[LiveNormal]

I am today 37w2d and the baby is measured 2.835kg. I told my OB that I would like to keep my pump on during labour but am not sure what to expect on the insulin requirement during the active/transition/baby-delivering/placenta-delivery stages. By the way I am giving birth in China and am currently seeing a regular OB. I also don't have an endo who can tell me what to expect. However, I don't want to compromise that with a C-section so am desparately seeking DF SOS helpline here... Also, what should I take during labour if I need to treat a low?

Thanks a zillion for your help in advance!

[ant hill]

Hello, WOW you are due to have a berth almost now!!! I would have a glucose shot but not to inject if needed at a crucial time as I would think that your body is very busy and you would need not in a position to eat as you are huffing and puffing ferociously. Also that I would think to see that BG's are at a safe level. Being a diabetic sucks when you are pregnant as you are far too busy delivering a baby and looking at D too. Apon delivery make sure that there is someone who knows Diabetes!!

I am also Male.

[sarahspins]

I had crazy short labors with all of mine.. so I really don't know the effects of BG during a long labor, but I used a 50% basal with the one I was pumping with and that kept me stable during labor. My BG with all 3 kids crashed after delivery though... just make sure you have ample amounts of glucose/juice/etc handy so that you're not waiting on a nurse to bring you something if you need it NOW. If you can arrange to eat a meal just after you deliver and don't cover it with insulin that would help too.

After delivery my insulin needs remained *very* low.. I needed nearly no basal for a few days, and reduced meal boluses, but eventually that evens back out to very close to pre-pregnancy levels.

[LiveNormal]

Thanks for chipping in Peter.
I am going to make another male take care of my D when I am delivering and he needs an algorithm from me on how to tune the pump settings base on BG...

[LiveNormal]

Thanks Sarah for your information. I envied your short labours! What I dreaded most is a long labour that really test your ability to think straight!!

I dare not reduce too much and make my BG skyrocketed before the baby is out since that will make his BG too low and warran a NICU stay (I am in China and my hospital don't have a NICU. If one is needed, the baby will have to be "transported" by van to another hospital which has the NICU. The hospitals here are so specialised that they either do delivery or NICU, but not BOTH!!). On the other hand, I don't want low myself since I know I have a big job to accomplish and I don't want to pass out without completing the job. Another annoying thing is that BG will only react to basal adjustment only 2 hours later, so I will need to bring alot of sweet stuff to treat lows just in case...

[ant hill]

Originally Posted by LiveNormal

Thanks for chipping in Peter.
I am going to make another male take care of my D when I am delivering and he needs an algorithm from me on how to tune the pump settings base on BG...

Aww Thankyou, Have a good birth and enjoy the attention.

Congrats.

[xMenace]

Like anything else, test, test, test.

My guess is the added stress is likely to raise your BGs, possibly significantly. Ask your OB about them testing you regularly during labor, or if you are doing most of the work at home, then you and your partner should test regularly. I'd think at least every two hours. I'd probably treat any highs as they happen and maybe adjust temp basals to counter-act any percieved trends.

Afterwards may be difficult too. The stress is gone and you may want to sleep long hours; though everybody's different. My wife stayed up all night and walked the halls.

Treat highs with sugar or juice, use gluco-tabs if you can get them.

[patricia52]

My DIL was only asked to remove her pump when she went into operation room (c-section). She inserted her pump again as soon as she was awake enought to do it properly. Her BG was monitored during the procedure and was told an insulin drip would have been given if needed. Talk with your doctor. Get the details and then talk with the nurse incharge when you get to the hospital.

[mazea]

I'd also be very interested in seeing what replies you get as I am 35 weeks and due in 5 weeks.

[LiveNormal]

Hi xMenace, I think I will just use the "test then adjust" method. However, in general, I think to let BS runs a bit higher is a safer way to go (I don't want to go into hypo seizure in the middle of pushing). I will bring along enough food to treat lows, like banana, chocolate drinks and isotonic drinks. So I think it should not be a big problem if there is a hypo (hopefully the hypo don't come big all of a sudden).

[LiveNormal]

Hi Patricia, yes I will talk to the doctor and the head nurse how my BS will be managed should I need their help. Thanks for your reminder..

[LiveNormal]

Hi Mazea, we are only 2 weeks apart. Are you planning for a natural birth? Most of the people that I have come across told me that they needed to reduce the basal down to about 50% during labour, then either stay that way or even lower after delivery. However, there a some minority who also said that there is no honeymoon period for them during labour, meaning they didn't change the basal up until about 1 week after delivery. So I guess everyone is just different and we will need to find out which category we belong by testing.

All the best to you!

[genie86333]

Originally Posted by LiveNormal

I dare not reduce too much and make my BG skyrocketed before the baby is out since that will make his BG too low and warran a NICU stay (I am in China and my hospital don't have a NICU.

Of course a drop in BG is a valid concern, but (unless they do things differently in China) that won't necessarily warrant a NICU stay - my daughter had a sudden drop in BG when she was born bad enough that they had a hard time getting her to breathe, but once they did, she was just put in the regular nursery. In fact, she actually went home from the hospital in less time than my other 2 did.

[Mystae]

I had c-sections with both of my daughters, although the first one was an emergency (and a good thing, too - come to find out, she was WAY bigger than they'd guessed at the ultrasound right before she was born), and in both hospitals - with vastly different medical standards, I might add - I had my pump taken off and was put on an IV of both insulin and glucose. It worked for me, although my youngest did have a BG crash and ended up in the NICU for two days.

If you are certain that you are going to keep your pump on, you might consider milk instead of trying to down a banana or crackers for a low in between contractions. It has enough carbs to raise your BG, but it also has protein, which will allow your BG to raise a little more gradually and will also give some sustaining power to you.

And try to relax. It will all be fine. :O)