Balancing Pregnancy with Pre-Existing Diabetes
Healthy Mom, Healthy Baby
by Cheryl Alkon.
Copyright © 2010 by Demos Medical Publishing.
Provided with permission by Demos Medical Publishing. All rights reserved.
For more information or to order this book, visit www.demosmedpub.com
What Blood Sugars Typically Do Each Trimester
Like everything else with diabetes, your experience may differ, but typically blood sugar control varies trimester by trimester, week by week, and even day by day. According to the book Think Like a Pancreas by Gary Scheiner, MS, CDE, insulin requirements start dropping around week 6, dip to their lowest around weeks 9 through 11, and gradually zip up from week 12 back toward where they were before conceiving by week 16. It's unclear what causes this pattern, though it may be related, in part, to morning sickness, according to Dr. Florence Brown. After week 16, the body starts producing a cocktail of pregnancy hormones that cause insulin resistance; from then, insulin needs steadily increase up to week 36, after which they level off or even slightly decrease until delivery.
"At 36 weeks, the placenta stops growing and the hormones it makes stabilize. Sometimes the insulin requirements decrease in the last three to four weeks of pregnancy, as the fetus siphons off increasing amounts of glucose," said Dr. Brown.
This means you'll need to take more insulin—sometimes double or triple (or even more) the amount you took before your pregnancy—until you give birth. After your baby and placenta are out, your insulin needs plummet. Sometimes, a day or two after delivering you might not need as much insulin as you required before your pregnancy—or any at all.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...