Extreme panic, ladies with GD on insulin or type 1 please advice!!

[bunny85]

Hi all,

I'm 30 weeks and have GD since 16 weeks and on insulin. I'm having hypos very frequently, esp at night (nearly every night), lowest I've been is 2.4 once but usually it's something like 2.7 or 2.9 or 3.0. Now I've just had an appt with my diabetic MW and she said these hypos are bad for the baby as they cut off his oxygen and can affect development!! I'm panicking now and in tears. Why didn't they tell me earlier?? I've been told only highs are bad and been doing really well controlling them. Anyone had frequent hypos and went on to have a healthy baby? The MW told me I wouldn't know if any harm has been done until the baby is 1-2y.o. Please if anyone has any words of wisdom help... Thanks in advance.

That sounds like something I should get ! (The gel tubes) it is so hard being diabetic. I bloody hate it.

Definitely ask your doctor to prescribe them. Actually quite yummy and act rapidly too. No need to stress out whether you've eaten enough or too much. Very easy to carry around too, not as big as a pack of juice (if you prefer smaller handbags like me).

I'm finding it very hard too and I'm not even type 1. I think about it a lot and really applaud women who go through pregnancy with type 1, so very tough, but hang in there, will be so worth it

Hello again.

Some update, and I don't know what to do and think anymore... I'm terrified and can't calm down... Basically I had to go to mdu where I saw few other doctors and my diabetic midwife (the other one). As expected, none of my usual diabetic consultants are available until Thursday. Anyhow, my insulin doses were adjusted and last night was the only night I didn't have a hypo (however my morning reading was high). Anyway I asked those other doctors about hypos in pregnancy and all of them told me they are bad for the baby! Nothing to do with oxygen they said but baby experiences hypos too and not good for brain development and growth. I was then given a scan which indeed showed reduced growth!! So that means hypos ARE dangerous. I've been having them constantly for more than a month.

I have so much fear that I stayed up all night last night. I will never forgive myself if I've harmed my baby. Has anyone ever experienced them so constantly and in the third tri? Don't know how I'll make to to Thursday. I just need someone else's experience I'm going really crazy with panic.

Thank you

Anyone?

Oh OP I just read this.. Did you manage to see the consultant today? This must be so, so worrying for you. I hope you can take heart from the other posters saying that they had frequent hypos and their babies were fine in the end! I hope it will be the same for you.

Thanks so much for your reply. Yes I saw the consultants yesterday, by mere accident got seen by another team who I never saw before, and the main one said I was on the cheap type of insulin which was notorious for causing hypos at night! So he prescribed me more expensive one and last night I didn't have a hypo AND my morning sugar was normal too! And that's on the dose which is less than a half of what it used to be!! I said I didn't want to see those other consultants any more...

As for the harm of hypos, he actually went to google it himself (well that I can do myself but never mind) and said that 'there haven't been enough studies to show any significant harm'.. Which in my understanding is different from 'there have been enough studies to show no harm'. So I'm still uneasy about it, and obviously pissed off about not having been offered the better insulin long ago when the other one clearly wasn't agreeing with me..

But I managed to calm down regardless. Thanks for your kind words and wishes. All the best to you and your baby too!

Hi everyone,

I'm so sorry to bring this all up again, but I'm still finding it hard to calm down and convince myself that hypos haven't harmed my baby. I was just thinking, was it in the first trimester only that you had hypos or throughout your pregnancies? In my case it's throughout (from the moment I started insulin that is at 16 weeks)... I keep going from feeling fine one day and really anxious another... Btw they adjusted my insulin doses so I don't get hypos anymore, however as the result of it my morning sugars are high almost always... Please can you tell some some more of your experiences. Especially those of you who had them throughout the pregnancy or in the second and third tri..

Thanks so much in advance.

Hi Bunny - sorry you're feeling so anxious about it, it's totslly understandable. I'm T1, on insulin, and had my daughter 2 yrs ago. Like others who've posted on here, I had many lows throughout the pregnancy - in fact I aimed to be slightly low much of the time, felt safer than being high!

