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Question

I have been a type 1 diabetic for 28 years on daily injections.I am 7 1/2 weeks pregnant and noticed my blood sugars have been fairly low and do not require as much insulin. Is this normal so early in the pregnancy?I know women who notice a decrease around 12 weeks and then it rises around 16 or so.Isn't 7 1/2 weeks too early? I may not be eating as much but not enough to put me as low as I'm going. Also,I know I'm early and that people really don't get a hard stomach well into their second trimester, however, I could've sworn that my stomach was feeling a tad bit hard, maybe not hard but swollen.Now I feel like the swelling is gone and back to flab. Is this also a bad sign? I had a m/c at 15 weeks last year, so unfortunately, I have not been able to enjoy this pregnancy due to all my fears from last time.I'm paranoid about everything and think I notice every detail.If I'm sick one day, and not the other, I don't have a baby or I was swollen in my stomach and now I'm not.Please help

Submitted: 115 days and 11 hours ago.
Category: OB GYN
Value: $9
Status: CLOSED
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Posted by Monika Hearne, M.D. 115 days and 11 hours ago.

Info Request

Hello, I would be happy to help. Please let me know what your levels are fasting and after eating that's causing your concern. Also, please let me know if you check your sugar one or two hours after meals.

115 days and 11 hours ago.

Reply

For example, I was taking 54 units of Lantus at night, but I was eating a full breakfas, lunch and dinner and a small snack. The past two days I really have only eaten a small breakfast and dinner with a very light snack. I'll wake up with a fasting sugar of 40, drink juice and two hours later, only be at 50. Once I eat breakfast, again a small one, I go up to about 150 after one hour and then will drop back to normal after 2 hours. B/c I'm obsessive, I check my sugars every hour (pretty much) so if I think I'm a little high at an hour, I may correct (which I know is bad) b/c I may end up going crashing. I guess my concern was the fastings being so low for the last couple days and even after eating or drinking something, it wouldn't go up right away. Plus I'm not taking nearly as much humalog either as I'm not eating much.

 

Also, had a question about the tightness or swelling. Again, I could be completely paranoid after my m/c last year, but I dont' feel it as swollen today, plus with the low blood sugars, I'm starting to worry again.

115 days and 11 hours ago.

Reply

Hi Dr.Hearne, I also forgot to mention that I do still have some dry heaving, not actual vomit, b/c nothing comes out, but I go thru the motions. I do dry heave probably 1-2 times a day.

 

My BS are rising again, after eating, so maybe I wasn't eating enough. But if I did lose the baby, how long do your blood sugars stay low. I remember when I m/c last year, I had sugars in the 300's and I told my doc I should've known this was a sign and she said actually it's the opposite, your sugars go low. So I'm worried that for the last two days, I've had lows, could that mean loss?

 

Is there anything I can do to check to see if I'm still pregnant? I don't have another u/s until the 1st of Dec and I think I'm going to drive myself insane until then. Will a pregnancy test prove anything or is it possible that I could've m/c and my HCGs are still high so it may show a positive??

115 days and 10 hours ago.

Reply

I should also mention that I'm on lovenox shots for MTHFR (due to my m/c last year). Could that be maybe why I had a lower swollen stomach and now my body is getting use to the injections. Although, my stomach is one huge black/blue/purple mark!!

Posted by Monika Hearne, M.D. 115 days and 10 hours ago.

Answer

A pregnancy test will still be positive if you've miscarried as it usually takes a few weeks to return to negative. However, your symptoms above do not sound like miscarriage. The dry heaving is actually a good sign as it is usually caused by the hormones of pregnancy, assuming your sugars are not very low. I would be happy to discuss your levels in order to provide you with more reassurance. However, the symptoms you have are normal. Your uterus is still very small and you shouldn't expect your abdomen to start feeling hard just yet. Bloating is normal, but may be increased if you haven't had a bowel movement. Signs of miscarriage include cramping (although mild cramping can be normal) and bleeding. If you are not having a significant amount of cramping or bleeding, you likely have not had a miscarriage--especially since you are keeping good control of your blood sugars.

 

The bruises are normal since you are on lovenox. But you should have had a CBC done after your first week of therapy just to make sure your platelets remain normal (a rare complication of lovenox therapy). Best wishes!

115 days and 10 hours ago.

