I’ve been working hard for the past 6 months in preparing for a second pregnancy. I lost 30lbs, got off the Metforim, onto the pump and a CGM. I found an Endo and booked an appointment but silly me got pregnant before my appointment. My BG has been all over the map, I’m constantly adjusting my basal rates and testing and was feeling overwhelmed so I called my Endo’s office to see if she could fit me in sooner. I get a call a few hours later and my “new” endo has dumped me, reason given was that she doesn’t treat pregnant diabetics!! WTF?
So I have my appointment with my Ob today for my first Ultrasound (I’m 6 weeks) and I ask her to recommend an Endo for me. I call that Endo and make an appointment and the nurse tells me she’ll talk to her and see if she can speed up my appointment. She calls me back 3 hrs later to tell me that I’ve been dumped again and she won’t take me…again I’m baffled!!
So, can someone please give me a hint as to why a qualified Endocrinologist would refuse to treat a pregnant T1 in the US? What the hell am I missing here? Isn’t that what they went to school for? I don’t necessarily need an endo most of the time as I’ve been self managed for many years but I do need an Endo as a sounding board for a pregnancy. My BG is all over the place, my dex looks like the Rockie mountains and the intramuscular shots are annoying!! It wouldn’t be so bad if I could pinpoint the trends but I’m missing something and can’t get an endo to see me…grrrrr!!
I’m Type 1 for 13 years and my Endo actually ASKED to stay with my treatments throughout my pregnancy. My Gyno suggested an Endo’s office that she works with frequently, but I was leery on switching Endos in the middle of something so important. I’ve had really bad luck with Endos who don’t understand the full extent of my disease, or who aren’t willing to allow me to self manage.
So, I’ve got my Endo, my gynocologist who specializes in diabetes with pregnancy, my high risk pregnancy team. Three offices for 8.5 months. haha. I’m so sick of going to the doctor’s office. Thank goodness my job is flexible with my schedule.
Wow, I can see why you are frustrated! I would be going insane. I live in Canada, so it took me over 1.5 years just to get an Endo. We don’t really get a choice of which Endo we would like to see, especially if you live in a remote area. I’m not sure where you live, but I’m just amazed that an Endo would turn you down while pregnant!
Regardless of all the years of self-managing this disease you might have, trust me, a good team is needed for adjusting those crazy roller coaster sugars you have while pregnant. A good team needs to be in place. I’ know you already know this. I thought I knew it all with adjusting my basals/bolus and now being at 11 weeks, I feel very lost at making the adjustments. Everything seems opposite of what I know and this is with 22 years under my belt.
Do you ever attend a diabetic clinic? Where I live, most T1’s are connected to a diabetic clinic and see diabetic educators every 3-6 months. Right now, I see my Endo and Diabetic Educator every two weeks and every week doses have been changing. Maybe call a hospital in your area and see if you can get in with the clinic. Diabetic educators usually work closely with an Endo and help manage your insulin/glucose. From there, the educator could probably get you in with a great Endo.
Hang in there. Take many deep breaths and be persistent.
I’m originally from Montreal so the last time I was pregnant my Gyno sent me to the antenatal clinic at the Royal Vic which had the complete team; Endo, Ob, Nurse, Dietitian and lab & Ultrasound tech. I had 1 place to go every 2 weeks until I hit my 3rd trimester and then I was there every week. During my last pregnancy I was one of 7 T1 diabetics so we ended up being each other’s support system and a fountain of info. The Endo on rotation loved us because the T2 would pump us for info on injection techniques, cheat foods etc…
Trust me, the reason I am freaking out is because I know how much I need an Endo right now as I am seeing something in my sugars that is making me wonder if I am not already resistant. It’s taking my boluses almost 2 hours to kick in. Freaky. I at least have a Dexcom which helps me see my trends if if they change from one day to the next.
I’ve gone through 2 diabetic day clinics, first time the year I was diagnoses and the second time when I got back from overseas at my 10 year mark. Needed a refresh. I recently moved to the US and I find the system here a bit frustrating. I love that my insurance covered my pump and CGM but hate that finding a doc is such a drama. Makes me nuts!!! I’m still waiting for my Ob to call me back with another recommendation.
3 offices? Yuck. I have a 2 yr old so there is no way I can do that kind of running around. I’m hoping the MFM calls me today but they also are waiting for my OB to send my file. It seems to to a waiting game for now.
6 month…that one of the fun months! Have you popped yet?
haha. YES. I have never been this big before, so my back is ACHING. But, it’s fun. It’s uncomfortable at this point already, but it’s fun to feel her doing her aerobics in there. Thankfully, I’ve gained only the amount of weight I’m supposed to so far (phew! feels like 50 lbs!) which means I will take it off easier after birth and that she is gaining the right amount of weight too.
I’m seriously seeing at least one doctor per week since the second trimester. They wanted me to come in multiple times for the first trimester, but I’ve gone through a miscarriage already and just wanted to get thru the first 12 weeks without them stressing me out with their appointments and stupid questions. haha. I still get upset if I go to an appointment and don’t learn anything new. Or if the appointment was just to check my vitals and they dont check on the baby at all. It’s like “I saw you 6 days ago. Do you not understand what I had to go through to get to this appointment?”
Where are you located? I’m surprised they wouldn’t want to take you on if you’re mostly self-managed. My Endo loves me because I do the research and monitoring and dosing myself, only calling him with updates or if there’s something I can’t quite crack the code to.
