# Don't ignore hypos in 3rd Trimester!!



## Twitchy

Hello all...

Well, although we're all still a bit shattered, the shock & awe stage seems to be passing now!  Charlotte is 6 weeks old now, so I thought I'd put our experience up here, in case it helps anyone...for those who don't "know" me, I've had type 1 diabetes for 30 years, and already have a little boy, Mike, who's 3.  I had background retinopathy before his pregnancy, and needed lasering for proliferateive retinopathy 1 1/2 years or so after he was born.

Early days
The start of the pregnancy was really stressful - almost immediately on becoming pregnant my sugar levels went haywire, & I had ketones for the first time in years - very scary!!  My insulin requirements shot up almost immediately too, which was different to my first pregnancy.  I was convinced the pregnancy would not end well!  Thankfully things calmed down a little, although with a toddler to wrangle & sugar levels haywire, things were stressful.

2nd trimester
I'd had severe pre eclampsia with Mike, to the point where I really wasn't sure if I should risk another pregnancy - even if it was milder this time it was terrifying before & he was born at 34 weeks & in hindsight small & needing a lot of attention (thank God, generally healthy though).  Even my the 2nd trimester I was stressing about getting PE again...but this time the scans indicated that she was actually macrosomic - a big baby - despite exellent control with a HbA1c of 5.7.  An early date was set for a C section.

The birth!
I had a growth scan 2 1/2 weeks before my planned section date because baby was getting really rather big.  At this the consultant said if my insulin requirements dropped by 20% or more to get in touch directly with him.  At this stage I'd been on the same insulin regime for a couple of weeks which was working really well, but I'd had an over night hypo the day before, which I'd put down to poor carb counting. The next day, I had a hypo before lunch, and because it was a nasty one delayed my insulin, testing to see when I needed to inject - and i didn't until 3hrs later, and then only about a quarter of the insulin I should have needed!  Again, I was unsure how significant this was, but decided to call the doc the next day just in case. The next day I called and was told to come in for monitoring, as the doc was away.  Before getting to hospital I had another nasty hypo before lunch - had 12 carb portions & no insulin - & my sugar levels were fine all afternoon!!  Because I was only having these massive hypos at lunchtime I was still unsure how serious this was.  

I was admitted to hospital until I could be seen by my consultant the next day...the next morning he decided a "semi elective emergency section" was required that day!  

Charlotte was born that afternoon, thank God healthy.  What had happened was the placenta had started to fail (hence the massive drop in insulin requirements) and as a result the blood oxygen levels were low - so when C was born she had a great apgar score because the oxygen levels she could breath out of the womb (despite being immature) were so much better!  The consultant described it as being like an athlete doing high altitude training to increase their amount of red blood cells!  Soberingly, his comment was "tomorrow would have been pushing it, two weeks would have been too late" - two weeks was the planned date for the C section, and would have been 38 weeks gestation.  Turns out I was passing protein again, although my BP was fine, so it might have been PE again, or might just be my duff body!  Either way, the point I'm trying to make is that if you are having serious hypos in the third trimester, don't dismiss them - make sure you see your diabetic obstetric specialist (the others really didn't have a clue!!) & get it checked - if we hadn't we would not have our beautiful daughter with us now!

That's it for us - two successful pregnancies after 3 decades of T1 is enough for me, especially as my eyes are really suffering...also I find being a pregnant diabetic incredibly stressful! We are going to be very thankful for two healthy kids (despite various early scares with both of them) and retire from procreation! 

Sorry this is so long, hope it helps somebody!  All the best to those of you who are expecting,

Twitchy x


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## Steff

Lovley to hear from you twitchy so pleased to hear charlotte is well, and wow 6 weeks already dont time fly, your post is brill a nd im sure it will help the pregnant ladies amongst us all 


take care x


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## NicNic

How jealous am I of your HbA1c!!!  Sounds like you've been through a lot during both your pregnancies.  I've been diabetic for 28 years and although my eyes are ok it is something I worry about (especially as I've been asked to go back to have them checked in 3 months and I usually just have then tested annually - the optician was unsure about something on the last test).  What kind of thing has happened/is happening with you and what was the treatment you received??  Sorry I've gone off track a little.. just that you've had diabetes around the same length of time as me.


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## xxlou_lxx

Twitchy said:


> The birth!
> I had a growth scan 2 1/2 weeks before my planned section date because baby was getting really rather big.  At this the consultant said if my insulin requirements dropped by 20% or more to get in touch directly with him.  At this stage I'd been on the same insulin regime for a couple of weeks which was working really well, but I'd had an over night hypo the day before, which I'd put down to poor carb counting. The next day, I had a hypo before lunch, and because it was a nasty one delayed my insulin, testing to see when I needed to inject - and i didn't until 3hrs later, and then only about a quarter of the insulin I should have needed!  Again, I was unsure how significant this was, but decided to call the doc the next day just in case. The next day I called and was told to come in for monitoring, as the doc was away.  Before getting to hospital I had another nasty hypo before lunch - had 12 carb portions & no insulin - & my sugar levels were fine all afternoon!!  Because I was only having these massive hypos at lunchtime I was still unsure how serious this was.



Thanks for sharing your story twitchy, The same thing happened to me in regard to insulin reqs dropping and needing to be delivered early... Im not sure how common this is but its good that you have put this thread up to make other women aware of the danger! 
It happened with me on the friday I noticed my bm not wanting to go above 4 the whole day, on the saturday (I think) I had acutally needed less than half of my usual insulin and that whole day but still having hypos so phoned nhs direct who were no help.... next day I woke up on 5.7 so left it for a bit as I didnt want to waste hospital time although the obs consultant was a little aprehensive of leaving me, anyway the monday arrived and it was worse so called the diabetes consultant and she arranged for me to be monitored at the maternity hospital where the obs consultant just admitted me there and then eventhough the babys heart tracing was fine! 
We still dont know if it was because of a failing placenta but I do know that its a big deal to the obs specialist when the drop in insulin is noticed! 
I was gutted I wasnt prepared but glad that my baby was healthy and that I had great care throughout my pregnancy


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## Sugarbum

Its really interesting to read your story Twitchy, and with such relief that everything has turned out ok in the end. It really goes to show that a decent consultant and associated team is worth its weight on gold.

Thanks for sharing something that really is so interesting to so many on here x


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## Emmal31

Hi Twitchy,

It's nice to hear from you again! I'm annoyed that I wasn't told until the last couple of weeks about unexplained hypo's can mean something is wrong thankfully I didn't have one before I was told about it   I had one unexplained hypo a couple of weeks before I found out I had Pre- eclampsia. Can't believe charlotte is six weeks it flies doesn't it. Jessica is almost 3 months old now  xxx


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## rachelha

Twitchy

Thanks so much for this post. I was not aware that we needed to watch out for this.  

So glad to hear Charlotte is doing well

Rx


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## emeraldgirl

Twitchy

Thanks so much for sharing your experience with us, this was not something I was aware of.  

Dee x


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## Cate

Wow, what a story!  I'm so glad it all ended up OK for you.

I've never been told to watch out for unexplained hypos - a bit worrying, especially since my son was born 9 weeks early after my waters went, which was subsequently put down to ?a failing placenta - most likely to do with him being a surviving twin, his brother was victim of twin to twin transfusion syndrome at 26 weeks.  It does make me wonder about going for number 3 though (in a couple of years, mind, our son is only 10 weeks old now!).

Hope the sleepless nights aren't too horrendous for you!


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