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As I’m having a c-section at 38 weeks, the baby needed to have a shot of steroids before she’s born to make sure her lungs are nice and strong when she arrives. I was surprised by this as I thought 38 weeks was past the date when steroids are required, but according to the latest Royal College of Obstetricians & Gynaecologists guidelines, it’s generally recommended that all babies to be born by c-section before 39 weeks are given steroids. So that’s what we did.
The one advantage of the whole situation was that because everyone was so busy telling me “steroids will play havoc with your diabetes” it did stop them from telling me that all diabetics have massive babies for a short while at least, so that made a pleasant change. Unfortunately I was unable to locate the havoc prevention setting on my pump, so instead I took to the interweb and asked people via Facebook, Twitter and various forums to share their experiences of how steroids impacted their diabetes so I could make a plan.
The general consensus for steroids in pregnancy seemed to be that they make you really high from around 2 hours after you have the first injection up until around 48 hours after the last injection. And the peak insulin resistance seems to be between 9 and 15 hours after the injection. And helpfully, that varies from person to person. Great stuff, just what you need when you’re pregnant. The hospital kindly offered a sliding scale to manage this for me, you’ll be surprised to hear that a diabetic control freak like me declined that option. I decided to manage it myself on pump and CGM.
I find with any form of insulin resistance, once you let BGs get high it’s a mammoth task to get them down again. So I decided on an aggressive strategy of pre-empting BG rises and increasing basal rates well in advance so in theory I should be able to prevent any shocking highs. Overall, I’m very pleased with how it went if I do say so myself. Here’s the detail from day 1:
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