What's going to Happen Next

Ok, here’s the situation. I am about 11 weeks pregnant (or should be), but the baby has stopped growing. I’m waiting for a miscarriage - soon I hope - else my obe wants to do a D&C.

I told my endo. He told me now that I’m ‘not’ pregnant any more, I should stop my insulin. That was given as an instruction by email last night.

I was pretty upset to see this message. Couldn’t sleep for hours. He has forgotten that I started on the insulin 2 months before I got pregnant, and we don’t know what type of diabetes I have. HE is assuming it’s gestational. I am pretty sure it’s not!

I have to follow his instruction. And monitor the results. SO at least he and I both know.

I have been taking about 30 units of insulin a day now. And I haven’t been having lows that weren’t easily caught - and I have been having highs if I eat wrongly (I got my all time high of 214 @ 1 hr, 178 @ 2 hrs three days ago after some rice and fruit with lunch - i was starving, but it wasn’t a huge meal either!!)

So I presume I am going to have a problem eating at all if I just stop the insulin as I’ve been instructed to do.

Advice dear people!

I assume that high blood sugars for a few days (up to a week to 10 days - until I can get in to see him personally) are not catastropic healthywise, even if they are distressing. The key will be to record exactly what I eat (I will eat as low carb as I can)… and to record my blood sugars to show him.

I just plan not to eat at all if my sugars are over 90 at any time (my target range had been 70 - 120).

If my numbers get up to 300 range (I sure hope not) I will be texting him with that result and not waiting.

I will get the results for the Anti-GAD on Tuesday (self-ordered without his consent). If they are positive it should be clear. If they are negative. Not so.

If I am type 2, at least very low carb with calorie restriction should result in weight loss, reduced insulin resistance and better control.

A week of this and a c-peptide should also be very revealing!

I don’t want to change doctors. I want to educate this one. He knows my very complicated history.

I am so sorry for your loss :frowning:

In your situation, I would continue testing, continue taking insulin. If you end up in the hospital for a D&C, it’s probably best to assume you’ll be self-managing your diabetes (whatever kind it may be) if they’re refusing to accept that you do have something going on diabetes-wise, and that you were on insulin prior to getting pregnant. Hopefully they won’t keep you long if that is the case - especially if they decide to “manage” your diabetes themselves while you are there (which is horrible - they usually do a very bad job of it).

Running high for a little while is truly not catastrophic if you WERE to stop the insulin… it’s a short term situation, and it sounds like you have enough sense to correct yourself if you get too high, but I have to caution you there - I went through something similar when they were trying to figure out what type I was, and my first doctor yelled at me over and over about correcting those 300+ highs saying I wasn’t giving the oral meds she was pushing “time to work” and that if I kept doing that, they would never work (which I now know is NOT true). That doctor refused to do antibody testing so I sought out another, who took one look at my prior labwork and proclaimed “you’re probably a type 1, but lets double check”. It was really no shock when all the antibodies came back positive.

I am newly diagnosed and have a similar situation to you in terms of the diabetes. I am thin and have post prandial bg in the 200’s and am not on any meds because I tested negative for antibodies and my c peptide was 2.2 It is very frusterating trying to manage this with a low carb diet. My bg will come back down within a few hours after eating but have to wonder what damage is being done. My exact type of diabetes is unknown but endo is thinking MODY. The test for that are very expensive. I hope you can find out something defenative.

This is mind blowing for me to hear. I am so sorry. Look this is not the time to teach a old dog or (b*tch) new tricks. Forget trying to educate doctors. They grow to resent you for knowing more then they do. You need to make sure your health is a priority.

Have you sought a 2nd opinion in the case of your pregnancy as well as a with your endo? I would really hate to see this happen this way. Perhaps there is an explanation. I am not experienced in such matters but I have gotten 2nd opinions when I thought my internist was wrong. I no longer see him. In my humble opinion, while you still have a fetus inside your body you are pregnant till otherwise. Your endo was pretty heartless to use those words with you.

