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[IPk] Re: Pregnancy and the pump


I have just checked with my sister - also a diabetic, and also a Member of
the Royal College of Obstetricians and Gynaecologists...
She thinks it highly unlikely that the baby produced sufficient insulin for
the mother as well - insulin is a growth hormone and a baby producing that
amount would be huge...
Insulin requirements increase during pregnancy - towards the end of my first
2 pregnancies I was taking at least 3 times my normal dosage.  My
requirements dropped dramatically while I was pregnant with my eldest
daughter - this was due to my placenta breaking down and resulted in my
daughter being born by caesarean section at 35 weeks.  I was also
polyhydramneous - a sure sign that I had high blood sugars - although my
HbA1c was less than 6.
Thankfully, Kayleigh is now seven years old and full of beans, but it was a
bit dicey at the end.
My pregnancy with Molly, while using a pump was completely different - it
seemed to last for ages (because I was conscious throughout!).  There is
every reason to consider pump therapy during pregnancy - my case alone
proves the advantages and I am sure that there are a lot more women who have
I am more than happy to discuss pump therapy during pregnancy with anyone
who needs to know more - you can get my number from Disetronic, but please
be careful about using examples like Stephanie - there are many worries for
a pregnant diabetic to contend with, and I applaud Susan for taking the
"best"option during her pregnancy.  There is no reason to feel guilty -
presumably you are not smoking, drinking or eating blue cheese!! (Yuk!) I
found these easy to avoid - but am still struggling with the incessant
cravings for chocolate!


NB  The baby controls its own blood sugar while in the womb, and will
produce enough insulin to reduce high blood sugars that pass across the
placenta from mother to baby.  After delivery, when the mother's blood is
disconnected, the baby will take a little while to adjust to producing only
enough insulin for its own body.  A diabetic mother's baby may need
intraveneous glucose post delivery while its system adjusts to its new
regime - ie the excess blood glucose present in the placenta from the mother
is removed.  A baby born to a diabetic whose blood sugars are uncontrolled
will be larger than average (due to the excess insulin), and will experience
hypos post delivery.  The fact that Stephanie's baby went hypo suggests that
her bloodsugars were not as "normal" as you imagine.

My polyhydramneous was caused by my babies flushing (as we all do with high
blood sugars),and therefore causing more fluid to be produced.  As I said
above - my HbA1c's were fine, but I see-sawed between unconscious and 20+.
My pump calmed everything down, and I managed my third pregnancy with no
fits, no bouts of hysteria, and only about 4 blood sugars above 10 in the
whole pregnancy! - and there was no evidence of polyhydramneous (the huge
weight gain was all me!)

Sorry if this seems incredibly patronising - I know from personal experience
how scary pregnancy can be and have spoken to a lot of women about the
benefits of pump therapy - I would advise anyone worried about any of the
comments made in these e-mails to discuss them with your diabetic team - or
the obstetric team at the hospital...
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