STM+ with Type 1 Diabetes

tpete12 · May 2015

I am type 1 diabetic and currently 22 weeks pregnant. I have been thinking about delivery lately and was wondering how much different a diabetic delivery is compared to a "normal delivery?" Do they take baby away right away and check it's sugar levels? Do you stay in the hospital longer? What happens to your insulin dosage after you deliver?? I will take any info to help me prepare myself for the delivery room!!

Seed0824 · May 2015

I also have T1D at 27 weeks. I asked at my hospital and they told me I can have the baby immediately and do everything normal assuming labor goes normally. They can even do many checks while baby is on me. As for my insulin, my endo is supposed to provide me with rates to start using postpartum. And I don't stay in the hospital longer again unless there is a problem.

missnacholover · June 2015

I had a scheduled C-section. I wore my insulin pump and CGM and monitored myself throughout surgery/recovery (with nurses overseeing me). It went smoothly.

My daughter was born with very low blood sugar and unfortunately it took a 5 day NICU stay to bring it up. But I think that is out of the ordinary so I don't want to scare you.

tpete12 · June 2015

Thanks for the info. I am expecting something similar to your situation @missnacholover. I think if I prepare myself for a longer stay, a smooth delivery/release will just be a bonus. I plan on asking my doctors these questions, but I will wait until a bit later in the pregnancy.

missnacholover · June 2015

I hope everything goes smoothly @tpete12. I was expecting some time in the Special Care Nursery but it was definitely a little longer than I expected and in the NICU, which wasn't even on my radar.

BUT, my daughter is happy and healthy now, which is what's important. We D-mommas rule!!!

leylacorbett1 · June 2015

I am a T1D, 22 weeks pregnant with first. I too am terrified. It's just one of those things where everyone is different so we won't know until we are there experiencing it. My friend who is also a T1D delivered naturally a year ago. She wore her pump during labor but told me she didn't need insulin for 24 hours after delivery because once baby and placenta were delivered she was extremely low.

missnacholover · June 2015

leylacorbett1 said:

I am a T1D, 22 weeks pregnant with first. I too am terrified. It's just one of those things where everyone is different so we won't know until we are there experiencing it. My friend who is also a T1D delivered naturally a year ago. She wore her pump during labor but told me she didn't need insulin for 24 hours after delivery because once baby and placenta were delivered she was extremely low.

Yes, definitely have a post delivery plan for basal rates. I ran pretty low as well.

leylacorbett1 · June 2015

Did you drop almost immediately? Maybe it would be best to remove pump completely and just use injections as needed for a day or so?

tpete12 · June 2015

^I second this question

PedsIsHardcore · June 2015

I am a type 1 diabetic and this is my 2nd pregnancy. I would talk to your doctors about expectations. I am pregnant in Kansas this time. Last time I was in South Dakota. Totally different ball game! Your doctors will tell you what is expected better than anyone on here can.

jham201 · June 2015

Wow. I am going to write down these questions! I am 20 weeks today and I feel like I am just trying to get through right now. I probably should be thinking further ahead too.

leylacorbett1 · June 2015

Being T1D are we at risk for preterm labor? I am to be induced Around 37-38 weeks but curious if I could go into labor naturally around then or before then.

PedsIsHardcore · June 2015

I would say no from my research and info on diabetes in pregnancy. You can always possibly go into labor around or before depending on what other factors play into things. However, I would want to know why you are being induced around that time when protocol is to induce at 39 weeks for diabetics.

missnacholover · June 2015

leylacorbett1 said:

Did you drop almost immediately? Maybe it would be best to remove pump completely and just use injections as needed for a day or so?

It wasn't like an "OH SH*T, I'm LOWWWWWW" situation. I actually programed my pump to my post-partum rates before my C-section and had my DH manage it during surgery to give me "micro boluses" if I started creeping up. Luckily I was steady in the 140s for the entire morning of delivery and surgery.

After delivery, I wasn't low as in I was in the 50s or anything, but I hung out around 70-90 for a few days. My endo gave me a post-delivery plan for my basal rates and it was about 35% of what I was taking during the final weeks of pregnancy. And I also went back to my pre-pregnancy I:C and ISF as well. I had it all written down in my "Diabetes management" folder that I brought with me to the hospital. I also made sure to pack my pump manual so DH could make adjustments if I wasn't able.

Also, bring your own juice boxes and snacks because if you do go low, you don't want to have to wait for the nurses.

I have a CGM so it wasn't terribly bad to manage. I just had to remember that a unit of insulin for a piece of bread was fine, whereas while pregnant, I'd need like 10 units, haha.

Also, if you are on the pump, make sure that you put your site in a spot that won't be affected by a C-section close to your EDD if possible! I had mine on my upper butt.

I think just err on the side of caution and you'll be OK.

Remember, we know our diabetes best. Trust your instincts!

jham201 · June 2015

Thanks! That is some great advice and I am going to keep it in mind as I get closer to delivery!

STM+ with Type 1 Diabetes

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