Labor and Delivery Diabetes Care?

Diabetes and Pregnancy
1

Hi all, I’m not currently pregnant, but planning and would like to know from your experiences, did you have control over your diabetes management while in the hospital for labor and delivery?

I use MDI and don’t have a CGM, but I test a lot. 8-10 times a day on a normal day, way more if I’m sick or traveling. My insurance won’t cover a pump or CGM, but I’m fine with my current routine, and even when I’m not feeling well I check my BG. Current A1C is 5.6 and I’ve always had pretty good control (under 7 since diagnosis), so my question is, did the hospital allow you control over administering your own insulin and testing your blood sugar? or did you have to give all control to the staff?

It makes me a little nervous handing over control to someone else. I don’t really trust anyone else to control my diabetes. I’ve been in the hospital before and I know how hard it is for someone else to properly dose you, with the right insulin that you currently take, etc. so I would just like to go into it fully prepared (if possible).

What have your labor and delivery experiences been in terms of your diabetes management? All the questions you could think of I have them, so send me your stories! :slight_smile:

2

@daisy707, I am no where near where you are. However, I can share with a pump and CGM, I was able to send the fingersticks and insulin by nurse packing while I was in hospital twice since 1/1/19. I was able to us my pump and CGM.

Thoughts.

  1. Would you feel better with a pump and CGM. An endocrinologist skilled with gestational D can work wonders with skillfully worded letters outlining the cost savings to the insurance company. Paying for a pump and CGM is much less of a payout than the cost of even one 12 hour ER visit because of a hypo or hyper glycemic misadventure.
  2. Have you been pregnant before? Points to ponder include how will you body respond to the changing activities of pregnancy? Will you develop hypo or hyper glycemic unawareness (one of the reasons patients are placed on CGMs)?
  3. Arranging placement of CGM & pump infusion sites with the first twinges of labor would allow you to have good control, especially if the pump has an active feedback system like the Tandem Control IQ system.
  4. Will you be able to stop in the middle of the delivery event to perform a BG test and calculate an insulin does and get it on board?