Fed up measuring 80th centile type 1 diabetic

[Givinguph0pe]

She was only measuring 50th centile four weeks ago.
My sugars have been largely ok but I've really struggled with insulin resistance in the evenings. It doesn't seem to matter if I eat or not, I get a huge rise. It's 12 now for example. At 5pm it was 5.7. So it's risen on its own.
Apparently my baby is at risk of being stillborn.
My hba1c was 40 but that was 4 weeks ago and since then I've really struggled with insulin resistance so I'm expecting it to be higher this time.

I'm doing my absolute best but I've still failed my baby before she's even here. I don't feel like eating anything for the next 9 weeks. Am 29 weeks and they will deliver me at 38 weeks at the latest.

[ThePug]

Who has told you your baby is at risk of being stillborn? There is an overall higher risk for diabetic mothers, but just because your control hasn't been as tight over the last few weeks does not mean you are now 'high risk' of this! Think of the mothers who come into pregnancy (and for some, remain) with HBa1cs of 60+; the 'risk' statistics include them. If your hba1c has been 40 or thereabouts up to 25 weeks you've done brilliantly for your baby.

I'm type 1 diabetic and currently 23 weeks.

Are you seeing your consultant regularly? What have they suggested for altering your insulin doses? I've been having issues with afternoon highs - e.g. after lunch it will be 12, then suddenly within the space of half an hour I'll be down at less than 3. My team told me to up my lunchtime insulin but then have a little snack mid-afternoon. When I remember to do this, it works well (although putting in loads of insulin with lunch is unnerving!)

Not eating is not the answer. I know the fast-acting insulin we have is only meant to compensate for what we eat, with the slow-release stuff keeping us steady in the background, but I know if I skip a meal (and the insulin dose) my levels will often do what you described.

I have my first growth scan on Friday (since the 20w scan) so am interested to see what centile baby will be on. 80th centile is not huge! To get an average, some babies have to be nearer the top and some nearer the bottom. Plenty of non-diabetic mothers have babies measuring at least as big as yours. Was the measurement done by a scan or by fundal height?

[Givinguph0pe]

By a scan. Fundal height is measuring 40th centile.

It was a consultant I've never seen before. She said if my sugars don't come under control it may result in a still birth. This is a typical day for me:

Before breakfast: 5
After breakfast: 7
Before lunch is usually pretty low - around 4 or occasionally a bit below.
Mid afternoon is usually around 6 or 7 but then in the evening it goes up.
Most evenings it goes up to about 11 or 12 for a couple of hours. Overnight is ok.
I've increased my evening insulin but it doesn't do it every night so I'm scared of whacking loads of insulin in when I know I will be going to sleep with a lot of it still active.

It was a trainee sonographer so I'm hoping her measurements were a little out. I feel like I've failed my baby.

It's so hard isn't it? I'd give anything for a normal non-diabetic pregnancy. Thanks for your reply.

[Vanillaradio]

Well 80th centile is really not massive. Also even if this was from a growth scan they are not always accurate. I was told constantly ds was 90th centile and over. The week before he was born they estimated him at 8lb 8. He was 7lb 5, exactly on 50th centile.
Type 1 diabetic here who was a nervous wreck through pregnancy. I had some horrible blood sugars both high and low. I spent a few days in hospital at 25 weeks with a chest infection which sent them into the 20s. Ds was and is fine. I know from experience how worrying it is but chances are high your baby will be fine.

As far as your sugars go I second the suggestion to talk to your team. Is there someone you can send a few days of readings to who can review exactly what is happening and suggest tweeks? Please don't stop eating, this really won't help. Take care of yourself and try to take it a little at a time.

[Givinguph0pe]

Thanks. That is reassuring.

I work in a school and I've picked up virus after virus. Currently I have tonsillitis and it's really not helping!
I've hardly been eating anyway as I've been so sick, that also makes it hard to know how much insulin to take as sometimes I eat and then I'm sick. M

I've been to clinic today and they've advised me to put my evening doses up, which I had anyway but I think it's a moving target.