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weight gain and insulin resistance

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the_anticarb

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Please can someone help - I have gained a considerable amount of weight with my pregnancy around 2 stone. Gave birth two months ago and have found post pregnancy it is much harder to control my blood sugars. I seem to need about twice as much insulin both basal and bolus as I did before. Whereas before I could have the odd snack between meals and not need to inject I now find that if I eat any carbs inbetween meals I will need to inject or else it pushes my blood sugar high. Even relatively innocous foods such as wholemeal bread will send my blood sugars quite high if I don't inject quite a lot of insulin to cover it and then of course if I get the dose wrong I am running the risk of going hypo etc which just adds to the stress of it all.

Is this likely due to the weight gain? Or is it just a sign that my diabetes has become worse and there's not much I can do about it?

I'm getting a bit fed up about this, don't want to be injecting loads of insulin all the time as that won't help me to lose any weight, thinking I will have to give up carbs at least until I have lost the weight does anyone have any other ideas/suggestions - thanks
 
Hi,

Quick question...are you breast feeding? If you are, then all the hormones involved in this process so have an impact on your insulin requirements etc. If you aren't, I believe it take a while anyway for your hormones to return to normal. It was about 6 months for me..but I don't know what is typical.

If you had one, give your diabetes specialist midwife a call. I had a follow up with her at 6 weeks which was useful.
 
hi sugar2 - just tried to call her but she can't help me any more now I have delivered.... honestly the peeople on here are more help than the medical professionals. And apparantly the other dsn's at the hospital can't speak to me without a GP referral - nhs bureaucratic red tape...
 
Hi anticarb,

When I was finally referred to the diabetic clinic I had nearly a four week wait between referral and clinic date. My DSN told me that they have a working agreement with GP practices that if the GP rings up and speaks to someone they will try to fit you in as an urgent case. Wish mine had known this! This might be a way to shortcut the referral process. It'd certainly be worth trying, particularly if you have a decent relationship with your GP.

None of us here are qualified to say why your control is worse at the moment, but from my other half's pregnancy experience (non-diabetic but other conditions) your hormones etc are certainly affected for a while. Weigh gain is also known to impact on insulin sensitivity. If you can fit some cardio-vascular exercise in to your day it might help; I find it certainly helps my sensitivity.

I'd also perhaps push back on the diabetic midwife - the NHS certainly does have a duty of care to continue looking after you and child post birth. One of the people with HCP experience can say more but this doesn't feel like a joined up pathway of care - it should not be your problem that there are different departments not talking to each other. If she won't speak to you (and I'd ask again, particularly for their written policy / guidelines that states when and how they hand over care to another professional) is she willing / able to refer you to the DSN?
 
Actually, midwives are only legally allowed to provide care up to 28 days after delivery so at 2 months she really isn't allowed to help. The trust I work has a policy of getting diabetic mums reviewed three months post delivery as a matter of course so it's possible that there is already an appointment in the pipeline. Chase the doc for a referral to the diabetic bods at the hospital.
 
hi all well just to update u i did manage to speak to a dsn she has upped my metformin and said i will need more insulin the more i weigh. she's also referred me to see the dietician although
i'm not sure what good that will do, i don't need help to work out my ratios just need them to go down!

TBH i think the only solution is to go very low carb until i lose some weight and maybe i can have a more normal diet again in the future but at the mo it doesn't feel like an option.

thanks
 
PS been doing some looking around on the internet and this forum and think I have found out what I have - double diabetes (or insulin resistance on top of type 1 (I'm actually a mody but my pancreas doesn't produce insulin so it's effectively similar to t1)
read a few articles and the solution seems to be a) weight loss via reduced carbs b)exercise c) drugs such as metformin.

Kind of already knew that was what I had to do but good that it has a name and a solution. I guess this means that, pregnant or not, you can't really get away with eating what you want and injecting bucketloads of novorapid (as I was towards the end of my pregnancy). ****! Thought I'd found the answer!!

I guess its goodbye to carbs again......... :(
 
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