Intro and Glyubride Question

amythest167

Hello! My name is Amy. I am 8 weeks pregnant with my second. I was diagnosed with GD at the end of my 1st trimester during my 1st pregnancy, so they thought it was pre-existing diabetes. I controlled with diet alone for 2nd trimester and took insulin shots for 3rd trimester, despite following the diet very strictly. Luckily, my A1C and numbers were great after birth, so it was not a pre-existing condition. However, I started having high numbers as soon as I found out I was pregnant this time around.

My new OB- who is just temporary due to insurance reasons- that I don't trust very much immediately prescribed glyubride when I failed the 3 hour test yesterday. Does anyone have any experience with this? I am just concerned because the Dr couldn't even tell me what my exact numbers were and just doesn't really seem to know what she's doing. She does not handle diabetes and immediately referred me elsewhere which also did not inspire confidence.

Sorry for the lengthy explanation... I am just wanting to do the best for this baby and am concerned because I know early pregnancy is the most important time developmentally for sugars to be in control. Anyone else develop GD so early in pregnancy? Any experience with glyubride? Any help at all would be greatly appreciated!

KnitPixy

Type 1 here... I can't speak to glyubride as I don't use any oral meds for control but I do know most of them are perfectly safe during pregnancy.  As for developing GD early in pregnancy it's not uncommon.  Usually women who had GD with a previous pregnancy will be tested earlier in subsequent pregnancies, so often it's not that you developed it any earlier, they just caught it earlier.

It's also not uncommon in any form of diabetes that your body builds more insulin resistance as the pregnancy progresses.  The placenta interfers big time with how your body uses the insulin it makes.  It happens with us type 1's too... the stat is something like by the end of the pregnancy it can take up to 3 times the dosage of insulin to maintain sugar levels.

For now I would test often, eat right and work on getting in to see a new endo.  Also remember to take your folic acid!

blueeyedbookie

I was also found to be a gestational diabetic during my first trimester this time around. I had it with my first pregnancy as well, but only during the third trimester. Anyhow, I was able to control my sugars by diet and exercise until my third trimester when I could no longer keep my fasting sugars down. So my doctor prescribed me 2.5 mg of Glyburide twice a day (once before breakfast and once before bedtime). The Glyburide really seemed to help, especially with my fasting sugar. And I should also add that I test my sugar before breakfast and two hours after each meal.

I hope it works out for you, and I hope my ramblings are of some help! God bless!

MrsL2B

Thanks @starla487. Here's my novel of advice:

Hopefully the OB referred you to a MFM who will see you soon and get you started on insulin quickly. In the meantime, I would suggest that you keep trying to get the OB to switch you to insulin, and explain that you used it previously and are comfortable with it. But it's not uncommon for OBs to be reluctant to want to work with figuring out insulin dosage that works best for every individual's ever-changing glucose metabolism. Even my Type 1 OB didn't want to work with me as a Type 2 diabetic on that.

Glyburide isn't the worst thing in the world, but it works by making your pancreas produce more insulin than it otherwise would all the time, not just in response to food. Its effectiveness can peak around 2 hours after you take it, and the pills usually work for 8-12 hours. Keep in mind that pills can be split, so if you start on a 2.5 mg dose, and find that's too much, you can cut them in half and go down to 1.25 mg. 

You may find that early in your pregnancy while on glyburide you need more carbs than you expect to have to eat or that you need to eat more frequently. You have to watch out for unexpected lows, especially in the middle of the night. Carry fast-acting sugar (glucose tablets, fat-free candy, juice boxes) with you at all times and keep some on your nightstand if you're taking glyburide at dinner or bedtime. For the first few nights after starting glyburide or increasing your dose at night, set an alarm to wake yourself up in the middle of the night to check your blood sugar so that you don't go too low while you're asleep. Follow up the fast-acting sugar with something small to eat that has a little protein and fat in it so that your blood sugar will stay up and not come crashing back down again within a few hours.  And let your SO know the warning signs of low blood sugar and how you need to treat those episodes.

This is a great article to read on the topic of diabetes management during pregnancy: https://www.glowm.com/section_view/heading/Diagnosis and Management of Diabetes Mellitus in Pregnancy/item/162

amythest167

Thanks everyone very much! This info was all very helpful. I'm switching to an OB with more experience handling GD so that should help a lot