Blood sugars dropping at 31 weeks

[Becky 123]

Has anyone come across blood sugars difficult to keep up, as opposed to down! I'm 31 weeks pregnant and been insulin resistant up until now, and over the last 3 days have had to reduce my insulin dramatically. I'm eating real carbs again and still getting hypos. Please any advise would be great.
I was admitted to hospital this weekend but they don't know what to do, I have the diabetic clinic scan and baby doctor in the morning.

Any advise would be great from actual diabetics would be super helpful though

 

[1Sarah1]

Hi you need to speak to your obs/diabetic team about how much you have had to reduce your insulin by.
It can be a sign that the placenta isn't working properly and they will scan you and do Doppler tests and check the blood flow and growth etc. they might strap you up for continuous monitoring of heart rate for a while.
I know as I had pre eclampsia first pregnancy and sugars dropped and second pregnancy with twins my sugars dropped and they decided they needed to come out (born last month).
Both pregnancies born at 35w

Have you retested your basal rates have they changed or is it just your carb ratio?

What were you admitted for? Assume on the ante natal ward?

 

[Becky 123]

Hi Sarah

I've been admitted due to not being able to keep my sugars up and constantly having hypos. My basal rates have also dropped from 28 units to 20, and my carb ratio has dropped by 20% or more.

I've had the heart monitors on over the weekend and they say baby is happy. During one of the monitoring sessions I had a hypo my blood sugar went from 8- 3.4 in 30 mins her movements increased dramatically and her heart rate was up and down up to 180 and down 110. They kept saying it was normal. Once my blood sugars evened out she calmed down. Tbh I'm not sure they had ever dealt with a hypo before. I've found the whole episode quite as I kept mentioning the placenta and they kept saying that can't happen.... I think over the weekend is not a good time to be in, no one knew what to do.


Thank you again

 

[1Sarah1]

Hi have you got a diabetic or obstetric consultant specialising in diabetes pregnancy care? I think you need to speak to them.

They took it extremely seriously for me when my sugars dropped.

I think the stress factor of it all plays in too though

Can you feel baby moving?

Are you on a pump or injections?

I assume they did all your obs and your BP is ok and tested for protein etc

 

[Becky 123]

Hi Sarah, I have been in today for my appointments, they have reduced my insulin even more.
Growth scan all perfect, no protein +keytones, but none in blood. blood pressure slightly raised.
I'm on injections.
been told to monitor baby's movements closely and to go back straight away If anything has changes. Also I have a scan booked for 2 weeks time.
but other than that I'm not much further forward.

 

[azure]

@Becky 123 When you went in today did you see a consultant obstetrician?

What others have said above about the placenta is correct. My consultant warned me each appointment to watch out for hypos.

Do you write your baby's movements down? If you do that, then it'll give you a better idea about whether anything is changing.

Never be anxious about phoning triage if you feel uncertain. I know from speaking to the midwives that they'd rather check ladies than have them worry or miss something.

 

[Becky 123]

Hi Azure

I saw a members of his team but not the consultant, also I saw my diabetic team. They mentioned the placenta but didn't seem worried, as my growth scan looks good.

I don't keep a record of movements I wish now I did, so I have started to do this.

I'm back in clinic in 2 weeks, if my sugars don't resolve with the reduced insulin they say get checked to see if baby is ok.
With only being diagnosed this year I think it could be my pancreas spluttering also.

It's a constant worry

 

[azure]

If you've only been diagnosed recently, then your 'pregnancy pattern' might not be the same as ladies who've had diabetes a long time. Your pancreas could still be having little bursts of activity. So don't worry too much - that's a good thing as it may be a possible reason.

But always keep the hypo thing in your mind. It's good to be cautious

For the movements, you'll probably notice a pattern - eg baby always moves lots after lunch, etc. if you write it all down, it's easier to check back without thinking your imagining things. Don't just count, write a short note eg 'baby kicked lots of times between 2 and 2.15pm, 4pm baby turned round, and did a big kick, etc.

It's any change in movements that you're looking out for. And that advice is the same for any pregnant woman, diabetic or not.

I hope you get your hypos under control. Test lots and take it easy. Do keep us updated too. I'm sure everything's fine, but don't ever think you're fussing if you feel you need to go in for an extra check. That's what the midwife told me

 

[1Sarah1]

Hi me again
Growth scans only show that the baby has grown to a point ie retrospective view it's the current movements that really matters. Like Azure says write them down.

I had a feeling that something was wrong I know it might sound daft but one of my twins was seriously ill and it wasn't diagnosed on any scans only when he crashed in theatre- if you are concerned go back again and get checked out and ask to speak to the consultant.

Hopefully everything is fine but better to be safe than sorry x

 

[Becky 123]

I will be keeping on this, I've asked all the questions and if in any doubt I will go back and back.... I keep saying I think something is wrong but scans and heart monitors say different. It's very difficult as I'm sure you guys are aware.
I have started to monitor patterns of movements, she isn't the most active baby anyway, after being monitored at the weekend I know don't feel half of her movements.

