybe there's a certain period of time after which they know it's fine if it's been steady so far?
I'm sure everything varies from person to person, but I hope this helps a little bit!
I was induced and they put me on an insulin drip pretty early on- I usually wear a pump. I was really surprised how low my insulin needs were when they put me on the drip. I was admittedly scared to go on insulin drip and have someone else manage my sugars, but the system the nurses had worked perfectly. It did require them to check my blood sugars every hour, however, and that was tough since I couldn't sleep even though my contractions weren't that strong yet.
I ended up having a c-section, and I honestly can't remember when they let me put my pump back on! But it was a dramatic effect of not needing much insulin pretty quickly afterwords.
They checked her blood sugar right after birth and then once a day later when she was continually fussy and they didn't know why. I think that was more the nurse's perogative though :)
Oh, and I agree with Kristin- no matter how good the hospital is, it's good to have juice, even a snack or two on hand! Best of luck!
I did the same! I am extremely hands-on when it comes to my insulin injections and glucose monitoring. Eg: I usually tell the doc what I'm doing and he just records it for insurance purposes. haha. So, when we were induced due to pre-eclampsia, they put me on an insulin drip.
I was really scared to go on the drip because I've had so many docs mess up my glucose in the past, but my sugars were PERFECT through the 21 hours of labor! I mean, PERFECT. And they only had me on 1 or 1.5 units per HOUR of regular insulin. That's without any basal insulin! It was incredible how low my doses were during labor!
Keep in mind, my insulin needs were HUGE in the last weeks of pregnancy. I went from needing 100 units per DAY to needing 130 units TWICE per day, plus 30-40 units of Apidra per MEAL (and I was eating mostly SALADS). It was insane. So, I went from needing close to 300 units per day to needing just 24 units to cover an entire day's worth- without needing any basal insulin either. The nurses checked my glucose every 45 minutes and it never once went over 140, never below 75.
After delivery, my glucose were still in really good condition, but I also snuck my meter and insulin pens into the recovery room. If the nurses found out, they would have confiscated them because we're not allowed to give our own medications while registered as an "in patient". Hospital policy. My needs were about 10% higher than pre-pregnancy (or like 70% lower than pre-labor, however you want to look at it).
Right after delivery, they checked baby's sugar 3 times to make sure it was stabalizing. They prick the heel of their feet. We were in hospital for 5 days post partum due to pre-eclampsia and baby had slight jaundice. They checked her sugar a few times per day. Often enough that she has a scar on her heel. She turned one year old today and the scar is still there. It makes me cry whenever I look at it.
Good luck to you! If you trust your doc, you will surely have a good birthing experience. I'm 5 months pregnant again and there are a few things that I hope to change about the process this time around, but overall it was a good experience for me.
Wow! Those are some great blood sugars! I'm going to do the drip as well. I just feel like there will be too much going on for me to focus on being in charge of my pump. The drip is what they know how to use best. I'm glad I asked about insulin needs, because I didn't realize they would drop so much!
I was induced 1 day before my due date (on May 17–this is my first post since, but I promise I’ll post my birth story soon!). Since I didn’t go into labor on my own, I can’t really answer this, but I will say that I started to have some lows.
My endo had my go back to pre-pregnancy settings on my pump immediately. I felt like I was taking tiny, doll-sized doses. I ran a tiny bit high for a few days-- my OB said that it would take a little while for the hormones to clear – and then was ROCK solid for a few weeks. It felt like I was 86 no matter what I ate or did. Then my needs increased some. (I was only diagnosed t1 about 8 months before pregnancy, though, and I wonder whether pregnancy did in my remaining beta cells?)
Pump at 50% basal, lowered to 40% at some point. I still ran low. But I was happy to, because it meant I was able to have some juice and jello here and there – I otherwise wasn’t allowed to eat during labor (standard hospital policy. If I hadn’t been diabetic, I could have had as much juice and jello as I wanted.)
I don’t know. Once the next day they did in in the room with us there, otherwise they must have done it in the nursery. No one ever told us about it; I assume there was never a problem. She did nurse immediately after birth.
My daughter took 8 days to arrive. Three hospital stays, two false alarms (which included one epidural and one C-section that never materialized), some truly terrible hospital food, and she finally arrived with the help of nothing much more than gas, air and paracetamol. During the first false alarm (at 33 weeks), I was injected with steroids to help mature her lungs. The steroids send blood sugar into the stratosphere so the hospital insisted on putting me on a sliding scale, as the nurses said they knew better than me how to manage blood sugar. After watching my blood sugar rise to 18.8 mm/ol (340), I was determined that I was going to handle my own BG during labour. Also, having the sliding scale is not a nice feeling at all as you are tethered to this big scary thing.
The hospital was not very happy about me managing my own BG but I stood my ground. Only thing they made me do in return was to provide a BG reading every hour on the hour, which was perfectly reasonable. My waters broke at 6pm and my BG was perfect (between 5 and 7) until the last two hours of labour when me and the midwives were too busy to check blood sugar.
If I remember correctly, the first thing I did after the baby arrived was to test my BG, while the baby was being cleaned up. I guess the fun and games of the last stage of labour was slightly stressful, as my BG was 10 point something (180-ish mg/dl). The baby's BG was almost exactly the same as mine at that point. Her BG then went a little low but stabilized fairly quickly.
Like Marps, my insulin needs were lunatic during pregnancy. Mornings, I needed a few units of Apidra just for oxygen. Even hot water for breakfast raised my blood sugar. The rest of the day was not so bad, 'only' 1 unit of Apidra for 1 gram of carb. After delivery, I monitored my blood sugar very closely as I had been primed for a change in insulin needs. My insulin needs did go down but quite slowly. It probably took about a week to go back to my pre-pregnancy insulin-carb ratio.
I don't recommend going on a drip during labour. I had one for the sliding scale and one for the epidural during my two false alarms and neither was pleasant. It was nice not to be tethered and to be able to flail about.
As you can see from the stories that others have shared, we are all different. Hope you find something that works for you. Good luck and wishing you all the best!
I hope everything went well with your labor and delivery! I blog about pregnancy, birth, and postpartum diabetes stuff at diabeticbirth.blogspot.com. In my experience, postpartum blood sugar management can be even more difficult than pregnancy management, because the needs change more frequently, especially as you lose the weight. Breastfeeding changes things, too.