Labour with Gest diabates - insulin and glucose drip?

[Ozziegirly]

So, I'm 37 weeks and have been on insulin for gestational diabetes for about 3 weeks.

I have my appointment with my endocrinologist on Friday to discuss my labour plan. I already understand that I will probably be induced at 39 weeks and I"m ok with this (currently trying to do everything to bring on labour sooner).

But one thing another endocrinologist mentioned was that I would be expected to fast for 12 hours, then come into hospital in the morning to get labour started and would be on an IV solution of glucose and insulin.

But this is the only time I have heard this - my obstetrician has previously indicated that I would come in to hospital in the evening for induction and hasn't mentioned anything about IV lines.

So, are there any insulin dependent gestational diabetics here who can comment on the liklihood of an IV line?

The hospital have been so good so far about agreeing to mobile epidurals if necessary, mobile heart rate monitors etc and I just hate the idea of having to lie there with an IV line in while I labour.

Any thoughts would be great.

Do they want you to fast in case they need to do a c-section?

I don't think so, he didn't mention that, and there's nothing in my notes to suggest I would need one (baby is measuring normal size etc).

He just kind of threw it in at the end of a telephone conversation and it sort of took me by surprise!

I have type 1 diabetes so not sure if it is the same but I had what they call a sliding scale (the insulin/glucose drip you mention). It means you don't have to worry about injecting any insulin etc but I had to test my sugar level every hour, not fun when your contractions are very close together! I wasn't told I couldn't eat before or during. I was induced and stuck on the stupid bloody bed for the whole 10 hours wasn't even allowed to get up to go to the loo (had hormone drip too and was attached to foetal monitor and BP monitor). I am still angry about this as all I heard before was how important it was to keep mobile. The sliding scale tends to beep everytime you move. I would just talk to your doctors so at least you can go in prepared and then there won't be any shocks/disappointments. The sliding scale really is a good idea as if you had a hypo you would just not have the energy to carry on.

Thanks sunndy - that makes sense, but I have been controlling the blood sugars really well through diet and insulin and have only had a hypo if I"ve done something daft like gone way too long between meals - and only then I've only had 3 (all this weekend!).

Hopefully I can talk them out of having me lying down as I agree with you, everything suggests moving around is the best thing to do.

Whatever your state of health you have the right to make choices about your labour. You shouldn't be compelled to do anything. It's your baby and your body. They won't get very far trying to do an induced labour if you don't show up Ultimately the decisions are yours - the docs can only make recommendations and tell you the evidence behind them.

Just to chip in, I would mention your hypos to your endo. They can be a sign that the placenta is working less efficiently. I have Type 1 and a 25% drop in insulin needs (and consequent hypos) was a sign my placenta was not as healthy as it could have been. FWIW, I was induced and put on a sliding scale for insulin with a glucose drip. I hadnt heard of that with GD but it is useful for them to have an IV in, in any event. My experience was that the sliding scale worked extremely well as the drs were used to how diabetics respond to labour.

If it helps, my DH counted 9 different things attached to me when I was labouring so it could be worse.

Thanks vole I actually was in hospital yesterday being monitored as I had had a bit of a reduction in movements, plus the hypos and was a little worried. Luckily as soon as I arrived and was put on the monitor the baby actually pushed against it, making it move and had a perfect heartbeat, but they are calling me in for a second trace tomorrow, just to be on the safe side. They are very risk averse here which I am pleased with.

Northern I totally agree, although I have to say, now I'm this close to the end, I am just keen to get this baby out safely and although I was totally against induction (and am doing everything I can to avoid it), if it means making sure all is ok, I am a lot more relaxed about it.

My Obs and midwives are really nice and have reassured me that even if I am induced they have various mobile thingys to keep me moving and when I told them my birth plan, they said I had basically asked for what they have as standard anyway, which was really pleasing.