Friends on insulin, watch those 36-week numbers

Hey all,

Hopefully my last standalone post here after 3 insulin-controlled GD babies in 3.5 years.

First, thank you to this community for being here throughout the ups and downs.

Second, I wanted to share the story of my surprise 37-week induction yesterday for any of you who find yourself in the same boat.

With my first two kids, I was well-controlled with nighttime insulin throughout the pregnancy. Each time at 32 weeks the babies measured LGA/suspected macrosomia and each time I was placed on strict glycemic controls. I was able to maintain 90-95% compliance with the tight controls and was induced at 39-weeks per ACOG guidance.

This time? Absolutely different. At the peak of my insulin resistance, I was on 40 units of Lantus at night with a mid-morning dose of 8 units plus 12-14 units of novolog before each meal. Even with that much insulin, I could only maintain 40-50% compliance.

Right at 36 weeks, things went absolutely haywire. I started experiencing hypoglycemic episodes almost daily and the MFM team was rapidly dropping my insulin doses to try and prevent it. A week after my previously mentioned dosages, I was at 40% of the insulin I had required and still having lows.

My 39-week induction was moved to 38 weeks and then yesterday unexpectedly called at 37 weeks. We will never know, but the MFM doctor theorized that my placenta was failing and wanted the baby out as soon as possible.

Our third baby was born this morning at 7lbs 10oz at 37+1 and has passed his blood sugar test and thus far avoided any NICU time. This is all to say that one of the most recurrent posts I see in this sub is about what happens to everyone’s numbers at 36 weeks and I want to encourage people to take it seriously. We will never know what was actually happening in my case, but I’m so glad that both baby and I are ok.

The other thing is that if you’re on as much insulin as I was or struggling as hard, advocate for a CGM if your practice doesn’t issue them as a standard of care. We wouldn’t have been able to identify all of the lows that I was having without it.

Good luck to everyone still on this journey. It is so difficult and we all need each other - strangers on the internet - to make it through.