Going against doctors orders

[vickiw1978]

I have gd and take 4 high shots of insulin a day and my levels r still high so they put me onetformin and i had a severe reaction to it and now refuse to take it...anyone else gone against doctors orders? What was ur outcome?

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[mim1]

I wouldn't say that's going against doctors orders. If you have a reaction to something I'm sure they don't want you on it.

I refuse to take iron supplements (even Elevit) as it gives me terrible tummy pain. I haven't had much angst at all from my Ob about that. That's about as contraversial as I get :D. I was only on tiny doses of insulin in my first pregnancy and my sugars were easy to control. This time around I've endured 3 glucose tolerance tests, the last one this morning which it looks like I failed ... but at 35 weeks I don't really see the point of doing it, but that's a whole other discussion.

Can you ring a diabetes educator and let them know you've had a reaction to the tablet? My mum has type 2 diabetes and can't tolerate that tablet - apparently it's common not to be able to tolerate it.

All the best!

[Ky]

Can I ask how many units of insulin you are having at each meal and a rough idea of your bsls?

I know that by the end of wach pregnancy, I am on over 300 units combined (novarapid and lantus) just keeping my bsls under control. I'm currently 18weeks and on a combined total of just over 150 units.

Are you allowed to adjust your levels or do you have to have approval from your GP/OB/Endo to change them?

I have never had metformin offered to me in pregnancy as it is no really a standard pregnancy medication. I did have my overnight insulin changed to Lantus last time and it meant I had much better control ...

[shinebrite]

Look at natural remedies if your willing to not take the meds. I know it's not the same but there are diets that can cure diabetes without medication. It's just not 'spoken about' not the 'norm'

[vickiw1978]

I take 6 before brekky 8 before lunch and dinner and 16 before bed.i ring the educator twice a week and she adjusts my levels accordingly.

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[Ky]

It sounds like you're on incredibly low levels of insulin. Maybe they need to be a little more agressive in what you are prescribed before meals ...

What overnight insulin are you using? I found a switch from protophane to lantus made a huge difference - I was able to reduce my overnight level without losing strict control.

Have a chat to the educator about a little more "education" and trust to adjust slightly your levels as needed yourself. I was taught quite easily by my endocrinologist how to calculate this and was able to maintain much stricter control than I did in previous pregnances where my levels were dictated by a doctor.

As I said before, metformin is not the usual chosen medication in pregnancy - it is only really used in cases of severe insulin resistance which, seeing the amount of insulin you are taking, I would doubt that you have. Take it up with the educator ... they should be able to do something more insulin wise to get your bsls under control.

Hope you have some success ... it is important that your levels are well controlled as bub could end up with very low blood sugars at birth (2 of mine did, even with good control) or macrosomic (one of mine was - 5.94kg at 36 weeks).

Good luck!

[vickiw1978]

I had a scan on monday and bub is 7lb 6 oz and measuring 38+6 weeks.they say im 34 weeks i say im 36+3 weeks.what happens if ur baby is born with low blood sugars

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[Mopoke]

there are several other tablets used to control diabetes but im not sure if they can be taken while pregnant......

as pp said, your insulin doses arnt that high (my sisters were about that) but they might of had a reason for introducing the metformin instead of increasing insulin levels.

[mim1]

I had a scan on monday and bub is 7lb 6 oz and measuring 38+6 weeks.they say im 34 weeks i say im 36+3 weeks.what happens if ur baby is born with low blood sugars

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If bubs has issues with low blood sugars it means they need frequent feeds (may need to be formula) or if that isn't enough they might need sugar through a drip meaning an admission to special care. I was told to expect my ds to be in special care for the first 24 hours for observation for low blood sugars. Different hospitals have different policies though and now (my ds was born 5 years ago) most babies stay with mum at least initially and then only go to special care if frequent feeds (BF/EBM/formula) aren't enough to control the sugars. My ds ended up in special care for other reasons, so it was all academic in the end for us.

And your insulin doses are really small, not big at all. Last pregnancy I was on tiny doses - just Novorapid 6 with breakfast and 4 with lunch & dinner.

[Mum5]

It sounds like you're on incredibly low levels of insulin. Maybe they need to be a little more agressive in what you are prescribed before meals ...

What overnight insulin are you using? I found a switch from protophane to lantus made a huge difference - I was able to reduce my overnight level without losing strict control.

Have a chat to the educator about a little more "education" and trust to adjust slightly your levels as needed yourself. I was taught quite easily by my endocrinologist how to calculate this and was able to maintain much stricter control than I did in previous pregnances where my levels were dictated by a doctor.

As I said before, metformin is not the usual chosen medication in pregnancy - it is only really used in cases of severe insulin resistance which, seeing the amount of insulin you are taking, I would doubt that you have. Take it up with the educator ... they should be able to do something more insulin wise to get your bsls under control.

Hope you have some success ... it is important that your levels are well controlled as bub could end up with very low blood sugars at birth (2 of mine did, even with good control) or macrosomic (one of mine was - 5.94kg at 36 weeks).

Good luck!

Ky has given you some really good advice. My second pregnancy I had GD, but it went undiagnosed until birth, I ended up with an 11pd baby (5.02kg) and she was extremely lucky to not have serious health issues. If I had of been on insulin (my diabetes was late onset, around 34 weeks) then it would have saved a lot of problems, alot of her growth exploded from 35weeks+ and because I had passed the 28 week GTT the doctors weren't interested in my concerns.

Please talk to your Dr about your medication not working, metformin is notorious for having serious side effects ( I have been on this for over 6 years so I know all about it LOL) There is a Extended Release metformin, and while you initialy have some side effects they go away very quickly. But insulin is the better way to go during pregnancy, metformin has not been cleared for use in pregnancy, and you'll find that there is a big split with Drs, those who will use it and those who flat out refuse. Insulin is also a much more precise way of controlling your sugars.

When your baby is in utero you are doing all the work for them in regards to processing of sugars/insulin etc. When baby is born that support system is taken away and bub all of sudden has to do it themselves. If they have been in a very high 'sugar' environment then they can crash out when born and their systems may struggle to cope. I developed Type II after my second baby, so my last two pregnancies have been insulin dependant. All three of my last babies had to be fed two hourly once born (quite draining when trying to establish breastfeeding) and they all needed top up feeds of formula to pull them through. They are subjected to the finger prick tests (but through their heel) every few hours to monitor their blood sugar levels and they need to get over a certain level before you're allowed to take them home.

I hope thats helped a little, good luck with everything!

[Penny88]

I went against my doctors orders in regards to the amount of insulin I was taking for my GD. The docotrs and public system diabetes educator wanted to put me on 4 shots of insulin a day, 3 of Novorapid before each meal and 6 of Protophane before bed because that was just their standard start off doses. I didn't think that sounded right as my readings were barely elevated for most of the day, over target maybe once or twice a week for breakfast and lunch. I argued with them over it, to the point they were telling me that my baby would die if I didn't do what they were telling me to do. I paid for a private diabetes educator who looked at my readings properly and put me on one dose at dinner which ended up controlling my GD beautifully, all readings on target. If I had followed the doctors orders I would have been having hypo after hypo.

I'm also surprised that they prescribed you metformin. I was hoping to have this prescribed for me instead of insulin and the doctor said to me that it wasn't safe for my baby and "it's your decisions but you'll have to live with the consequences for the rest of your life". Sounded so bad I went on the insulin. Sounds like you should be able to increase your insulin though to control your GD without Metformin.

Oh, and my DS was born with no problems regulating his sugars and at a healthy 3100 grams.