Reply

I love you, thank you for making me feel better. However, I should say that when I m/c last year, I was 15 weeks and I woke up in the a.m. to urinate and that's when I wiped a little bit of blood. The doc said wait an hour or so and see if I'm still bleeding. The bleeding had stopped but I just didn't feel comfortable, so I went in and they found no heartbeat. The baby stopped growing a little after 12 weeks, so my body took awhile to do anything. I'm afraid the same thing could be happening. I do not have any bleeding or cramping as of now. I know a woman who knew she was m/c due to hcgs numbers decreasing but she was still having pregnancy symptoms. I'm worried the same thing could be happening to me. Unfortunately, I haven't had any dry heaving today, although yesterday, I did a couple times. Is it normal to have symptoms one day and not the other?? It sounds like there isn't anything I can do for now to check and see if I'm still pregnant, right??

Posted by Monika Hearne, M.D. 115 days and 10 hours ago.

Answer

I apologize I didn't see you made two posts in a row so I did miss your sugars. This early in your pregnancy, the low sugars aren't likely to affect your baby. However, you definitely don't want to have the swings of lows and highs much longer as it is very dangerous for the baby. It is difficult to try to correct things due to your ever changing hormones, but now is the best time to figure out why you are having the low fastings. The most likely problem is you're taking too much lantus at night, especially since it's difficult to raise your sugar with juice. You need to back down on the amount of Lantus you're takiing at night and eat your evening snack before bedtime. Of course, eventually as your sugars climb above 95-100, you will have to increase the Lantus again. Your goal is to keep your fasting between 70-95.

 

The nausea and dry heaving may seem better on days you're eating more frequently and your sugars are better. For all women, we recommend taking in something every two hours to combat the nausea.

 

So, what can you do today to make sure your baby is ok? My only suggestion involves a trip to the hospital. You can express your concerns and request them to obtain the heart tones of the baby using a handheld doppler device. If they can't obtain them, which is frequent since they may not use the doppler everyday, they should obtain an ultrasound to be certain.

 

Again, I think you should be fine. Right now the baby depends more on its yolk sac for nutrition. Smile

115 days and 10 hours ago.

Reply

Thank you Dr. Bearne!! I had an u/s at 6weeks, 4 days and the HB was 147. That was just a little over a week ago. My husband and I were wrestling on the couch, well I should I say that he pinned me down and I was using my arm strength as much as I can and I did use my legs too as well to try and push him off. I was panting like a dog afterwards, I could hear my heart beating fast. It took a few minutes to come down and that's at the point when the paranoia started. I keep telling my husband he hurt the baby and I may not have one now, due to the struggles of wrestling and that overexerting myself could've hurt the baby. Is that possible???

 

Then with the sugars and now not feeling my stomach as hard, I've worried myself to a panic. And now not having any dry heaving today, I'm a freak!!!

 

I also forgot to mention I'm on progesterone suppositories, so is that what helps the yolk sac get nutrition?? They tested my progesterone at 4 weeks and my number came back at 12.5 and felt it was best I go on it.

 

My last A1C was 5.9 and that was a few days I ago that I took it. So I think I'm doing well in that dept.

 

I'm sorry with so many questions. It's so nice to be able to speak to a doctor on the weekends. My dad is a physician as well, but he is a cardiac and thoracic surgeon and knows nothing about obstetrics/gynocology. So I'm at a loss...

 

I promise after I get your next response, I should be done with questions. You've been wonderful, thank you!!!

Posted by Monika Hearne, M.D. 115 days and 10 hours ago.

Answer

No, from the sounds of the wrestling match, there wasn't any trauma to cause injury to the pregnancy. I have known of women who placy contact sports and skydive during early pregnancy and do fine. Smile

 

I agree with the use of progesterone, but it supports the developing pregnancy (placenta). Once the placenta is proficient in making it's own progesterone (usually around 12 weeks) you shouldn't need it anymore. The yolk sac is a natural occurrence on the developing fetus and delivers nutrition (similar to the yolk in a chicken egg).

 

Since you're taking care of yourself this time, I think you can relax. I do recommend decreasing your lantus however and discussing this with your doctor next week. Keep in mind that with your insulin changes, your dietary intake has to remain steady.

 

I am happy to have helped. Have a great baby!!!

115 days and 10 hours ago.

Reply

God Bless You Dr. Hearne, you've been wonderful!!!!

Accepted Answer

You're so welcome. God Bless you and your little baby as well!

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Expert: Monika Hearne, M.D.
Pos. Feedback: 99.6 %
Accepts: 919
Answered: 11/21/2009

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