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In L&D for Insulin Adjustment (long)

orriskittenorriskitten member
in High-Risk Pregnancy

Hi ladies!

I'm on day two of being admitted to L&D to get my insulin under control. My numbers were not TOO crazy, but the MFM I am seeing didn't feel comfortable being aggressive with my treatment and increasing to the number she thought may work while I was home. So she asked when I could get my affairs in order and I decided yesterday was as good as any day, so here I am.

I am very frustrated. Rather than going off of what I was on and adjusting from there, she decided to scrap the entire regimen I was on and start fresh from my weight. My insulin injections were as follows up until yesterday:

Morning: 12 units regular, 14 NPH (long acting)

Before Dinner: 12 units regular

Before bed: 12 units NPH.

As of today/last night this is what I have:

Morning: 16 units regular, 34 NPH

Before Dinner: ??? (they wouldn't let me talk to a doctor and were not going to increase my insulin for dinner when I've been consistently high, so food did not get here until 8:30, no nurse came in to give me insulin so when we asked for a third time, she said it was too late)

Before bed: 13 units NPH

My fasting numbers have been the highest and increasing it by one unit did nothing (had a 113 fasting today). Then my "diabetic" breakfast came.  It consisted of a belgian waffle, a cup of oatmeal, milk, syrup (FFS!) and coffee. No protein. Then I was assured that a nutritionist designs this meal. Ummm... what nutritionist?! I have yet to meet with this mysterious woman and made a stink about it. Managed to get some cottage cheese and didn't eat the oatmeal. I was then given the okay by a resident to bring in my own food so that this "experiment" (her word) would be more accurate. After she made a point of earlier telling me I was to eat only what the hospital provided.

I was alarmed with the increase of my NPH because some days my after lunch numbers are just fine (113, 118) and I do have lows in the 80s on some days between meals. At least if something bad is happening, it will be in the hospital. Now I'm just waiting afraid to sleep because it won't wake me up if I bottom out.

I am kinda at my wits end and just trying to keep it together. DH is a saint and sitting with me, slept curled up in a reclining chair last night and all I can hope is that they will figure something out and I can be released before my shower, this Saturday. Although that is pretty low on the priority list right now.

Thanks for listening to my rant/whatever this is. I didn't sleep last night and poor DH is getting upset by my being upset lol. Being hormonal just doesn't help either and if one more doctor says they don't have the time for me, I just may scream.

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Re: In L&D for Insulin Adjustment (long)

  • kpowers982kpowers982 member
    Okay, I realize this is totally easier said than done, but you have to do your best to relax!  Stress can affect your sugars.  And I would confirm with whoever you can talk to about what kind of diet you're on...when I was hospitalized, I was on the GD diet, and it was NOTHING like what you're describing!  Although the holding of meals until your sugars are reasonable, etc they did with me too.  Although I was under strict orders not to eat anything other than what they brought me, so I'm kind of blown away that they're letting you bring in food.  Good luck and I hope you get out of there soon!
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  • Loribelle73Loribelle73 member
    That sounds awful.  I hope they get your dosage figured out soon!
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  • orriskittenorriskitten member

    imagekpowers982:
    Okay, I realize this is totally easier said than done, but you have to do your best to relax!  Stress can affect your sugars.  And I would confirm with whoever you can talk to about what kind of diet you're on...when I was hospitalized, I was on the GD diet, and it was NOTHING like what you're describing!  Although the holding of meals until your sugars are reasonable, etc they did with me too.  Although I was under strict orders not to eat anything other than what they brought me, so I'm kind of blown away that they're letting you bring in food.  Good luck and I hope you get out of there soon!

    They weren't exactly with holding food- they just didn't have any on the floor and there wasn't going to be any until breakfast and I hadn't eaten in hours at that point.

    I met with the dietician and she said that there is a "secret menu" of basics that are always available, just not printed and that the regular patients know that. She has worked with my usual dietician, so she said I can either try to piece together my meals from the menus offered here, and supplement with food I can have people bring me and some snacks she brought me (light yogurt, peanut butter and cottage cheese). My numbers have been pretty steady aside from my breakfast of belgian waffles, ranging from 116-140.

    I have some severe white coat syndrome so they know my numbers will be elevated (this was confirmed by the dietician, MFM and nurses/residents) so they are not aiming to get me perfect before they release me, just making sure I don't crash too low to be in danger and then they will gradually increase me once I'm home and no longer stressed. My daily insulin has been increased by 27 units of nph and  13 of regular. They couldn't do it out patient, but after these increases and possibly one more increase tomorrow they will release me and then continue to more gradually increase (probably in 2 unit increments)  until I find the right numbers that work for me on my usual diet, doing my usual thing.

    Its a relief, but I still cannot wait to get home.

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  • mmookimmooki member
    NPH has a pretty drastic peak, from what I understand.  Those insulins require strict meal times to deal with the peaks so your blood sugar doesn't crash.  I am surprised they let you go that long without eating being on those insulins.  There are other options for insulin as well.  Logs and Lantus as opposed to NPH and Regular.  Hang in there!  Hope you get things sorted soon!
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  • orriskittenorriskitten member

    imagemmooki:
    NPH has a pretty drastic peak, from what I understand.  Those insulins require strict meal times to deal with the peaks so your blood sugar doesn't crash.  I am surprised they let you go that long without eating being on those insulins.  There are other options for insulin as well.  Logs and Lantus as opposed to NPH and Regular.  Hang in there!  Hope you get things sorted soon!

    For some reason, this hospital/MFM only does the NPH and Regular. Today it finally started working, so fingers crossed I'll be going home tonight! If not, then definitely tomorrow morning.

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