Sorry to hear the sad news.

Your endo is concerned about dangerous lows if you no longer need insulin. I’d try a couple days without insulin to see the results, but I wouldn’t wait long. Would take a while to correct any highs with the type of insulin you use.

Please keep up posted.

I have thought about a second opinon but have decided that for now I would be scared to be on insulin because of the possibility of having a severe low. I had a low of 52 a month ago and it was horrible! I felt so bad and was really tired afterwards. I also had gestational diabetes with one of my pregnancies but that was eight years ago. In April I had a oral glucose tolerance test and failed it. My fasting levels are between 100 - 120 so mainly I just have a problem with when I eat. Would love to know what you find out. Take care!

I’m so sorry about your loss, Sally. I know you’ve had a lot of hope for this baby.

I agree with Sarah and Gerri. I don’t think you should discontinue insulin (unless you start having extreme lows). Who would you be doing this for, the doctor? Many of us self-manage our own diabetes only checking in with doctors for prescriptions or if we have a problem. As someone who lived in a third world country for two years, I really came to know I was on my own and that’s ok. I think things will really come clear when you get your tests back, and if they go as you expect you will get more doctor support if that is important for you. I know the feeling about hoping it will be confirmed as type 1 because your gut tells you it is and then it will be confirmed and people will take you seriously. Let us know how it goes.

No i am not on anything. I am walking 3 miles a day and eating low carb as much as possible. I think that the day I had the low I had not had enough carbs. It is a true balancing act with or without meds/ insulin. I know I am frusterated and can imagine that you are too.

I am so very sorry you are dealing with this. I lost a baby at 7.5 weeks back in May. I too am 40. My OB and I opted for a medical miscarriage at home using a drug called Misoprostol. It starts very strong uterine contractions approximately 2-6 hours after you take the pill(s). The longer the tissue stays in there, the greater your chance of infection (not good for a diabetic). There is also a very bad condition (I cannot remember the name of it) that you can get if the tissue stays in there. My OB told me that the fetus should be tested, so after my miscarriage, it was sent for analysis, and we found out it had Trisomy 15; rare and fatal. It gave us a lot of info and leaves the guesswork out. Does gestational diabetes crop up in early pregnancy? That seems so strange to me, since most gestational diabetics I know found out late in the second trimester. For me, I failed a glucose tolerance test in the second trimester with myf irst pregnancy. My OB was really confused by the BS readings given my thin frame etc. He sent me to an endo who tested for GAD-65 the next day. Positive. I would RUN (not walk) out of your current endos practice for good. It is not your job to educate the physician. Where do you live? Maybe we can offer up a recommendation for a good endo in your area. All the best to you.

I’m so sorry for your loss. It sounds like you also have a bunch of stuff going on which may have made things very difficult for your pregnancy.

I’d like to suggest to you that while you believe you should be diagnosed into “categories” type 1 or type 2, don’t accept that thinking. You should start thinking about your “condition.” Realize that hypothyroidism can “cause” blood sugar control problems (http://journal.diabetes.org/clinicaldiabetes/v18n12000/Pg38.htm). Find out what is wrong with you, it may well be that something is affecting your thyroid and if that condition is addressed, other things fall back into place.

That’s a difficult situation, and made more difficult by not knowing if you need to continue on the insulin or not. I’d say, if you feel that you should wean yourself off, do so slowly. If you don’t feel that you need to, don’t - and find a different doctor.

I too was pregnant a year ago. I had a sonogram at 10 weeks and my baby had stopped growing at 6 weeks. I was told I’d miscarry, I didn’t, and I had to have a D&C. I was released the same day, and while at the hospital I allowed the medical personnel to care for my diabetes. For me it was a little more clear what needed to be done, because I’m definitely without a doubt Type 1/insulin dependent.

I’m sorry about your loss.