Steroids at 38 weeks & being admitted to hospital

[VP83]

hello all

T1 diabetic, 34 weeks pregnant, things seem to be going well with everything. HBA1C was 36 at last check, which is the lowest I have ever managed - definitely all thanks to my CGM.

Consultant has said that I will need to be admitted to hospital for two days prior to my induction date at 38 weeks, for steroids. I understand that these are going to raise my blood sugars rather a lot, and as I am on MDI they will want to put me on a sliding scale. With some of the slightly worrying dealings I have had with various mid wives/nurses at the hospital (have been noted as a T1 diabetic, T2 diabetic and having GD in different places in my notes.....and some people don't seem to know the difference!) do you think it is feasible for me to self manage my blood sugars by increasing my basal dramatically, and then topping up with bolus when I need it? Don't mind doing +20 injections a day if it means I can be in control of my blood sugars myself.

Sorry for the long post.....getting nervous now!

 

[azure]

@VP83 Have you been told why you need steroids at 38 weeks? That sounds unusual.

 

[VP83]

@VP83 Have you been told why you need steroids at 38 weeks? That sounds unusual.

Apparently it is the norm for T1's with this particular consultant. He has published various research papers that show a clear decrease in babies being admitted to neonatal, if steroids are given if the babies are born at/before 38 weeks.

I understand that I can refuse to take them, but this was something he was fairly firm about, and I think I need to listen to the wise man on this. I didn't realise that it was that unusual though, might do a bit more reading on the subject.

 

[VP83]

Sorry....posted too quickly. The steroids are to help the baby's lungs be ready.

 

[sekv]

Hi VP83.
I had a planned induction at 37+2 weeks due to my insulin needs decreasing to pre pregnancy needs (I'm type 1).
I didn't have steroids and was told these aren't given unless baby was less than 37 weeks.
I am also on MDIs and was very unsure of being a sliding scale but I have to say, I would definitively have it again. I didn't have to worry at all about controlling my diabetes and could focus completely on the labour. I am a control freak and didn't think I'd be able to let someone else be in control but it was a lot easier and my control was fantastic. I had to test my levels every hour (or my husband did it for me) and then they adjusted the scale if necessary.
Hope that helps

 

[azure]

@VP83 If he's published research, it would be sensible to look at it and ask any questions you might have so that you're happy in your own mind about the steroids.

Like @sekv I was told I wouldn't need steroids unless I gave birth before 35/36 weeks. The consultant did mention lung development is sometimes behind in babies of diabetic mothers though. I guess the professional opinions vary.

There's a lady on here who had steroids and stayed on her pump. A Search might find her (sorry - I can't remember who it was). I'm not sure about MDI but, again, a search may turn up some info.

No one can make you go on a sliding scale if you don't want to. If you're uncertain, could you perhaps wait to see if your BS rises out of your control?

Congratulations on your HbA1C Don't be nervous - there's no need to be Do lots of reading and mental preparation, and enjoy your last weeks of pregnancy

 

[VP83]

Thank you azure and sekv! Will do some more research and discuss further I think.

 

[jade88]

Hi VO83 I was induced at 38 weeks but was not given steroid injections - I too was told I'd only need these if induced before baby was classed full term. I went on sliding scale - I was wary of this and queried but my diabetic midwife advised it and I'm so glad I listened once in established labour I couldn't even test my bloods (my partner did it for me!) let alone work out how much insulin to take! But it's completely your decision nobody can force you to do anything you are not comfortable with! Good luck! xxx

 

[Postitnote]

I Wass induced at 37+4. steroids weren't even mentioned. I refused the sliding scale and successfully managed on MDI although my husband was testing my sugars for me! Similar reason to yourself I think; I didn't trust the staff to manage my BS as well as I knew I could. It wasn't too tough though as I wasn't allowed to eat or drink anything (except in the case of a hypo)!