Advice please....35, pregnant and diabetic

[teachnz]

Hi all......I am 35, on my third pregnancy (one miscarriage, one preterm birth last January in which baby didn't survive) and diabetic type II.......
My husband and I went to the doctor last Friday and got our first ultrasound at 71/2weeks.....the baby looked good and had a steady heartbeat...... of course we went in with fears of our own given my age, my diabeties and our past history of failed pregnancies......
We met with a perinatal diagnostics center specialist and an ob/gyn.....of course they went over our risks given our risks factors, yet all seemed optimistic about this pregnancy.....
Then this week, i have gotten several phone calls from the doctors office ob nurse.....first was a call about abnormal test results....I hae an UTI, and swollen glands in my throat, so they want me to start on an antiobiotic....my husband and I figured okay, lets treat it and monitor, no big deal....... then the next day they call to say my a1c blood glucose test results came back and they were a bit elevated in their opinion (I have gone from a 6.2 to a 6.7 since January----for those who don't know anything less than 7 is excellent for someone already diabetic), yet with the pregnancy they want to start me on insulin and then refer me to a diabetic center for further tests and monitoring....... now today the nurse calls and says they need to schedule me for a cvs (chorionic villus sampling) where they pierce the placenta and take a sample to test for down syndrome and a nuchal test.....
My questions/concerns if anyone can answer......anyone taken insulin during pregnancy after taking oral meds.....did you have complications, low blood sugars, etc.....
my second question to those who had/didn't have testings done.....did you incur complications, what did you do with your results, why have the tests if I know my husband will not allow an abortion, any advice?

Thanks......

[adgal]

I am not diabetic, but a girlfriend of mine has been insulin dependant diabetic for most of her life.  She is now 39 and the proud mom of a beautiful set of twins and a singleton, all under the age of 3.  I know she monitored her blood sugar, etc. very very closely and all went well.  Good luck to you!  You can do it!!

As for testing, that is a very very personal decision.  I opted for all of it, including amnio.  For me, it was not about terminating...I knew that would never be a decision I would make.  But, I did want to know...I was 40 when my son was born.  I figured it would do one of two things..either put my mind at ease (which is what ultimately happened), or help me prepare for any special needs he may have.  For me, it was the right decision.  

[Super_sally888]

Hi,

I was 37 and on insulin from 3 months pregnant.  I did have very good control on insulin (it was such a relief to be on insulin after struggling so hard with diet).  i had a perfect beautiful daugher at 38 years old.

I am now nearly 40 and trying for No. 2.  I am on insulin already in preparation.

You can do it.  And it's worth it.

I wouldnt go for the testing necessarily.  I did none with my daughter.  didn't see a need and it wouldn't change the outcome.

best regards

[oceanv]

basically there's two different issues

1.the optional testing cvs, amnio, triple screen, nuchal, quad screen - these are all up to you, they can't make you do any of them, although the nuchal, triple and quad screen are fairly non invasive.  the cvs and amnio are invasive but give you the best warning of potential problems but if you're not doing anything with the results.......

2.the blood sugars, have to be controlled, the earlier the better, if you have high blood sugars in early pregnancy you run the risk of some issues, one of them is heart problems for the baby (i think its fairly rare), they did a level ii ultrasound with special attention paid to the heart for me, the most common one is high birthweight, high blood sugars at birth.

good luck and i'm so sorry for your losses,
joanne

[nola0805]

I did not take insulin but I did have a CVS.  I was 39 when I became pregnant (I am now 36 weeks).  I would not have terminated but I wanted the peace of mind if things seemed okay and I wanted to be able to prepare if things were not.  The CVS checks all of the baby's chromosomes and tests for any chromosomal abnormalities (not just Downs).  I would ask your doctor why they are recommending it.  It tells you similar things to an amnio (except it does not test for neural tube defects)- it is just done sooner.  My CVS was a little uncomfortable but most people are not and it was over very fast.  I got my results in one week and did not have any complications.  The rate of problems with a CVS is slightly higher than with an amnio but researchers are also not sure what to attribute that to as the test is done before 12 weeks.  The rates of miscarriage after CVS or amnio have really come down in the last several years, especially when they are done by specialists who do them all day long - the numbers frequently posted that say the risk is 1:200 is from a time when OB's did them in their offices without ultrasound guidance.  The rate at my center was 1:1600.  

That being said, there is absolutely no reason to feel that you have to do the CVS - it is totally up to you.  I would listen to your doctors reasons, but given your history and the fact that you would not terminate if there was a problem, it may make more sense to not have it done.    

Good luck and congrats on your 7 week old little bean!!

[oceanv]

should read cvs has higher complication rate than amnio

[oceanv]

i took insulin, didn't take oral meds.  insulin was very easy.

my baby was born at 37weeks no problems, no high blood sugar, no withdrawl.  my complications were partly blood pressure, and my need for insulin was dropping so the placenta was starting to act up.


the nuchal, quad, triple etc... is due to your age, pretty sure they can't make you do cvs (pretty sure it has higher complication rate with amnio), don't do it if you don't want to do it.  
The testing is optional, some people want a heads up if there's a problem some people don't want to know beforehand.

i was 39 when i got pregnant.

try not freak out, just follow their plan with the insulin and you'll be good. i'd ask for the pen for the insulin though if it were me, i really liked it.

j