Thanks so much for all your advice it's really helped and I know now to keep pushing and I'm not being paranoid.

 

[azure]

Trust your instinct. I know it's really stressful because once you start worrying, it's so easy to get paranoid. Keeping movement records will help make your judgement more 'scientific'. But if you ever feel something's wrong then ring and go in. You can also ask for a second opinion if youre not sure that you trust what's being said.

I was induced early because of just slightly reduced movements and my sugars not being as high as they had been. I didn't actually have big hypos or anything. I still can't say for sure if anything would have gone wrong if I'd not been induced then. My consultant said that there's no definitive test they can do for the placenta failing so that's why they give the hypo warning. It's a judgement call. You're quite a few weeks away from your due date so I can understand why they'd be cautious.

If you're anxious, could you ask to be seen sooner? Could you speak to your actual consultant on the phone? That might reassure you more.

 

[Becky 123]

When were you induced? It's really hard to get a happy medium I don't want to be the girl who cries wolf, and I don't want to get it irreversibly wrong.
Keep your fingers crossed

 

[azure]

My induction was at approx 36 and 1/2 weeks. My son had to spend some days in NICU because of a breathing problem. I sometimes wonder if I could have gone on longer, but I know I'd make the same decision again because I felt I had to. My induction had been booked for 38 weeks, but I just started to feel anxious and noticed a decrease in the insulin resistance and my baby just seemed quieter. When I went into triage, they listened to baby's heart and it was fine, but they decided to bring forward the induction as a precaution.

I know how anxious you must be. Could the reduction in movements be due to baby changing position? I noticed I felt more when my baby was facing a certain way. Once I got myself really worked up because I hadnt felt much for a day, but it turned out baby had moved. If you're aware of what position your baby is in, then you can judge whether their movements feel normal for that position. Also. If baby usually moves when you gently prod them, or have a cold drink, etc, and they don't seem to be doing that so much, then that can be useful information.

Don't worry about 'crying wolf'. When I was pregnant, I was on a pregnancy forum and one lady had called triage 9 times for reduced movement and gone in. Everything was ok though, and I remember she said triage told her they'd rather see 100 women unnecessarily than miss the one that needed attention.

Pregnancy is a time of worry - and doubly so when you have diabetes!

 

[Ash2014]

Hi Becky,

Agreeing with the others on placenta being the main culprit for the low blood sugars, at 35 weeks I was back at pre-pregnancy insulin due to low blood sugars, they admitted me straight away to monitor me and baby, all tests / ECG looked fine but baby went into distress 6 days later and they chose to induce, delivered a healthy boy at 5lbs 8. He avoided NICU too keep a very close eye on it and always trust your own instincts, mummy knows best.

Take care

Ash

 

[Becky 123]

Thanks, I wouldn't worry so much if I was a bit more pregnant but, 32 weeks is too early to make an appearance!! I suppose maybe we are a little luckier than others as we get a little warning with low BS. That's a big maybe though...... I've been into contact with nurse today, and reduced insulin further. How I wish there was a test to say for sure one way or another

 

[azure]

Becky, remember there are things they can do if someone's baby has to make an early appearance - things like steroid injections, for example. Hopefully, you and baby will be fine. And, as you say, now you've had a little 'alert', it'll be in your mind and you'll be able to watch now. That's a positive thing amongst all the worry.

Take care X

 

[1Sarah1]

Hi Becky
My twins born last month at 35w I had steroid injections and my little boy went into intensive care and had to have surgery for something not diagnosed ante natally. I was in another hospital with his twin sister for 2 wk. There were babies in special care born at 24w next to him. They can do lots these days.

With this pregnancy I went straight in to get checked with the sugars dropping. With my daughter who is nearly 2 (next week!) I didn't really know much about it and I was induced but ended up having a section as she was in distress because of the pre eclampsia.

I kind of think now that if I wasn't diabetic I wouldn't have these warning signs and things could be different and I now have a 2yr old and new baby twins (dd was 2 days ago!).

Have you written down baby's movements over past day?

Are you working as worry and stress can impact too.

Sarah x

 

[Becky 123]

Hi Sarah

I know there is so much they can do neonatal are an amazing unit, in an ideal world we wouldn't go in there. I'm so glad your babies are well. I am working which doesn't help, I own my business and lost a member of staff last week..... But this will be my last week, and I'm working minimal hours.

I've been keeping a record of movement patterns, I'm happy at the moment she is moving well. So far today I've not had a hypo X

 

[Becky 123]

Just like to thank you all for you help advise and support over the last couple of days. You girls are worth you weight in gold

 

[Ash2014]

I wish I knew this forum existed when I was pregnant, it's great for support and knowledge! Xx