GD moms on insulin

bellepeppers

Do you manage your own dosage or do you wait for your dr/nurse to tell you what to do?  If I see an upward trend for a few days, I will up my dosage by 2 units on my own and email my doctor and let him know that I did.  He seems to be fine with it.  Just wondering if this is the norm.

Also, how much insulin are you on? I started at 4 units of NPH twice a day at 15 weeks and now I'm 30 weeks and I've had to up it to 20 in the a.m. and 22 in the p.m.  I fear it's only going to go higher the next few weeks.  I'm already on an insanely low carb allowance (15 for meals and snacks) - and I'm still gaining weight!!! I thought that was supposed to be the only plus side of GD - low weight gain! I'm up 24lbs!  I'm being robbed  

Hope you're all feeling well! 

juliane2004

I have type 1, not GD, but that's how I do it. If I see it going up (or not being good enough) for 3 days, I increase my ratios/increase my insulin, and let them know later.

If I have a question (like how much to increase it by), then I email them before changing.

I'll answer the 'amount' question but keep in mind that I am type 1 (not GD), so it's a bit different.

I am 26 weeks, and I take one kind of insulin on a ratio for breakfast and lunch (novo rapid), one other type on a ratio for dinner (toronto), and a third type (levemir) for bedtime.  Overall, I take about 60-80 units for meals a day, and 60 units levemir at bedtime, totalling about 120 units per day. My ratios were MUCH smaller (much less insulin) prepregnancy. It's normal to increase every 5-10 days.

MiahT

I'm type 2 controlled with meds per-pregnancy and have been on insulin (in addition to metformin) since I was around ten or eleven weeks, with appointments every two weeks to check my numbers.  I take 12 units of regular/22 of NPH in the morning pre-breakfast, and 9 regular/12 NPH at dinner plus I have additional injections as needed on a sliding scale if my numbers are above 130 two hours after a meal.  I've also been told to compensate if I know I'm going to have a carb heavy meal, another 5 to 8 units of regular pre-meal.  So my insulin can change from day to day, depending on my numbers or if I have some pasta for dinner.  Some days I only need the two regularly scheduled injections, some days I need three or four.

misthang_1

I've managed my insulin with both of my pregnancies.  My GD case manager has taught me when to increase my dosage and she is comfortable with me increasing it as needed.  If I have any questions, I make sure to call her, but usually I just tell her where I am with my insulin at my appointments.  I was up to 60 units of Lantus and she moved me over to an insulin that is 5x stronger (Humulin).  She had me back down to the equivalent of 55 units of Lantus and I woke up with my sugars in the 40's, feeling dizzy...you better believe I was on the phone with her on a daily basis until we got the dosing right (apparently it worked better for me than she has ever seen, and I was taking the equivalent of 30 units of Lantus).

memali26

I was on insulin both pregnancies. My first I was seeing the dietitian/nurse and OB weekly and they would adjust my doses at those appts. My second, I saw my dietitian/endocrinologist monthly (I was diagnosed much earlier the second time) and if I needed adjusting in between I would call my endo. They usually got back to me within an hour and would let me know over the phone how many units to go up. I could have adjusted it myself and I think my endo would have been fine with it, I just felt better calling first.

As far as amounts, it depended on the type of insulin. With DD1, I was on long acting only (Humulin N, I think?). I started at 10 units at bedtime, and by the end of the pregnancy I was up to 24 units at breakfast and bedtime and 4 units at lunch. 

With DD2, I was on Humulin N at bedtime (started at 5 units, upped to 22 by the end) and Humalog (rapid acting) with all three meals. I think we started at 3 units with each meal, and by the end I was at 7 units with breakfast and lunch and 8 units with dinner.