Type 1 diabetic induction and labour advice please

[PipeDownSmallFry]

So I'm a type 1 diabetic, 36 weeks pregnant having my second baby. Had gestational diabetes with my first 4 years ago so everything was a bit different.

I don't feel like I've had the best experience of antenatal care this time round and am feeling anxious about the labour and birth, mainly due to the fact that everything I've read and previous experience seems to be different from advice I'm being given by the doctors at my hospital.

Last time with GD I was booked into hospital and induced at 38+6 and had dd bang on 39 weeks so I was in hospital when I went into labour. This time they want me to have a sweep at 38 weeks with my community midwife (despite never having met her) and have booked me in for an induction at 39 weeks.

Everything I have read (including care pathway from my hospital) says I should deliver the baby by 38+6 and that my blood sugar levels need to be closely monitored during labour. I'm worried that if the sweep works and I go into labour at home 1) I won't realise until I'm almost giving birth (was 9cm dialatedwhen it became obvious in hospital last time) 2) I won't be able to manage my sugar levels effectively outside hospital. Also concerned my induction is booked for after the recommended 38+6.

Thinking of refusing a sweep and asking for my induction to be brought forward by half a week.

Any advice really gratefully received. xx

[AveEldon]

You are well within your rights to refuse the sweep

And as the NICE guidelines say you should be advised to deliver between 37+0 weeks and 38+6 weeks asking for the induction to be moved forward seems sensible

I was advised with GD to come to hospital immediately if labour started before induction

Good luck!

[MrsNuckyThompson]

Pipedown - interesting. I was desperate for a sweep and to give birth naturally but wasn't allowed, had a failed induction at 37+6 and ended up with a section.

I was absolutely, positively sure that I didn't want anyone else to monitor my blood glucose than me. Why do you think if you're in labour at home you / your DP won't be able to keep an eye on your levels and correct as needed? Just interested to know - the last thing I wanted was for anyone else to control my testing or indeed insulin (ie using a sliding scale).

[MrsNuckyThompson]

I should also say that you can of course refuse anything you want, and can ask for what you DO want. If you are Type 1, I assume you are under a consultant? if so, I would speak to them and insist that the induction be brought forward...

Also - when you say you had GD for your last pregnancy, did you develop type 1 afterwards?

I just came on here to start a T1 support thread as I found it really useful in my last pregnancy. Hopefully you'll join even though you are very close to the end now :D

[Mastermarinermum]

Hello - I'm lurking with Gestational Diabetes which was diagnosed at 8 weeks! Am interested to hear also if Pipedown subsequently was diagnosed with Type 1 after GD....

[MrsNuckyThompson]

Master - I don't think it is common. As I understand it, GD is much more akin to Type 2 diabetes because it is insulin resistance, whereas Type 1 is the body's failure to make any insulin at all. Therefore, I wouldn't necessarily have thought there was a particular link, although would be interested to be proved wrong!

[Esker]

MrsNucky I am type 1 in very early pregnancy- where's your thread? I'll join in!

OP I'm afraid I don't have experience as this is my first pregnancy, but it certainly doesn't seem right for you to have to have the sweep if you feel uncomfortable about it or the timing. Good luck!

[PipeDownSmallFry]

Goodness sorry only just seen these replies. Thanks everyone!

Yes I had GD with my first baby, it went away afterwards, I was monitored for type 2 diabetes then two and a half years later I had all the classic diabetes symptoms, blurry vision, weight loss etc. doctor ignored my queries for 6 weeks and didn't really want to do a long range glucose test but when he finally did wanted me to go straight to A&E and was diagnosed with type 1. Fairly unusual I understand.

I am consultant led care but the clinic is terribly busy and you just see a conveyor belt of medical staff (never the same) and a member of the consultants team. I have found the consultant to be very brisk and rushed when we have met.

To update, I had to fight but have refused the sweep and am being induced 5 days earlier which does bring me just within the NICE guidelines. Feeling much happier!