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Changing onto a pump while pregnant?

Discussion in 'Pregnancy' started by saruhbeau, Aug 22, 2017.

  1. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    I recently found out I am pregnant. It wasn't exactly planned but I was getting healthier in order to get pregnant so I am happy, just shocked and anxious! I think I am at least 10 weeks but it's such new news I am waiting for an urgent scan.

    I was on the waiting list for a pump but now I am pregnant my DSN is applying for funding urgently so I can start the pump as long as I'm 12 weeks+

    I just wondered if anyone else has been in this position? How long should it take to get basal rates right etc? I've already noticed my insulin needs have increased. My last a1c was 6.9 so not bad but could be a lot better.

    I have had 6+ weeks of extreme nausea and vomiting leading to two admissions, which has made it harder to control my levels. If I go hypo it can be impossible to keep anything down to bring it up. I'm hoping the pump will help.
     
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  2. azure

    azure Type 1 · Expert

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    Congratulations @saruhbeau ! :)

    We do have ladies here who've swapped to a pump when pregnant or shortly before conceiving.

    It can take a little while to get your basal rate right, but pregnancy is a time of changing basals anyway, so that is something that even an experienced pump user would need to consider. If your team think a pump would be good for you, then I'd imagine they've considered all this and are confident it would be right for you.

    It took me a week or two to sort my basal but that was because I was lucky enough to have a good pump trainer who pretty accurately guessed what I needed, so that was a good starting point and made things easier. I woukd guess you'll get extra pump support anyway being pregnant.

    The pump won't immediately help if you're having a hypo and, as you know, pregnancy hypos can be sudden and fierce. I used Lucozade but if you can't even keep that down then chewing a glucose tablet and holding it in your mouth can help.
     
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  3. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    Thank you @azure :)

    I was hoping to start pumping before trying to conceive, but I know there's no point regretting that now. I am amazed I got pregnant without trying and extremely grateful as I always imagined I would have trouble conceiving.

    That is good to know other people have been in a similar position. I also have quite bad retinopathy and some maculopathy and have noticed my visions been blurred for over a week. I have an extra eye screen next week and my dating scan is next week too, so I am anxious to get those done.

    Thanks for the tip about glucose tabs. Luckily they are one of the things I haven't gone off, and on the days I am being sick every 30 mins I use them for lows.

    My GP just prescribed omeprazole which is safe in pregnancy and that has definitely helped, along with ondansatron which I am only taking when the vomiting won't stop. I am really hoping it subsides as the pregnancy goes on.

    Hopefully it shouldn't take long for funding. I think I am between 10-15 weeks but really have no idea. I'm hoping being on the pump will make doing small corrections easier as it's hard with such tight targets. At the mo if my bg is 8 and I do 1u I would go hypo.

    Were you pumping during your pregnancy/s births?
     
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  4. azure

    azure Type 1 · Expert

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    The vomiting sounds awful @saruhbeau I didn't have anything like as bad as that. I'm glad the meds are helping. I had normal nausea and that eased off around 14-20weeks (it varied for each pregnancy). I hope yours reduces soon.

    Yes, I pumped during pregnancy. It does make thing a lot easier, particularly for basal adjustments. Your basal needs will change a lot during pregnancy and a pump will allow you to make changes to more accurately suit your body's needs. As you say, the ability to do tiny corrections is also very useful. It helps you stay on target without risking an overcorrection and hypo.

    I also found my pump fantastic during labour and delivery. I obviously had to test my BS regularly, but apart from that, I almost forgot I was diabetic and could mainly focus on labour. My BS stayed controlled throughout, and I kept my pump on the whole time :)

    Just a thought - could you get a half unit pen while you're waiting for your pump?

    .
     
  5. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    The nausea and vomiting is awful but I am not that surprised as just taking the pill made me nauseous and vomit too, I am very sensitive to hormones. In a way it's a relief to know what is causing it. I thought it was severe gastroparesis before doing the pregnancy test and was waiting for a gastro referral! I haven't vomited in 2 days now which is great and I am hoping that means it is easing off :)

    The nausea and vomiting has been replaced with frequent and severe hypos. I know part of that is because I am correcting with too much insulin. I am testing a lot and over correcting. Which I know I need to stop cos it isn't helping - it is just leading to yo-yoing. I seem to be more sensitive to insulin. I'm hoping that will settle down as atm I am really concerned I am harming my baby :( it will be a relief to have my first scan.

    I would need to change from humalog to novorapid to get a half unit pen. But that is a good idea and would make things easier for now. I don't mind changing to novorapid if my dsn can organise it without it taking ages. I will send her an email now actually!

    I would really like to avoid going on a sliding scale in labour and I hope the pump means that is possible.

    Thanks for your help @azure it's great to hear from someone whose been through pregnacy etc on a pump. I'm sure I will have lots of questions once I get my pump get more pregnant!
     