My lowest was about 1.7 and I literally saw stars getting back home, I was so close to passing out. Not recommending that BTW! But my consultant (an excellent consultant at St Thomas', where they deal with loads of high risk pregnancies) was not concerned about lows in anyway, apart form for my own safety.

How have your HBA1Cs been? Highs later in the pregnancy are common, but I did try to keep them in check by taking little adjustment doses of insulin regularly (but don't make any changes on your own - I've been diabetic for 32 years so I've had some time to practice!)

Try not to worry - it's inevitable, I didn't dare hope everything would be ok til it was, and it was all totally fine, DD was completely fine.

f1ddlesticks, thanks so much for your reply. So nice to know your LO is fine! May I ask, did you have any lows in the third tri as well? I had quite a lot, nearly every night, until they corrected my doses (was on too much). I wonder if hypos later in pregnancy are worse for baby or doesn't matter?

My Hba1c has always been good, 42, 32, 35, these sort of figures. But I don't really take them too much into account since many lows and highs will give a nice average in the end, right? So doesn't really say much if I understand correctly.

As for adjustments, they actually instructed me to adjust them myself! (Hence I ended up on too much insulin in the first place). They said to go up 2 units the next day every time I'm high. So that's what I'm doing. I hardly have any hypos during the day, night is a problem, so they adjusted my basal insulin and that one I don't change myself

Possibly not as bad in the last trimester but I definitely had them, multiple times every day. Just not as low as 1.7 again! I remember saying to the consultant that I would rather take slightly too much insulin all the time because at least the only surprise would be a low, not a high. She thought I was a bit bonker but because I was doing so well she didn't try to correct me!

& your HBA1Cs are great! I agree they're an average, but if you had tons of really high blood sugars then your average would be higher. It's a sign of good right control. I was far more concerned about the highs, they're much more harmful over the duration of a pregnancy.

You have really reassured me about the lows, thank you so much. I certainly agree about the highs too, but they just seem absolutely impossible to control in the morning ( fasting), even my consultant said I'm a challenge and he's at the end of his tether. I either go low at night and fasting is then fine, or no hypos and end up with high one in the morning. Mystery! Have you maybe got any advice on that?

Thank you for the feedback re hba1c, strange it's still normal though as I'm having so many highs... Have to adjust doses nearly daily as all of a sudden the numbers went through the roof now that I'm almost 37 weeks. Baby is average size though, even rather on the small side...

It's a scary journey isn't it? But you have a medical team working with you to help every step of the way, and they'll be keeping a really close eye on your baby...

Out of interest, do you test in the night? I have always woken up in the night, and take the opportunity to test, but it's not for everyone! Essentially, if you test in the night and it's normal, but then you wake up high and bring the level down quickly by taking insulin then you know you haven't been high for too long, and if it's a little high in the night you can make a little correction then.

Also, dawn phenomenon is a well documented thing - I've found not eating breakfast can wierdly raise levels, whereas eating something and taking insulin tells your body to reset, effectively. I was also much more insulin resistant in the morning, so would need to correct with a high dose than the afternoon.

I treated the whole thing like a big science experiment - and tested about 20 times a day! Obsessive I know, but it kept me sane!

Oh you are exactly like me! I'm also obsessed and test 10-15 times a day. And just as you say, I wake up a lot at night and use this opportunity to test always! I sometimes test up to 4-5 times a night. If I see a concerning tendency, like 5.6 before bed, 4.1 in 1h and 3.6 in 2h I know for a fact I'll hypo and I set an alarm in another hour, or now I started preventing it by eating half banana or something. As for my numbers at night, actually 99% of time they are normal throughout the night, on the lower side up to around 4pm and then start rising gradually. But rarely they are proper high (around 6) at night. Then in the morning I almost always end up high... Lately they've been also high after breakfasts constantly, do you think this staying high for the morning and after breakfast could have done any harm? I'm so nervous. It's a very very hard journey as you say. Thank you so much for taking time to reply, it means a world to me. I've been struggling..

