Control Of Diabetes During Labour

Sarahstar82

Active Member
Messages
31
Type of diabetes
Type 1
Treatment type
Pump
Hi, I'm hoping someone could enlighten me regarding how normally diabetes is controlled during labour now a days. I'm currently 30 weeks, type 1 and on an insulin pump. 9 years ago when I had my daughter I wasn't on a pump and a sliding scale was set up. During labour my blood sugars shot up and I developed an infection. I was very close to having an emergency c section. Recently I found out from my sister who is a nurse and was there as my birthing partner that they hadn't actually connected me to the sliding scale drip, she realised they had forgot and had to do it herself, she also had to take over doing my obs. We both understood they were run off their feet but as you can imagine this does leave me with some anxiety. The actual induction and birthing of baby I have faith they'll be great. Is it practical for me to control my diabetes myself with my pump? I have asked a midwife and she basically shrug her shoulders and said talk to your DSN as midwives aren't medically trained and that her herself wouldn't deal with a high risk birth like mine and couldn't my sister be my birthing partner again! My husband was sitting next to me! and wasn't pleased. This same midwife asked if I'd done my glucose tolerance test then talked about her type 2 diabetes I honestly wanted to cry.
 

1Sarah1

Well-Known Member
Messages
304
Type of diabetes
Type 1
Treatment type
Pump
Hey @Sarahstar82 dont stress!
So I was pumping through both my pregnancies. My daughter who is 2 (also t1 and pumping!) - I had pre eclampsia and they induced me early with her. It didn't work so ended up having emergency section. My sugars did go up a bit when I was induced due to stress I think. Anyway I kept my pump on throughout and through the section. I went onto sliding scale afterwards and changed back to the pump about an hour later.
With my baby twins I was adamant I wanted to keep my pump on and just made sure they checked my sugars during to make sure I wasn't too off track. I was written up for a glucose prescription as in effect that's the other side to sliding scale. I kept my pump on throughout and no sliding scale. You have to test all the time anyway.
You know your diabetes best and hopefully you will have an idea on how you want it to be managed. My consultant was surprised I kept my pump on but very supportive. They just want the best outcome for you and baby xx
 

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
Hi @Sarahstar82 I kept my pump on thoroughout labour and delivery :)

You should be able to choose what you prefer, unless there are special considerations.

I advise you to add your choice to your birth plan. The midwives were fine when I was in labour. All they did was ask me what my BS was when I tested it and added it to their records. They didn't fuss about my pump at all. My OB had written in my hospital notes that I'd be wearing it and controlling my own diabetes. My pump didn't get in the way at all during delivery :)
 

Sarahstar82

Active Member
Messages
31
Type of diabetes
Type 1
Treatment type
Pump
Thank you @1Sarah1 and @azure, you have eased my anxiety, I'm a control freak when it comes to managing my diabetes and pump. part of me would love to just deal with the birthing side and give complete control of diabetes management over to someone else but I doubt I'll feel comfortable with that. Knowing that it's perfectly OK to stay on a pump means I can plan with husband how I want to manage it. I do like to plan ahead but a lot of midwives and specialist say it's too early to go into it, I'd rather not spend the next 8 weeks feeling anxious. Thank you
 

hels

Well-Known Member
Messages
311
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I am on MDI not a pump but thought I'd share my experience.
My first son I was on sliding scale which I believe was the preferred control at the time (3.5 years ago and I was quite newly diagnosed).
My second son, 18 months ago, they were happy for and recommended that I controlled myself and would only consider sliding scale if I struggled to keep control.
 

Charisma_1630

Well-Known Member
Messages
204
Type of diabetes
Type 1
Treatment type
Insulin
When I had my first 4 years ago I was on injections. But I was so high on all the drugs I couldn't have told you which day of the week it was never mind remembering to test my sugars. If I remember right they tested me hourly, then I went into emergency c section after 5 hours and had a nurse in there with me testing my sugars. Well done to those who manage to stay level headed enough to control your pump during
 

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
My partner helped by being 'in charge' of my blood meter and reminding me to,test. I found my sugars remained very good. I ate lightly and had no problems with control.

During the induction, testing was just like a normal day, if you see what I mean - not a distraction. As for the actual delivery, I completely forgot about my pump and my whole focus was on my labour and my baby :)

Don't worry :)
 

Pitsgate

Active Member
Messages
40
Type of diabetes
Type 1
Treatment type
Pump
I also stayed on the pump during the induction & deliver y 2 years ago, and it worked great. My husband was in charge of the testing and marking up results (and dealing with the pump too), don't think I would have quite managed it by myself towards the end.

Keeping the pump was in the birth plan but we still had to say 'no thanks' to sliding scale several times - it all took a few days & shifts so whenever a new nurse or doc came by they seemed somewhat unsure about it but it wasn't a big fight at any point. Having the good results to show on paper helped x
 

Sarahstar82

Active Member
Messages
31
Type of diabetes
Type 1
Treatment type
Pump
Thank you all for some insight into how you managed your diabetes during the birth of your babies. I had a great chat with my husband and we both agree that if I'm capable of managing it myself I should and he'll be there to help with blood testing if needed. Also we'll have the sliding scale as a backup if it all gets too much.
 

tigger

Well-Known Member
Messages
558
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
registrars asking silly questions
My dsn advised putting a temp basal of 50% in labour but thought I'd be on a sliding scale. In the end i managed to keep the pump throughout. I'd randomly set a number of hours for the temp and weirdly the baby was born 10 mins before it ended. Maybeif i'd set a shorter one i'd have had a shorter labour....
 

Loulou52

Member
Messages
24
Type of diabetes
Type 1
Treatment type
Pump
Had ds2 seven weeks ago. On pump and used the freestyle libre alongside blood testing. Was a totally different experience to being on a sliding scale as I was four years ago for ds1. DH scanned the libre every 10-20mins during active labour. I instructed action based on results used in tandem with blood glucose. suspended insulin a couple of times (long labour) but was a good distraction and I avoided hypoglycemia or readings above 7.5. My consultant had put instructions in for the midwife which basically said let me do controlling of diabetes unless BG won't come down and are over 7.5, 3 times in a 3 hour period. If BGs don't come up give glucose drip. Such a positive experience in the context of the diabetes and allowed for DH to feel properly involved. Good luck!!
 

Sarahstar82

Active Member
Messages
31
Type of diabetes
Type 1
Treatment type
Pump
Thank you @tigger and @Loulou52 for your input. I'm 34 weeks and soon will be getting a date for induction. Next week I see my DSN who will set my pump for pre and post labour. From what I gather the diabetes team would prefer me to be on a sliding scale and feel that I should concentrate on labour and allow the midwives to deal with the blood sugars. They have said that they will help if I want to stay on a pump but if my bg goes to 7.9 I have to be put on the sliding scale. The diabetes team will be putting together a strict plan so I have no worries. I just need to decide what is best for me. At the moment I have to refill my pump daily and may find it too much hassle if I have to do that whilst in labour. There are a few things I need to consider before I make my mind up. Either way I'm feeling confident, calm and excited.
 
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