# Sliding scales and c sections



## NatalieC88 (Sep 4, 2020)

Hi all
I'm currently 36 weeks pregnant with my first baby and have been diagnosed with type one since last year.
I am having a elective c section as my baby is breech and has been for several weeks.
Today my consultant told me I have to have a sliding scale, which I was desperate to avoid as had a bad time with it when I was first diagnosed. Has anyone experienced anything similar or even had a c section without needing a slide scale? I really wanted another option but was told there isn't one.
Any advice would be really appreciated


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## trophywench (Sep 4, 2020)

Nobody on the forum has experience since Covid as far as I know Natalie, whereas pumpers were previously offered the option of their personal diabetes manager and them taking joint responsibility for the mother's BG and signing to absolve the hospital from that.  Are they even offering the choice of an epidural right now?


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## Pigeon (Sep 4, 2020)

trophywench said:


> Nobody on the forum has experience since Covid as far as I know Natalie, whereas pumpers were previously offered the option of their personal diabetes manager and them taking joint responsibility for the mother's BG and signing to absolve the hospital from that.  Are they even offering the choice of an epidural right now?


Yes I kept my pump on last December, but as Trophy says, that was before Covid. I didn't sign anything, but my dsn had written in my notes that I had good control and understanding and I met the anaesthetist the week before and persuaded him I could manage it and that would be better for my anxiety. We agreed that if anything went wrong and a GA was required he would remove the pump and do a as sliding scale then - dosages were already recorded at my 35 week appt.


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## NatalieC88 (Sep 4, 2020)

trophywench said:


> Nobody on the forum has experience since Covid as far as I know Natalie, whereas pumpers were previously offered the option of their personal diabetes manager and them taking joint responsibility for the mother's BG and signing to absolve the hospital from that.  Are they even offering the choice of an epidural right now?


As far as I'm aware nothing regarding pain management has changed even since covid. I don't pump so maybe that's the issue. Was desperate for a different option I really don't want to have a slide scale


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## trophywench (Sep 4, 2020)

I'm talking about the anaesthetic Natalie, not pain management!


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## NatalieC88 (Sep 4, 2020)

trophywench said:


> I'm talking about the anaesthetic Natalie, not pain management!


Yes I know, I'm sorry maybe didn't phrase my reply well. You still have the full range of options even during covid


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## Pigeon (Sep 4, 2020)

It's probably because you don't pump then. Immediately after delivery insulin requirements go back to pre pregnancy levels or lower, and so you need to be able to adapt insulin levels quickly. Hope all goes well, focus on the beautiful baby you will soon hold! My c section was such a positive experience, the team were amazing and we felt in such safe hands throughout.


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## Inka (Sep 5, 2020)

NatalieC88 said:


> As far as I'm aware nothing regarding pain management has changed even since covid. I don't pump so maybe that's the issue. Was desperate for a different option I really don't want to have a slide scale



Ask them @NatalieC88 Get them to explain why you need a sliding scale and exactly what will happen. It’s easier to accept something you’re not keen on when you know the reasons behind it. You can also then tell them about your concerns and get them to note them if appropriate.

If your worries are going low because your previous sliding scale wasn’t suited to you, for example, tell them and make sure they write it down. What I can say is that you’ll be closely monitored and so will your baby too. XX


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## SB2015 (Sep 5, 2020)

I had a fear of sliding scale being used for me after my experience at diagnosis.  

However it is a totally different ball game when it is planned, and I was able to talk through the plan and starting doses both with the anaesthetist and my DSN.  After the spinal surgery I had I was so glad not to have to manage my levels.  They explained what they were doing whenever they made a change.

Perhaps talk to them again and ask their reasons for wanting the sliding scale.  I suspect it is because you are not on a pump and it will enable more rapid changes as needed.


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## PhoebeC (Sep 5, 2020)

Having not to worry about my diabetes when I was in labour was a total blessing. We didn’t have a good birth there’s no way I could have managed without it. One less thing to worry about was what I needed. 
After I had her they took me back off it pretty quickly maybe the next day, and even then having one day I could just rest and sleep it really helped. 
As others have said get their reasons for it, and explain your concerns.


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## everydayupsanddowns (Oct 2, 2020)

Hope the sliding scale works out well for you @NatalieC88 

Have you spoken to your team about your concerns? It may help them to know what happened last time, so hopefully they can make this a better sliding scale experience?


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