If you have a level of 3.6 in the night you could try having a small glass of milk, it's a bit more gentle in terms of blood sugar boosting. Id often have a glass of full fat milk (basically fat makes carbs go in slower) if my blood was heading downwards, to catch it before it fell too far, but do it didn't then bounce back up too sharply. In the final trimester, as far as I can remember, youll probably only need a very small amount of carbs to raise your levels.

So perhaps the banana is too many carbs? Might be causing a delayed spike. After breakfast high is also quite typical - I'd need a higher dose of insulin in the morning compared to what I'd take in the afternoon for the same number of carbs. You could also try injecting around 20 mins before eating, so the insulin gets working before the carbs go in.

Sounds like you're super on-it! You can drive yourself crazy with worry but you're doing all the right things and thats really the best you can do!

OP I have gotten so angry reading your posts and the incorrect information you've been given! I'm T1 and have been catagorically told by my diabetic nurse,consultant and obstetrician who are all highly respected throughout the country for their work and research in caring for pregnant diabetics, that a hypo has no affect on the baby. It's not good for YOU,especially if you cant treat yourself,but will not harm baby. What insulin are you on? before I got pregnant with my first baby I was switched to lantus to take before bed,which is the only insulin (or it was at the time) that had been researched and approved for use on pregnant women - theres not a lot of research for obvious reasons but it's been done on lantus. It's a long acting insulin that helps keep your sugar levels steady during the day,i also take novorapid with meals which is fast acting and covers the sugar increase for what you eat. The difference between my sugars,and the number of hypos I have, now and when I was on my old insulin is massive. 32 weeks pregnant with number 2 and I also tend to run my sugars on the low side,high blood sugars really can cause problems. It's a delicate balancing act and I can go from extremes at time but pfb is absolutly fine and so far this ones looking good too.

Please please PLEASE stop googling,it will make you worry which will increase your blood pressure which really isnt good for your baby

Your hb1c looks good,what are your readings before bed? I find that if I got to bed with anything lower than 6.5 I WILL hypo overnight so I eat before bed,nothing massive usually a couple of digestive biscuits or a cerial bar, and that helps me hold steady overnight.

F1ddlesticks, I didn't know that about milk! I'll start trying it right away. I'm having a banana before going to bed as advised by my diabetic nurse. Now the consultant also said I must have BS of at least 7 before I go to bed. You are right it might be giving a delayed high. After breakfast is a struggle and I can only afford a tiny amount of carbs in the morning now, but it's ok. It's true about delayed action of insulin - those first consultants were saying to inject 'when food is on the table', whereas the new ones I switched to are now saying to inject 30mins or even an hour before food, which is what I do.

Mrsleomcgary thank you for your reply. I'm so happy to hear of yet another person who was told hypos are harmless. I'm on different types of insulin. Humalog before meals and Levemir in the morning, at the moment. Hard to believe but they tried everything on me. I've been on Humulin and Lantus too, before bed only/split between morning and bedtime/only morning etc with all these types. I kept going hypo at night no matter what. Levemir in the morning seems like the only insulin that doesn't give me hypos, but then again, I'm ending up with morning highs as a price for it. Interesting you say Lantus is the only one that's been studied in pregnancy, from what I read it says that all insulins are safe since they don't cross the placenta. In fact, the only basal insulin that's been officially approved in pregnancy and has a cat B is Levemir... Very strange, lots of conflicting info out there! Did they tell you to switch to Lantus because of its safety over all others? How long ago was it?

And ladies, please tell me how bad is it that I'm having highs so often? What can be the harm of them (except for a big baby and baby having a low BS after birth), are there any major long term effects?

You know,since I posted last night I admit i've been trying to remember exactly what was said re research for lantus in pregnancy,i am 99% positive that I am right in what i've said but this was 3 years ago so willing to be corrected. I was switched from levimir to lantus though and I was told it's the prefered long-acting insulin in pregnancy. Highs in the morning make me think you need long acting at night and the hypos are a result of too much fast acting but go with what your consultants are telling you,not my word! plus i've never been on humalog so no experience with it.

