Type 1 Rant (Kind of Long, Sorry!)

buggymuncher

So for my first two pregnancies I had an OB and an endo who both took care of their respective fields. This time we live in a different state and I am going to the university hospital. My endo told me she is completely comfortable with the MFM doctor taking care of my diabetic control during pregnancy as he specializes in it. And up to this point we've done great.

Now the frustrating part. I am 23 weeks and hadn't met his midwife as she was always out. So the midwife I did see handled my insulin prescription. I guess my pharmacy had a question about the script and called. They ended up talking to the midwife I've never met and she changed the whole prescription because "she has never seen a patient take so much insulin". Needless to say instead of a 3 month supply I only received enough to last me a little over a month. I was (am) furious.

So I met her on Tuesday and she still reiterates that she's never seen anyone take so much insulin. Which really offends me. I've had type 1 for over 17 years and not once has an endo even blinked at my insulin intake, even while pregnant. I'm really contemplating sending an email stating that I've been happy with the control we've achieved but if my insulin needs are overwhelming in any way I'm more than willing to go back to my endo for diabetes management who will have no problem prescribing the correct amount of insulin.

Am I being crazy or would you be ticked, too? I love the OB and will put up with this lady for the few months I have left but holy hell did she get under my skin. Sorry, rant over!

KnitPixy

Rant away!  I'm angry on your behalf! 

I was complaining to the diabetic nurse on Tuesday how much it sucks to be on so much insulin right now, she just laughed and told me "wait until you have to change your pump every day!".  It is a very well documented fact that insulin needs can go way way up during pregnancy.  Since about 20 weeks I've been steadily increasing my dosages and due to the size of the placenta from my a/s they figure it's just going to keep going up.

Even if the midwife is concerned about the amount of insulin you are taking she shouldn't be cutting back your supply.  I can see suggesting something like metformin or such to try and lower the insulin resistance and thus decrease your insulin requirements but just cutting back the perscription is nuts!

Can you talk to the MFM about it?  Or maybe your regular endo?

Sorry you are dealing with this

mmooki

How can she change the script without seeing you??? That's crazy. My last pregnancy, I was on 160 units per day in my pump. Normal for me is well under 100. My script was written for 200 u/day to give me a buffer. I'm so mad for you!!! Hopefully you can get this sorted out.

buggymuncher

Thanks Starla, mine is 12! I can't imagine what it'll be at the end of this! If I ate no carbs it'd be much better, but that's just not gonna happen

KnitPixy - I know with my last daughter I was changing my pump site almost daily and my pump holds 300 units. So I'm sure I'll be close to that again!

Thanks for the support and making me feel a little better about being so upset. I love having you guys around

buggymuncher

mmooki - I am currently taking 125ish a day and also was way below 100 prepregnancy. They were forward looking for the next 3 months and wrote the script for 200 so I won't run out as my needs increase. Thanks for making me feel like I'm not as much of a freak!

buggymuncher

I have a Medtronic Paradigm 751. It holds 300 units but still has the same bolus constraints (25 units). I sometimes have to split doses like you. If it happens it's at breakfast since my carb ratio is so tight during that time.

heie0008

Wow! That is insane! I would be raging too! At the end of this pregnancy I was using 3× as much insulin as I usually did. My mail order pharmacy delayed my shipment because they had to contact my MD to make sure the prescription was right.

mmooki

@starla487‌ I have the revel 723, so it's the larger reservoir and I have the same max bolus issue. I just double bolus for larger meals. The endo said to bolus for twice the number of carbs I am eating, but that doesn't solve my issue.

@buggymuncher‌ it was great for extra insulin. I didn't change the script for a while after my daughter was born. It's nice to have a cushion of insulin just in case.

KnitPixy

I'm now questioning how I have my max bolus so high. Mine is set at 30 units currently... My pump gave me a bunch of warnings when I adjusted it at my endos office but it has stopped me having to split boluses for starchy meals. I believe mine is minimed veo

kedbach

Hi all, I created a Diabetic group, please join- it will make this easier!

I would be angry too. I'm not particularly happy with my new Endo right now, which is sue or frustrating.