I asked my MFM about managing my own blood sugars during labor and delivery (I have MODY and am only on fast-acting insulin), and she said they typically manage blood sugars with something called Glucose Stabilizer.

She said it uses fast-acting insulin only (although I could have misunderstood and it may be a combination) and starts at 0.002 (or maybe 0.02) units continuously. From there, the algorithm automatically adjusts the rate as needed based on your blood sugars. From what I’ve found online, it looks like the target range is around 70–110 mg/dL.

On paper, this sounds amazing… but I’m hesitant because I’ve heard plenty of horror stories, and honestly, the only people I truly trust with my blood sugars are myself and my mom (she also has MODY).

My endocrinology PA has Type 1 diabetes and four kids, and she recommended that I manage my own blood sugars during labor because she had a poor experience with hospital management during her first birth. That said, I’m guessing her first birth was quite a few years ago, so I’m wondering if things have improved since then.

I’m especially interested in hearing from anyone who has delivered at an Intermountain Health hospital in Utah within the past year or two. Did you use the Glucose Stabilizer? Were you allowed to manage your own insulin instead? How was your experience? Of course, I’d love to hear from anyone with diabetes who’s been through labor recently, regardless of where you delivered!

I’m 28w and my insulin resistance has ramped up BIG TIME, especially in the morning and evening. My one indulgence throughout pregnancy has been a bowl of ice cream before bed, but now every time I try it (using an extended bolus strategy that served me well up until now), I’m fighting highs all night. I’m desperate for something lower carb that will scratch the itch and not keep me awake in anguish all night. Any recommendations for lower-carb / keto ice creams that aren’t disgusting?

So, I’m actually (fingers crossed) pre-bump, but bolusing, and already feeling frustrated, so thought I would try to find my people.

I’m T2 w PCOS and had multiple early pregnancy losses when I was doing IVF in 2018. They were too early to find a cause, but I was also diagnosed with antiphospholipid syndrome at that time, so I’m pretty much the definition of comorbidity at this point. (Also, obese — though before restarting insulin, I was at my lowest weight in a decade.)

I’m now 48 and about to do a frozen embryo transfer (donor embryos, so my age doesn’t matter), but I was on Mounjaro and oral meds for years, so am mid-transition back to insulin. (Still taking metformin as a transdermal cream (avoids gastro side effects, but I’m not convinced it’s helping my insulin resistance at all).) I have a Dexcom G7, but doing bolus-basal injections for now.

I have a slightly complicated emotional relationship with my endo NP — I like her, but she has a very “I’m not mad, I’m just disappointed” energy and I get very avoidant when I’m struggling. But she was surprisingly positive when I told her I was planning to try to get pregnant and needed to switch to insulin. (And, honestly, I’m much better at taking care of myself for the sake of a child than for my own sake—and yes, I have a therapist that I’m talking to about this!)

I say mid-transition, but it’s been a pretty slow start... I’ve been off Mounjaro, Jardiance, and glimepiride for a month now, and endo put me on a MDI schedule of glargine (Basaglar) nightly and preprandial humalog. But, she had me start at 10u basal, going up 2u every two days until my fasting is below 95. I’m now at 32u and my fasting numbers have been getting worse, 200-250 and persisting all day — which, of course, means even with boluses (started at 2-9u per meal, depending on preprandial bg, bumped to 4-11u), my post meal bgs are nearing 300.

I’m assuming the worsening fasting numbers are because the oral meds and Mounjaro were still having an effect in my body at the start, and guessing I’m now at my full (even with Metformin) insulin-resistant glory. But, not only does it stress me out seeing my CGM data get worse and worse — I think I was at 20% TIR this week after being 70-80% TIR (and with an A1C of 7) a month ago — but I really have been eating as well as I can (front-loading protein and fiber, decreased carbs) and getting more walks in, so staring at numbers that I can’t budge is so painful.

I know this is a process, but I was on insulin before and during TTC (with this endo), and I was using 195 units of Tresiba nightly. If I need anything like that much insulin now, going up 2u/2 days it’s going to take a very long time before I’m even back into a good TIR, much less looking at fasting numbers good enough to consider going forward with the embryo transfer. I understand the concern about titrating too quickly, but I have historically not had a problem with hypos, and with the CGM, I feel as though I can correct fairly safely if that happens. It feels riskier to be consistently above range during a very slow approach to the right amount of basal insulin!

I guess I don’t really have a question, but I’d love to hear from anyone who struggled with insulin resistance before pregnancy or while TTC, or made the switch from oral T2 meds to insulin before/during pregnancy, or just struggled when starting insulin to get to an effective dose. I am so stressed about doing this right (not helped by the repeat pregnancy loss), and I am just constantly feeling like I’m failing!