There are other potential complications with constant high blood sugars,most notably still birth but also later developmental issues and learning difficulties. But PLEASE dont stress about it,it wont do you any good,I'm only telling you here to keep you off dr google.

DD had low sugars when she was born (nothing to do with my levels being high),there was talk of her going into special care purely for extra monitoring but at the last minute she got above the level they were looking for. Her sugars were monitored every 2 hours for 24 hours in the post-natal ward and we stayed in for 3 days but that was so they could get my levels right and because we struggled with breast feeding.

Thanks so much, I really appreciate. I thought high sugars can only cause birth defects when they happen in the first trimester, later on in pregnancy I thought it's mainly stillbirth/large baby/low BS after birth. Never knew about developmental issues and learning difficulties! I'm just so so confused now... I've had so many of them, even though Ive always stuck to my diet religiously, they just keep getting out of control... I'm just so so so scared and terrified... I'm only praying my baby hasn't been harmed...

Try not to worry bunny, based on the figures you've told us for your sugars it sounds like your control is pretty tight. High sugars can cause a lot of different problems, but like I said before, if your highs were really prevalent, then your average would be pushed up & your hba1c would be higher.

My DD did have low blood sugars about 12 hrs after she was born, and my control was excellent - I even managed my own sugars all the ways through a 36hr failed induction & EMCS! And I had expressed colostrum for her, but it wasn't enough. She spent one night in SCBU - but she was totally fine. My consultant said she was surprised she'd had low sugars.

You mention your baby's predicted weight is fine, which is great - one sign your sugars are doing ok.

Remind me how many weeks you are? Do you have a plan for being induced early or will they let you go to term?

F1ddlesticks, thanks so much for the reassurance. Yes I'm also surprised your DD had low bs after birth, sounds like you really were on top of things. Very happy to hear she was fine and only had to stay there 1 night. You know, I also tried expressing and nothing came out and it made me even more depressed that I'll have problems with colostrum not coming in too.

As for my hba1c its true it looks good, but throughout my second and half of my third tri I was having hypos every night, so I thought maybe they balanced the high ones out. I do hope you are right though and hopefully my good hba1c's mean it's not as bad.

Yes, baby's weight is below average in fact (both me and my DP are petite so no surprise here). Baby seems to be growing ok touch wood.

I'm nearly 37 weeks. Induction is another thing, at first they were saying they'll let me go till my due date, then on my last appt they said they'd induce me at 38 (next week that is!). And the reason they gave me for induction was that I've been having hypos at night and it's not safe for me. No other reason! So I declined since I'm not having them anymore. I said why not induce me at 39 weeks at least which after a lot of persuasion they agreed to. But I just want to check again on Thursday with them as to what other reasons are there for them to be pushing me for 38 weeks. All I care about is my baby, I know I can deal with the hypos. I'm so confused.

Sorry about the long post! I've got no one to talk to about in RL who really understands the subject.

At what week were you induced with your DD?

I was induced at 38 weeks, but I had early signs of pre-eclampsia so to be honest I was keen to get on with it! The birth itself and my early experiences weren't all that great (not to scare you but my induction failed & I had EMCS, then the night in SCBU, and then trouble getting DD to latch and BF) but all things considered she was safe and well, so they all paled into insignificance! I think after all the worry I was just happy to have her out and healthy...

I think it's just standard that a hospital will push for a slightly earlier birth with diabetics, but some women especially with GD do push to go to full term and it's fine. There is the worry about the placenta deteriorating late in the pregnancy, which is why they like to avoid that time after 38/39 weeks, but there are symptoms to keep an eye out for. Push for what feels right for you!

Feel free to keep posting and asking questions, happy to be here! X

Thank you so much for taking your time to reply. I really appreciate. Feeling a bit better now... This panic comes in waves, right now feeling more reassured and calmed down. Only 2 weeks left until I'm 39 weeks, I'll just try and do my absolutely very best now to keep it all under control. Thank you again for all the advices and help! X

I hope you had a great birth experience and enjoying your baby now. It’s been a while since this post and I was worried about the hypos.