I am 20 weeks into my 7th pregnancy and finding myself incredibly discouraged with my care providers approach to gestational diabetes. In my first 5 pregnancies, I passed the one-hour glucose test, but failed it by one-point in my sixth pregnancy. So, being the compliant patient I was at the time, I took the 3-hour test and failed miserably (course, I also just sat in the waiting room from one draw to the next not knowing it would be smart to be active instead). There is diabetes on both sides of my family, I was 38 at the time and I have a history of larger babies (8 pounds 6 ounces, 8 pounds 15 ounces and 9 pounds 1 ounce were my three largest). So, I continued to be a compliant patient and I followed all of their directions regarding diet, exercise and eventually, insulin. My son was born weighing 8 pounds 4 ounces. His initial blood sugar level was 40 and they climbed up from there. He was considered jaundiced and they sent us home with a biliblanket.
Because of the gestational diabetes in his pregnancy, I was told I had to take the one-hour glucose test at 14 weeks. Unfortunately, it never occured to me to refuse it. I drank the glucola, went to my pre-natal appointment and returned to the lab one-hour later for my draw. It took the tech three pokes and 30 minutes to get blood out of me (finally succeeded in my hand). I failed the test by several points, but refused to take the 3-hour so they turned me over to the Diabetes and Pregnancy Care team whom I have been working with for the past 5 weeks (it took a week before I had test results and an appointment). Before meeting with them, I started keeping a food log and testing my glucose levels 4 times a day. For the past 3 weeks, they have been pressuring me to start insulin because my fasting levels are above 90. My fasting levels range from 85 to 111 with the majority of them falling between 90 and 100. So far, they are not concerned with my post-prandial numbers.
I am incredibly hesitant to start on insulin at this point. I have been told the point of insulin is to reduce the risk of having a big baby and because I have a history of big babies to begin with, there is more reason for me to start on the insulin. I am not concerned about baby's size so much as baby's blood sugar levels at birth. I have been told the only side effect to insulin is the potential -- albeit quite rare -- for me to get hypoglycemic. I'm struggling with the guidelines they have established for fasting numbers (60-90) as they seem low and rigid. I'm quite concerned -- based on previous experience as well as those of friends and acquaintences -- about the amount of intervention that will be "recommended" as I progress through the pregnancy.
Can you direct me to anything in particular regarding insulin therapy in pregnancy that would support not starting it at this point? would you agree with my care providers that it is in mine and baby's best interests to begin?
Thank you so very much for your time and reply!