Diabetic please advise - failing placenta?

[Sweetcharlotterose]

I'm nearly 20 weeks and the last week or so my insulin requirement has dropped. From around 27 units a day to 23 units a day and my sugars are running lowish at 4 or 5. I'm eating and taking no insulin.

I know I have an issue with the cord being velamentous so it doesn't go directly into the placenta but goes into the membranes instead. Could the placenta be failing already? I'm not sure if it can be linked to this issue or not. My understanding is the placenta should kick out hormones that cause insulin resistance and this should increase not decrease.

My 20 week scan is next Friday when I will be 20+3 and I don't know if I should call someone before then. Or who to call. And what to say.
There's probably nothing that can be done anyway but if I'm going to lose my baby I'd rather know. I think.

I would say that with urgency, you need to speak to a dr/midwife who is a diabetes specialist. Say what you have said here.

Yes I guess so. I'm meant to be at work tomorrow, I'm not sure what to do.
Do you have direct experience with this or is it just general advice? I'm very very worried. It's taken nearly 4 years to conceive this baby and I'm in last chance saloon.

If contact your consultant team first thing in the morning. When did they start to drop and what type of diabetic are you (gestational or t2 I'm guessing?).

Insulin requirements in pregnancy can vary and I think the steep curve where they increase is from week 26/28. In early pregnancy requirements can drop, although I'd say you were beyond that.

Have you changed your diet / increased exercise? There are other factors that can influence insulin requirements but please, please speak to your consultants tomorrow first thing.

Note I'm not a medical professional but I'm a diabetic who has been through pregnancy (and currently 11 weeks).

I'm type 1.
I have no idea how to get hold of the consultants. They won't just put me through will they? I can feel baby moving so at least she's still alive at the moment.

I noticed they started to drop last weekend but today has been the lowest day in terms of insulin requirements. I haven't changed anything but I will say I've been absolutely starving again like I was at about 12 weeks. I actually experienced resistance from the start and my insulin went up from around 20 units a day to around 27 units a day but now they seem to be coming back firm again.

Sorry I'd misread and thought you weren't taking any insulin at all.

It can vary in pregnancy a bit though. Last few weeks I've reduced the amount I take and have had several hypos. I spoke to my consultant team about it and they weren't concerned.

Do you not have a consultant team? In my trust as a diabetic I have fortnightly (at times weekly) appointments with the whole team and I'm in regular contact with them via email. Do you not have a diabetic specialist care team? Who do you normally see?

I have a consultant but I don't have a phone number or anything. I attended clinic last week but had been about six weeks before that as they said I knew what I was doing and my hbA1c is good.

I did mention my requirement had dropped a bit when I went last Monday but it had only just happened and hadn't fallen much at that point. The consultant said it was unusual but they was about it. However it's carried on reducing from there on in. I'm not going low but I would be if I hadn't dropped my basal rates (on a pump).

charlotte Please don't panic that you're losing your baby; it is unlikely that is what is happening and the stress will do you no good.

What you should do is get in touch with your consultant; go on your hospital's website and find the diabetes section which should list the consultant and their secretary. Do you have a diabetes specialist nurse? I was given the direct lines & email addresses for two at my first antenatal appt!

I'm surprised they are letting you go 6 weeks without seeing you; I'm type 1 and currently 14 weeks and seeing them every 2-3 weeks and have been told that will become 1-2 weeks the further along I get.

FWIW, I've dropped my basal rate from 16 to 14 and still getting frequent hypos. My breakfast insulin dose has gone from 4 to 2 and I'm still down at 3 by mid-morning most days. My understanding is that during 2nd tri insulin rates are relatively stable and start increasing rapidly in the final trimester. I wouldn't say that your 4 units reduction is major, but definitely contact your consultant.

Hmm see if you can call the hospital and ask for your consultants number of that of his secretary. I'd definitely want to speak to somebody to check what was happening.

Even with a really good hbA1c I'm still dragged in once a fortnight and I did have a moan to my husband about it but I'm kind of glad they are so available

Really hope all goes okay for you

ThePug waves we're only three weeks apart.

Let us know how you get on today charlotte

Nice to find someone in a similar boat salty Maybe we should start a Pregnant & Type 1 thread on the pregnancy board so we can all compare notes?

Have just read your thread charlotte and wanted to wish you the best of luck for today. What a horribly stressful time. I've got GD as well and on insulin, though I'm in the 3rd tri, and I've been having frequent hypos pretty much since I started insulin... Your sudden drop in doses, however, should certainly be investigated. Please let us know how it went today, keeping everything tightly crossed for you and your baby, good luck

Hope you are ok and have got through to either the consultant, specialist nurse or someone - we had specially trained hv's who attend all the diabetic clinics and specialise in diabetic patients.
Hope you get to speak to someone.

ThePug I'm a low BMI, reasonably fit, insulin dependent type 2, not type 1 (actually it's type 1.5). It runs in the family and I have to manage it pretty much the same as somebody with type 1.

Sweetcharlotterose just wanted to check in with how you are and if you managed to get hold of somebody.