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Don't want to change to insulin during pregnancy - Metformin?

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Hi everyone - I hope someone can help me with this as I'm awfully confused!


I'm Type 2 (my last HBA1C was 6.1) and have PCOS as well. I'm 6 weeks and 4 days pregnant, and have my first hospital appointment in two days, when I'll be speaking to an endo as well as the antenatal people.


I met this endo before during the summer. I was referred to him because my husband and I were planning to try for a baby, and my GP thought that I should change from Janumet to insulin before trying. At the appointment, the endo laughed at me and said that as I have PCOS, we may not be able to conceive, so we shouldn't bother worrying about medication till I actually achieved pregnancy.


I also mentioned to him that I had heard that hyperinsulinaemia can be dangerous during pregnancy and is thought by some doctors to be related to the very high miscarriage rate in women with PCOS; that worries me because I'm insulin resistant and would have to start on a very high dose; this would increase massively as the pregnancy progressed. He said 'Oh, I don't decide your dosage, that's up to the nurses' - I don't think he had actually listened to the question at all!


Two months later, I went to my GP, having had a positive pregnancy test result, and she panicked and took me off my medication, saying that if I didn't get a hospital appointment within a week I'd have to go to A&E (normally in Ireland you'd have your first appointment around week 20).


I've been eating well and exercising gently and BG results have been fairly god, but not quite good enough for pregnancy. What I'd like to do now is go back onto Metformin for the rest of my pregnancy; I've been on it before and know that I can handle the headaches, I was doing pretty well on it without trying very hard, and the only real problem with it is that there haven't been enough studies of it's effects during pregnancy. There haven't been any documented cases of it causing problems, whereas there's mounting evidence that insulin may not be the safest option in my situation.


Does anyone have any advice about what treatment I should be getting, and how I can manage to get my concerns across to an arrogant, opinionated, not-interested-in-listening-to-his-patients consultant?





Oh, and sorry for being so long-winded : )

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