Radha did the Atkins diet and glyburide in her 3rd trimester
as a pregnant type 2 diabetic.
She found a doctor willing to help with her goals and plans.
She hopes her story helps others wanting to do things differently.

Baby Uma

After suffering from an early miscarriage in 2003, I had some difficulty getting pregnant again. It was my heartfelt belief that my low blood sugars induced by insulin contributed to the miscarriage although some of my physicians didn't quite agree.

However I worked hard at trying to reverse my type 2 diabetes with diet and exercise alone. This was something my physicians told me was impossible given that I was a skinny 100 pounds already. I put myself on Atkins, traded my vegetarian diet for meat, and cut out caffeine. I went straight to the maintenance part so didn't really lose any weight I couldn't afford to. My fasting blood sugars dropped for the first time in 13 years to below 100 (except when I cheated). I was elated - but I still had difficulty getting pregnant.

My cycles were irregular and short - 16 to 18 days. After nearly a year I was ready to give up. Turning 40 didn't help the process. Although the reproductive endocrinologist told me that my labs were fine (so were my husband's at 45), I was just ready to let nature take its course and let my biological clock tick away. So by April 2004 I stopped testing regularly went back to caffeine and carbs and was ready to go back on medications for type 2. Maybe having waited 13 years to have a second child was a terrible idea.

Then in early May I found out I was pregnant. I went to a regular OB and a perinatologist. My perinatologist was extremely supportive and told me to get back on the Atkins maintenance diet. He said he would help me figure out a way to gain weight by gradually increasing carbs. He agreed to let me go without insulin in the first trimester although he would watch me closely. My fastings were below 100 mostly and I had 2 hrs at 120 mostly. I did panic at the occasional 200 but doc was cool and told me that so long as no more than 25% of my readings were out of range, I was fine and so was the baby.

Looking for birth stories at this time I must say that coming across Rebecca's on DiabeticMommy.com (a precisely documented one with blood sugars) gave me so much hope.

The next few weeks were uneventful except for my bouts of anxiety and I often read and reread the other mom's postings and birth stories on Diabetic Mommy to help me through.

One of my doctors advised an amniocentesis at 19 weeks. My perinatologist assured me that he was skilled at this and the risk of miscarriage when he performed the procedure was less than the statistical one. He was calm, comforting, and told me to avoid the AFP test and nuchal ultrasound because of a high incidence of false positives. We would have kept the baby no matter what, but at 41 I wanted to be prepared and responsible.

The day my husband called me at work and gave me the all clear on the amnio was my happiest one. I could finally tell the world. Even my mom hadn't been informed. I was morbidly secretive. I just didn't want to deal with people if something went wrong this time around. My fetal echo and level 2 were fine too.

At 22 weeks my sugars drifted lower, giving me another bout of anxiety. However, at 24 weeks, right on track, the pattern shifted. I had more fasting readings in the 100-110 range and my 2-hour checks in the 130-140 range.

The peri put me on glyburide 2.5 x2 a day. He explained that university physicians had great outcomes with glyburide in the 2nd and 3rd trimester. He set to rest my fears of the drug not being FDA approved by explaining that it was not FDA approved for use in pregnant women as no drug company thought it worthwhile to spend millions of dollars on getting approval for such a small demographic - pregnant diabetics. Not worth their marketing dollars.

I went a little crazy once I got on glyburide, loaded up on carbs for the first couple of days, and my sugars went haywire. So I went back again to a restricted diet and gradually increased carbs and distributed it through the day. I had gained about 18 pounds and because I was near my goal of 20-25 pounds, I relaxed and started to take it easy.

The rest of my pregnancy was uneventful. Weekly non-stress tests (NSTs) after 32 weeks showed the baby's heartbeat was reactive (a good thing). I did ask about induction but was told that I would not be considered till 40 weeks unless my sugars or NSTs went haywire.

At my 37-week exam I was 3 cm dilated and 85% effaced. The OB performing the exam told me to go home and walk and predicted a New Year's baby. This was Thursday, December 30th.

My contractions started to become stronger but were still irregular. The weather in southern New Jersey was great for the next couple of days (in the balmy 60's) so I walked for almost three hours each day for the next three days.

On Sunday January 2nd my contractions became stronger. When they were 7 minutes apart, I called the OB on call and went to the hospital.

At 4:00 I was 5 cm dilated. I got my epidural. The OB came in and broke my waters. The pressure started. The anesthesiologist was rushing from room to room. He came in to give me the epidural and didn't quite check if the IV had been turned on before giving me the epidural. This caused my blood pressure to drop. My pulse almost disappeared and the baby went into fetal distress. I was conscious through all this - although shaking and light headed.

Baby Uma made her entry into the world at 5:46 pm with a little help from suction .At 6 pounds, 8 ounces, and 19-1/4 inches (petite like me) she's perfect. Truly a miracle. I also think my sugar being under control was another miracle in this pregnancy. With my older daughter, 13 years ago, I was very often in the 300-400 range!

Bjay and all you Diabetic Mommy hostesses and posters, you were wonderful in the support and advise you offered. Love you all, God bless!!

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