My doctor wants me to inject insulin four times a day, even though the only time my levels have been too high is on waking - the rest of the day they are normal, usually in the 5s.
Is it necessary or overkill? He can't really seem to give me a justification other than 'last time you had a big baby'.
My sugars are about 5.5 in the morning and creep up during the night - starting at dinner 7.5s and 8's. My Ob phys has me on 1/4 of Daonil twice a day - we are looking to change to insulin probably within a week or two. No matter how much carbs I limit, it cannot be controlled.
Understanding GD better has helped me understand where my Ob phys is coming from.
The type of insulin may be the reason for the change. There are short acting and long acting insulins. Short acting are usually used at meal times.
Don't forget that the placenta is the one producing the progesterone, and as your pregnancy progresses baby gets bigger so does the placenta therefore increasing the amount of progesterone - causing your body to increase the glucose its producing - so you may think you woke up in the middle of the night and devoured a block of chocolate, but alas - its just your liver producing glucose!
Just remember that having high sugar levels are not passe, I would suggest he is putting you on the dosage for a reason - if you do not feel comfortable, question your OB to the hilt - I did that to mine when he put me on Daonil as it was a category C drug(mine is a VERY well respected physician - in otherwords, you dont question him, even my regular OB said that )never the less my body my baby - give me a reason why I have to take this - don't just write me out a prescription. He proceeded to give me research documentation and advice and studies, not just the pamphlet in the box or what I found on on google.
i'd agree that the type of insulin can be a factor but would also say that if he can't give you a reason other than you having a big baby last time then i would certainly seek a second opinion.
is this an endo or an ob or a GP? i found that the endo i saw when i had GD was very helpful & really looked at me & my situation as an individual case whereas the obs i saw at the hopsital very much lumped me in a 'GD' category without really taking into account my individual circumstances etc. obviously this isn't the case for everyone (mine was at a public hopsital so not the same ob every time & large patient volumes) but i found the endos to be great.
I agree with Sloane - maybe see if you can get a referral to an Endocrinolgist or at the very least an Obsterician who specialises in GD. My OB referred me straight to an Endo and i tried diet controlled GD which only lasted 2 weeks before my levels were sky rocketing no matter what i ate - so at 32 weeks i was put on insulin injections three times a day. one before breakfast, one before lunch and one before dinner all with varying doses of insulin.
From memory with my own GD when my morning levels were high I just had to have insulin the night before. (obviously I couldn't predict the following morning so I had to use my judgement..
Have you seen a dietician and a diabetes specialist>? I have had it will all 4 pregnancies and I have seen them every time..
Yes this is an endo that I was referred to by my OB. I also see a diabetes nurse and a dietician.
The nurse (who has instructed me in the all the monitoring and injection procedures) seems to think I don't need it either, and was the only one who bothered to take notice when I said my levels went up with new strips (they went straight down again with different ones).
I can see why the slow acting, night one might be needed, but with all my day levels normal, I'm finding it hard to think it's not just a doctor who can't admit when he didn't listen and got it wrong. And of course, he was quite defensive over the phone when I questioned it.
Obviously, I don't want to do anything that might ultimately harm my baby, but how can I be sure unnecessary insulin won't do that either?
I'd like to get a second opinion but we don't have a money tree
Bit frustrating. Thanks for your replies, I will have to think on my options a bit I guess.
If it is only your morning results that are high then they should just start you on the long acting night time one and play it by ear for adding the short acting meal time one if/when it is needed.
If you are only getting 5's after meals then taking insulin would have a good chance at giving you a hypo which is rather uncomfortable.
The molecules are too big to pass over the placenta.
If you are seeing a Diabetes educator, then what is she doing?
She should be going in to bat for you really thats how the relationship works the DE is the conduit to the endo, especially seeing that they know you better.
If you aren't happy seek another endo opinion.
It's best not to compare your own diabetes and what happens with others here. Everyone is different so the care plans and paths others have gone through might not be suitable for you.
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Anyone with a good knowledge of GD?
)never the less my body my baby - give me a reason why I have to take this - don't just write me out a prescription. He proceeded to give me research documentation and advice and studies, not just the pamphlet in the box or what I found on on google.
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