Decreased insulin needs at the end of pregnancy?

My insulin resistance has been increasing from weeks 19 to 33. Now in the past two weeks, my insulin needs seem to be decreasing and I’m having a lot of lows. This caused my endo to be concerned about the possibility of placenta deterioration. I’m going for non-stress tests every second day now and our little guy appears to be moving in his usual rhythm.

I was wondering if anyone else experienced less insulin resistance at the end of her pregnancy??? My endo said that it can happen after week 36, but she is concerned that it started already in week 33.

My blood sugars have been awesome recently (never a reading above 140 in the last few weeks), which felt good, but it has been accompanied by more lows. Now we are concerned about the sudden change in my insulin resistance. One of my theories is that in the past few weeks, I was pretty inactive due to bad hip pain. That disappeared last week and I think that I am moving around more now. So perhaps my decreased insulin needs are due to high mobility.

I would be curious to hear anyone else’s experiences. Did your insulin needs grow until the end of your pregnancy?

I have no experience-but maybe it’s just that your baby might be coming earlier? I don’t know I’m just wondering-will be thinking of you as you come closer to holding your baby!

For me my insulin needs decreased throughtout my pregnancy. I have no clue why, but I never did get insulin resitenance.

Interesting! Thanks for sharing. My insulin resistance has also been less severe than others. It didn’t start until after week 18 or so. But my insulin needs did increase (but not as severely as other posts have indicated). My total daily dose before pregnancy was 28 units and now it is around 45 (with less carbs).

Sharon – this could be – given his size (measuring big), they have told me that I can only go until week 37, but they want to monitor carefully until then as well.

My insulin needs at the end of my pregnancy with my daughter leveled off and I had a few lows here and there. I went the full 40 weeks and ended up having to have my cervix ripened to help start labour (no induction). My daughter was still growing pretty quickly in the end and was taking a good amount out of me. The resident OB at the clinic kept asking me every week when I was scheduled for my C-section because she was a big girl (vaginal delivery @ 10lbs 11oz). Are they doing Ultrasounds to check the condition of the placenta?

Hi -

My resistance definitely leveled out a few weeks back. I’m 37 weeks now, and over the past few weeks I’ve lowered my lantus (long-acting insulin) because I was going lowing consistently at night. I’m not sure which exact week it was, maybe ~3 weeks ago (so at ~34 weeks prego). I don’t think my activity level has changed too much - if anything I’m exercising less now (being I started maternity leave so don’t have to make my daily treck to/from work for a while! :slight_smile: ).

I’m also doing the non-stress tests (I’m doing them twice a week), and they have been normal. I’m not doing them because of the insulin decrease, though, but just because it’s standard at my hospital for diabetics. My endo is not doing ultrasounds to the check the placenta.

Congrats on the good blood sugars!

My insulin needs haven’t increased since week 24. I’m 29w & 3d now. It’s weird i think. But in the last couple of days i had to increase my lantus in order to stay in the 70-90 rate for the night-morning numbers, but i haven’t increased my basal. In fact, i started having more lows, so i guess i should lower my basal a little bit.

Why did your endo think the placenta could start deteriorating? Due to lows? Or the lows and the insulin decrease are a sign of placenta deterioration?

I’m starting to wonder what is going on with my baby and the placenta. I haven’t had an ultrasound since 21w and the next one is at 32w. I’m begining to wonder if i should go earlier. What do you think?

I went for ultrasounds at 24, 29, 31 weeks and since then every week (because he was measuring big and they wanted to keep track of his growth).

My endo is concerned about placenta deterioration only because of the lows (there have been no other signs), but I wrote here and on the positive diabetic pregnancies mailing list and got a lot of reassuring replies that many people experience decreased insulin needs near the end and the placenta was fine.

Still it may be a good idea to go for an ultrasound earlier so that they can check how your baby is growing and they can look at the placenta.

I’m thinking of doing that (maybe even today). I have days when i wonder if he is growing ok, not too big or too small and if he is developing properly. At 21 w everything was ok, but a lot could have happend during this time.
So you are saying that lows can deteriorate the placenta?

The way that I understand it is that the lows don’t cause the placenta to deteriorate, but can be a sign that it is. BUT many other mom’s wrote that their insulin needs did lower and after birth it was clear that there was NO problem with the placenta. So your insulin needs can decrease for other reason too.

If you can go, it may still be a good idea – just to have the peace of mind.

Are you feeling movements from the baby?

Yes, i am feeling him every day, sometimes more often and stronger but sometimes he isn’t so active.
You can imagine i would have gone a long time ago for an ultrosund if i didn’t feel him.
But i still start imagining things, so i think the best thing to do is to go and check up on him, cause my stress is harmfull as well.

It seems that the doctor is not in untill next week, so we have to postpone the ultrasound.

Kristin is correct. The lows are a sign that the placenta is deteriorating. I talked to my OB about this and he said the placenta gives off more and more of a hormone that creates insulin resistance, so our insulin needs should increase more and more as the pregnancy progresses. He said if I started having lows for more than 2 days, I should call to go in for an ultrasound and non-stress test to check the placenta.

I’m going in for my first non-stress test today. Not for any issues, but because it’s standard for a Type 1 in my OB practice.

Lows dont always mean the placenta is deteriorating. It’s just something you might want to check. Even if just to give you peace of mind.

Good! Movement is a sign that he is getting what he needs :slight_smile:

Our little guy have more and less active days for sure. He is also more active in the afternoon and night than in the morning. I just pay attention to the movements so that if there is any change then I can call the doctor or go to the hospital.

I was relieved to read that the placenta deterioration is usually not something that happens overnight. They can see signs of deterioration a week before your baby would be in trouble.

That is relieving to know!! Then once a week non-stress tests are good!

My endo indicated that anywhere in the last month of pregnancy I could expect lower insulin needs. He also said that in the past this was thought to have been because of placenta deterioration, but now that the medical field knows more about diabetic pregnancies, this is typical even with a healthy placenta. This seems to be especially true since you seem to have controlled glucose levels throughout!

Thanks Hayley!! That is SO reassuring to read :slight_smile:

I went for a non-stress test and an ultrasound today. Everything was fine :slight_smile: At the ultrasound, they checked the condition of the placenta and it looked perfect. So my OB-GYN said that my decreased insulin needs must be for another reason. So no more doctors until Monday :slight_smile:

Thanks for all the reassurance!

It’s very good to hear, congrats!

I hope i’ll receive good news next week too.

My biggest problem is that i am on my own. I don’t rely on my endo and ob-gyn too much. Last week my endo told me things that gave me the reassurance that he is not that well informed. Needless to say about my ob-gyn…Unfortunately, i don’t have many options around here, because they are all pretty much the same.

I rely on you guys a lot and i have learned a lot from you. Thanks!