Ok so I am a little over 12 weeks and I am seeing a high risk and an ob but I am not seeing an endoconologist. My inurance is really crappy so I really can't afford the 2 drs I already am seeing. Is this a mistake? My High risk wants to take me off Lantis and put me on Novolin which I have never heard of or tried. He is also asking me to only test for fasting 2 hours after eating and bedtime sugars no before meals or snack testing. As a type 1 I have always tested every 3 hours whenever I have changed treatments and have always been told to test before meals so I can correct or plan. He also wants me eating 3 snacks a day with no insulin or testing. This sounds really risky to me as I have heard that 1st trimester is crucial in development and high sugars can really mess up my baby's health. What is your experience in this area? Should I try the insulin treatment he recomends or should I get a 2nd opinion? I know it is normal to increase amounts but is it normal to switch insulin types during pregnancy?
I'm sorry to hear about your insurance because in my experience it its really important to have all three Doctors on your team while you are Pregnant. I'm just speculating but I am sure he wants to change your insulin to the Novolin because it will be easier to tweak in the future. It is a lot easier to be on an insulin pump when you are pregnant, but if that is not possible, I wouldn't be scared about him switching your insulin. As far as the checking your glucose goes, check it as often as you want. The first trimester is crucial, but don't beat yourself up because its not good for your stress level which will directly affect your baby and sugar level.
When I first found out at 5 weeks that I was pregnant I called my hospital/doctor and the high risk OB changed me to Novolog (while still using humalog for meals) also. I tried it for a few weeks and found the spikes to be too dramatic and the coverage spotty. When I started seeing my regular high risk OB he said he was fine with me changing back to Lantus if that made me more comfortable and kept my sugars stable. I switched back and with the help of my endocrinologist have adjusted it lower because of the lows I was having at night. I am now 14 weeks and have seen it start to creep up a little in the past few days and will probably start to increase again. For me, having the advice from both the High Risk OB and my endocrin has been valuable. I can then balance that with what I know best about my body. I hope this helps! Congratulations on your new little life!
I also test 10-15 times a day. I do a fasting in the morning, before meals, one hour after meals, before bed, and sometimes at 3am. And anytime in between I feel I need to know. Again, you know your body best and you’ll figure out when you need to eat and when you’re okay. I eat snacks because otherwise I feel nauseas, not necessarily because of BG levels.
Not all OBs know much about diabetes. Yours sounds clueless and you should try to find another doctor who is either knowledgable or willing to learn. You need to be really informed too and not depend exculsively on your doctor. Read a book like "Using Insulin" by John Walsh and "Balancing Pregnancy with Pre-Existing Diabetes" by Cheryl Alkon for good information.
I didn't see my endocrinologist while pregnant. My OB and I handled any diabetes issues and he communicated my results back to my endo. But my OB was knowledgable about diabetes. I was his first type 1 expectant mom, however he frequently checked in with colleagues who were more experienced.
There's not a lot of research with Lantus and pregnancy, so some doctors want you to go off it when pregnant. They typically switch patients to Levemir. Some expectant moms choose to stay on Lantus though. Do what keeps your blood sugar best managed.
Test all the time when pregnant. It's the only way to keep your blood sugars managed and create the best environment for your baby. When pregnant I aimed for a non-diabetic A1c with no lows. Because of a pump I was able to do it. With shots I don't know if it is possible, but you can definitely do better than what your OB is suggesting.