First let me say congratulations on your pregnancy! I hate to hear you are having such a difficult time when this is supposed to be an exciting time. I can’t imagine being turned away from any doctor. I am very blessed to have a hands on specialist and obgyn that are working great with me pre ttc. Sorry I don’t have any advice for you and this may be selfish/insensitive but I HAVE to ask. How did you lose 30 lbs in 6 months? I have my a1c down but I’m trying desperately to lose weight before ttc and I’m not having much luck. I’ve been looking for advice. Any tips? Thanks for your help even though this is you discussion
I lost my weight with HCG. The website is www.poundsandinchesaway.com. I wouldn’t recommend it to someone who isn’t a totally self-managed diabetic because you do need a very good understanding of how your body uses insulin and it’s a lot of work. Talk to your doc about metformin, it’s a great way to reduce the amount of insulin you’re using while working out. That’s what I started with because my 30 lbs was baby weight I just couldn’t lose. Good luck.
That’s awesome about the weight. It’s really important because it will make a difference with the insulin resistance. Trust me, I put on 40 lbs and it took me forever to get it off after my daughter was born and she was only 10lbs 11oz of it…lol. Don’t worry she was that big due to genetics and not my diabetes, my a1c were awesome.
I’m in Michigan and I have no idea why they won’t take me. I don’t trust my PCP to help me here. My OB’s office was suppose to get back to me today with some news but guess it’ll wait til Monday. I just need and Endo to confirm my suspicions that my boluses are taking too long to kick in and I may need to switch insulin because I refuse to bolus an hour before eating…that’s just not doable with a toddler!
My OB’s office manager is trying to find one that’ll take me now. She was a bit baffled but the whole thing. We’ll see what happens on Monday, in the meantime I’m basal testing and adjusting the best I can.
Meformin was a life-changer for me. I was on it for 3 months last spring. I was using it to help with my insulin resistance because my dosages would double every year. For example, prior to conceiving, I was already taking a dose of 35 units of Levemir in the morning, plus 45 units of Levemir at night. Now I’m doing 60 and 65 units to get through the day. Metformin really helped me gain control of my insulin intake again- plus the bonus was it helped me drop 10 lbs wihout trying (in only 3 months). AND I was able to come off of my “no carb” diet because suddenly I could process carbs again. I’m still “low carb” but that’s better than NO carb.
I reccommend Metformin to Type 1s regularly. As long as you’re strongly self-managed. There will be a lot of dosage changing while your body becomes accustomed to the non-insulin resistance. My doc gave me a really hard time about prescribing it to me because I’m Type 1, but he eventually gave in. It was the best diabetes management move I’ve ever made.
That, and it seems really safe. It has been around since 1920s and it increases your fertility. WIN WIN WIN.
They’re saying 15 lbs so far and we’re a little over 6 months. I MISS my skinny clothes!!
Can’t wait to meet her though.
Good luck with the Endo and please keep us posted. I don’t know any tricks for the MI area. Hopefully someone on this forum will be from around there. Or maybe your insurance company can reccommend someone?
When i was pregnant I had to call like 10 gyno offices to schedule an appointment because they wouldnt take me as a type 1. Now i’m at the high risk clinic anyway, and they work closely with an Endo team there.
Congrats on your pregnancy! So sorry to hear that you are going through this in such a happy time in your life. That is unbelievable!!! I am not from Michigan and not familiar with the various hospitals there, but my advice would be to go to a university hospital if one is close. In California most of the University hospitals (UCLA, UCSF, etc) have very solid high risk pregnancy/diabetes management programs. I would also contact your local American Diabetes Association chapter. I am sure they have some info, or referrals of endo’s in your area. Last resort, look into any state run programs? I know in CA there is a program called “sweet success” where endo’s and CDE’s work at high risk pregnancy OB GYN’s to work with women with pre-existing or gestational diabetes. Hope you get in to see someone soon, keep us posted!
Nancy, two more ideas. Perhaps your insurance company would be able to help? I have BCBS here in CA, and called them numerous times to get reco’s, talk with advice nurses, and they even have a diabetes management program. Also, if you use a minimed pump they have certified diabetes educators available to you to help adjust basal/bolus ratio’s. Not sure if they work with you when you are pregnant, but it could be better than nothing in the meantime while you are searching!
I did Metformin too for a year. My insulin resistance was insane!! I had to go off Levemir because I was 48 Units in the morning and 52 at night. My Endo told me that you should not be taking more than your weight in Kilos which at that time I was. I was switched to Lantus and then over to the pump with Metformin. I loved the benefits and will probably go back on it after this pregnancy.
I’ve been running into road blocks every step of the way, I get an Endo and then they refuse me because I’m pregnant. They are idiots because I am self managed and this is my second pregnancy so I’m not as high maintenance as they think I am.
I called Maternal Fetal Medicine and they need to review my records first before they book an appointment. I’ll be calling them back tomorrow. They are about to find out what a persistent pain in the butt I am! I’ve already made some MAJOR increases to my basal rates and am seeing some big improvement and I’ve identified foods I shouldn’t even touch, It’s tough cause my little one has a nasty bladder infection so I’m juggling phone calls and pediatrician appointments. They found glucose and ketones in her urine so they want to do draw blood, I’m not too concerned because her blood sugar was 102 when I checked her. I’ll do a fasting one tomorrow morning. Yes, I test my toddler. I let her poke my finger and then let her push the button to do hers. She thinks it’s cool.
Talk to your doctor. I know of many Type 1s who are taking Metformin during pregnancy. The reason many diabetics come OFF of Metformin during pregnancy is because the hormones have SUCH an effect on insulin resistance that Metformin doesn’t do much to combat it anymore.
"“We began prescribing Metformin to these women, and suddenly, their insulin needs were going down. We have, at this time, had 20 successful deliveries of healthy infants to mother’s of type 1 diabetics who used Metformin during the pregnancy,” Kelley says.
