Changes in care after being put on insulin... — The Bump
High-Risk Pregnancy

Changes in care after being put on insulin...

My fasting #'s are creeping up the further along I get and I know insulin is going to be inevitable for me... I was wondering for you ladies who are on insulin - what changed after you were put on insulin?  (I.E. how long they will let you go without having to be induced, NST's, etc).  Thank you!!!
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Re: Changes in care after being put on insulin...

  • The only thing that changed for me was that I now have to have an NST and a biophysical profile each week until I deliver (started last week at 36 weeks). I am under the impression that if I were diet controlled, then I would just have the NST, but I'm not sure.

    As for induction, etc., I was told that there really isn't any change. They still won't let me go more than a couple of days past my due date and we will discuss induction/c-section at 39 weeks depending on LO's size and how favorable I am.

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  • Thanks! :)  My doctor said we won't do NST's if I'm diet controlled but we have one BPP at 35 weeks.  Also if I'm diet controlled he won't induce labor until 41 weeks (which happens to be DH's birthday, lol).  Maybe I should chat with him on Wednesday about it so that I know what's coming if I can't find a way to get my #'s down.
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  • Since I've been on insulin, I've been informed that they want to induce at 39 weeks. Also, I have weekly NSTs. I'm not sure about how frequently they are going to ultrasound me to check growth - I had one last week. I've been allowed to stay with the midwives, but I see an OB periodically to check on everything.
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  • I went on insulin after a week of monitoring the blood sugars so I'm not sure if what I'm experiencing is GD& Insulin related or just GD related.  I've been having weekly checkups since 32 weeks (really 31, but if my doctor hadn't been on vacation earlier, it would have started at 32) and have a NST at each checkup.  I had an ultrasound at 32 weeks (and due to low amnio fluid a "follow up" the next week) and will have another one at 36 weeks.  I also will have 2x weekly check ups at 36 weeks.

    I was told that if I don't go before the due date, I will be induced.  So far we haven't talked about being induced earlier and if the baby stays on target it seems like we'll wait until the due date.  I also asked if being on insulin meant I would have to be hooked up to an insulin drip or something since I have to take it 3x a day. However,  I was told that they rarely do that and that even though I am on insulin, it is well-controlled and at such low doses I will be fine.  That was a huge relief.    

  • With DD, I was diet controlled and there was really no change except a growth u/s at 38 weeks.  I was induced, but that was because they wouldn't let me go past my due date.  This time, I am having a repeat c-section, so I will have a scheduled date (and I only ended up with the c because DD's head was turned to the side and stuck in my hip...she was only 6 lbs 1 oz).  They also told me that since I am on insulin this time, I will have to come in for NST's and growth u/s 2 times a week once I hit 32 weeks.
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  • I get a weekly BPP and NST, and I am not allowed to go past my due date. I take insulin, but only at night for my fasting numbers. 

    I am trying for a VBAC, so he has to come on his own, with no medical intervention, otherwise I will be having a RCS. 

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  • Thank you ladies.  I really appreciate all of your responses! 
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