37 weeks, insulin, perinatal, ok for high numbers....?

alkinney

I am being sent to a perinatal dr. at 37 weeks because my GD has become unresponsive to Glyburide, diet and exercise.  Kind of a major bummer.

I am being induced at 39 weeks, so I am guessing that I will be put on insulin for the remaining 2 weeks.

Here is my question:  It is Tuesday, and I can't get in to see them until Friday morning.  That means that I have to make it 2.5 days with high numbers.  To give you an idea, my ranges have been 115 for fasting, 140-160 1 hr. post breakfast (of only protein), and 130-145 for 1 hour post lunch and dinner (regular GD mealplan). Isn't it bad if I have these numbers for a few days?

I assume it's ok because my Dr. made the appt... but sometimes I wonder.  Curious what you all think and what your experiences have been.  Thanks!

sunnybrook.

I was on insulin when pg with twins last time. I'm now 35 weeks pg and just started insulin yesterday when Glyburide stopped working for me. Generally when you get farther along in the pregnancy, your numbers will start to raise. Insulin is a lot easier to adjust since its an immediate response. They'll likely adjust your insulin dosage every few days. I asked my perinatologist what you're asking. The two key things are that you and baby are being monitored (BPP, NST, AFI, etc) and that your numbers are under control when baby is born. He reassured me that past high numbers don't matter. They just have to be in the normal range when the baby comes. It sounds like you'll be ok. I know it's hard not to worry though!

DBride2006

I'm not a doctor, but I *THINK* they keep the ranges on the super-conservative side, just to be safe. (Some people don't stick to it, to be extra cautious, etc.)

So, I think the ranges you listed are ok for a few days while you figure out your insulin plan. I would probably eat as high protein as possible and walk after every meal to do what I could, but not stress about a couple days of somewhat high numbers.  

My dieticians also told me that insulin resistance peaks at 38 weeks, so you MAY start getting a little break soon.  

MamaEngland

I don't have gestational diabetes, but I am a Type I and pregnant so maybe I can offer a few words of comfort. I agree that your Dr would have set an appointment for as soon as humanly possible if he/she felt you or your little one were at risk. I know 160 seems high, but when pregnant, the range we're expected to fall in is fairly low in comparison to what a non-pregnant diabetic person faces. Whether GD or not, most women see higher sugar levels for numerous reasons starting as early as 26 weeks. Although you wouldn't want to spend your whole pregnancy this high, these few, short days should do no damage. One of the GD patients at my MFM clinic just had a very healthy baby and her sugar levels stayed up in the 160 - 180 range for her last few weeks. One of my greatest comforts is knowing that plenty of diabetic ladies of all types have had healthy babies for many years (even back in the day when diabetes management at home was utter ridiculousness).

alkinney

Thank you for all of your feedback.   This has helped tremendously.  Fingers crossed for a good appt.

MotherMonster

The reality of it is that your numbers are good! Most of the time the reason they want to look at 1 hour after meals is that it sees how well your body is reacting to the medication.

I'm a type 1 diabetic as well.

115 is considered a higher fasting number even for the non pregnant diabetics, but it's not bad.

Also know that glucometers can be off 15% to 20% so it's not an exact science. 

However I am very refreshed that you're doctor is okay with you staying within non pregnant range!

Usually it's 140 max 2 hours after eating and 110 max for fasting when not pregnant.