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  6. azure

    azure Type 1 · Expert

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    There's a hal unit pen for Humalog - Humapen Luxura HD :)

    Pregnancy hypos are very common - and very fierce. You definitely want to try to avoid overcorrecting as the actual hypos are bad enough. They're strong and unpredictable. I had to reduce my basal and snack on carbs with no bolus.

    Fingers crossed your vomiting is easing. That must be ten times harder with the diabetes too.
     
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  7. ringi

    ringi Type 2 · Well-Known Member

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    Is it possible to get a hospital chemist to dilute insulin?
     
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  8. azure

    azure Type 1 · Expert

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    There used to be paediatric insulin solutions but I don't think they're available now. A half unit pen generally suffices, depending on the correction factor.
     
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  9. tigger

    tigger Type 1 · Well-Known Member

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    I started on a pump with my last pregnancy. I asked for one on finding out I was pregnant (never wanted one before) and got it 5 weeks later so started pumping around week 9. It took a while to sort out the basal but it's definitely doable. As a result of having it I avoided any of the really bad nighttime dips I'd had in previous pregnancies. If you possibly can get a cgm or libre for your first few weeks to help work out your basal. If they'd been around then I would have paid for a libre myself as it's such a help in checking your basal is right.

    Good luck!
     
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  10. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    Thanks so much @azure :) I'm a pharmacy technician and had never heard of that! I emailed my dsn asking her but found out she is on holiday, but have been given a diabetic clinic appointment next Tues.

    @tigger thanks for sharing your experience :) I was using dexcom up until a month ago, self funded. But I have had hyperemisis gravidarum and have had the last 6 weeks off work and I just can't afford it now. I am going to see if the clinic will provide me with one sensor while I get basal rates sorted but know I will probably have to find the money from somewhere.

    So I had my scan this week! And found out I am 16 weeks and having a baby boy so shocked I thought I was nowhere near 16 weeks. They did all the checks they will repeat at 20 weeks too, and everything looks perfect. I am so grateful!

    Since then I have seen the diabetic midwife, had bloods etc. Been referred to a dietician, and have an appointment with the obs consultant who sees diabetics in 3 weeks.

    They have also made me a diabetic clinic appointment for Tuesday. I am hoping there is some news on the pump because I am really really struggling. When people said diabetes is harder in pregnancy I didn't appreciate how hard, with the added anxiety that it may harm the baby. I had a severe hypo of 1.3 on Wednesday and nearly needed an ambulance. Happened in my sleep. 1u drops me too much and unless I eat (which is hard with this sickness) I can't safely correct unless I am 9mmol/l. Dexcom would make this so much easier!!

    I also had my eye screening this week as I have quite bad retinopathy. And also given fragmin today which I am told I must injection daily until 6 weeks after baby comes.

    I feel well looked after anyway!
     
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  11. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    [​IMG]
     
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  12. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    Sorry to post again but I don't want to make a new thread so will update here. I am starting my pump on Wednesday!! Funding has come through :)

    My hba1c is 48/6.6 which is better than I thought. Previous to that it was 6.9. Also had other blood results for liver and kidneys etc and they are all fine. I had the results from my retinopathy screening which shows maculopathy and severe pre-proliferative retinopathy but I already know I had both of them. My diabetes consultant has sent a letter to eye clinic asking for them to see me urgently. I feel very well cared for by the NHS since finding out I'm pregnant I can't fault them
     
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  13. azure

    azure Type 1 · Expert

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    Great news @saruhbeau ! :cool: Both about your pump and about your HbA1C :)

    It sounds like you're getting really good care. XX
     
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  14. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    Thanks Azure! I started my pump on Wednesday

    [​IMG]

    It's been a difficult few days.. and my DSN went away on holiday on Friday for 10 days so not the best timing, I spoke to her on Thurs though.

    I have been left to it to change basals although she did give me instructions. I feel more confident than I did on Thursday hah! At first I was on a fixed basal rate every hour, but I have increased it from 2am til 6am where I seem to go high. I'm going hypo every evening too so am reducing that 2 hours before I am going hypo to start tomorrow.

    It has been a bit worrying to see my levels a bit all over the place. I'm testing every 2 hours though (got through 50 strips since Wednesday! )

    Had a nightmare this morning where I woke up to find my kitten had chewed completely through the tubing and blood sugars were 20! Highest they have been since I got pregnant...need to get a pouch or something to hold it.

    I'm not missing injections that is for sure :) I expect as soon as basal levels are sorted my insulin requirements will increase.... I am just over 18 weeks and have noticed my insulin carb ratio and correction factor have changed so I need more insulin. Guessing it will just keep rising now!
     
  15. Antje77

    Antje77 LADA · Well-Known Member

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    Congratulations with your pregnancy and say hello to your kitten from me. Highs suck, but kitten-induced highs are much better than most!
     
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