I posted this in my local group, but since this one is much more active and definitely relevant, will try here as well.
I live in Syracuse (Central NY) was recently told by my endocrinologist that his professional insurance does not allow him to see pregnant T1 patients. In fact, according to him, there is simply no endo in town/immediate area who does (for the same reason). I was floored by that admission and highly disappointed since my husband and I are hoping to get pregnant soon with our first child. I will be seeing a high-risk specialist throughout the pregnancy but his speciality is obstetrics, not endocrinology. Generally I do quite well adjusting my own basal and bolus levels on my pump + I wear a CGM, but I am concerned with all the unpredictability of the pregnant diabetic experience, which I read is common. Has anybody heard of such a limitation for doctors elsewhere too? Does anyone in the area maybe know for a fact that there are endocrinologists nearby who WILL accept a new pregnant patient (a recommendation would be most welcome)? Has anybody maybe gone through a T1 pregnancy without regular contact with an endo? (How did you do it?)
I’d love to hear back either on this forum or in a private message,
Where I used to live, and had my first full-term pregnancy, there were 2 hospitals that delivered babies: Meriter and St. Mary’s, which were covered under different health insurances. I saw doctors that were in the Meriter system. It was common knowledge that if I became pregnant, then I would not see my endo or DNE during my pregnancy, because there was a high-risk perinatal clinic that I would go to who had a DNE/NP whose patients were all pregnant women with diabetes (T1, T2 and Gestational). Because she was so specialized, it made sense to not see the endo during pregnancy. With St. Mary’s, I would have also not seen my endo during pregnancy, but would continue to work with the DNE I worked with when non-pregnant, as well as the MFM.
I haven’t experienced the same issue as you, but I was given the option upon becoming pregnant of either seeing my endo to manage my diabetes or having the doctors at MFM manage it. I did talk with the MFM doctors and they felt very capable (one specialized in diabetes in addition to her other credentials). I’ve ended up sticking with my endo, but I would have been fine with MFM managing my crazy diabetes changes during pregnancy. Good luck - I’m sure it will all work out!!
I had two babies and this situation was the same with me. My OB/GYN and a Perinatologist managed my blood sugars very carefully during my pregnancy. I had to call in blood sugars or upload them twice a week. I was in for fetal monitoring twice week the last trimester. I went from a 1 to 15 ratio for my bolus to a 1:2. The pregnancy hormones definitely change your insulin needs. Perinatologists and their nurses are used to this and the perinatologist can even be there to deliver the baby. I was in an HMO, so everyone communicated with each other. If you need to go find a perinatologist find one that specializes in diabetes. I LOVED my perinatologist. He delivered my second baby by c-section along with my OB/GYN. He was in charge of that operating room! He made sure I had a real anesthesiologist (not the nurse anesthesist they had in there to start). Perinatal doctors and their nurses are used to pregnancy, complications of pregnancy and carefully managing my diabetes. I was confused at first too, but it really was for the best!
I don’t have an endo per say. My regular doctor that handles my diabetes is an internal medicine specialist, but whatever. In any case, I found out I was pregnant pretty early with a positive home test about about 4 weeks along. I called my OB office and they said they typically schedule their first appointment at 8 weeks. I told them I was a T1D and would need to see maternal fetal medicine as well. They told me that “that would be decided at my first appointment”. As a first time mom, I started freaking out knowing how crazy pregnancy could be. So, I called my regular doctor and told him that I was nervous that no one wanted to “manage” my diabetes or even really talk to me for at least another 4 weeks. He began going over my blood sugars with me weekly (even gave me his personal cell phone number!). It really wasn’t so bad in the beginning, but I just felt a lot better knowing someone was helping me.
He ended up getting me through most of the first trimester until I met with Maternal Fetal Medicine. They gave me a choice of using their office for diabetes management or sticking with my current doctor. I chose MFM because they do this ALL THE TIME and my regular doctor was starting to slip a little at that point and not always call me back right away. (Whereas MFM has people that specifically review blood sugars and can concentrate on the patients that need it).
Once it was all said and done I went back to my regular doctor.
By the way, if no one has told you yet please check out this book–Balancing Pregnancy and Pre-Existing Diabetes. It was really helpful for me. Here’s a link to it on Amazon:
I appreciate your sharing your experience and the book recommendation, @KSMERK12 – I did read this book just recently and am sure I’ll be returning to it as a future pregnancy (fingers x-ed) actually progresses. In fact, it was all the personal stories in it that made me search for forums online (I ended up registering here and on MyGlu) where I could correspond with women dealing with T1D + TTC/pregnancy/delivery.