I am 14 weeks pregnant. I was diagnosed with gestational diabetes around week 10. I have a slight hypothroid condition diagnosed pre-pregnancy. I am struggling with the "Dawn Phenomenon". That is when your blood glucose is elevated in the am, normal around 2-3AM and normal when I go to sleep. The rest of my numbers are slightly elevated but within the normal range. I have been following a low carb diet and exercising regularly. I just cannot seem to get my fasting number down. The midwife wants to put me on insulin but I feel like there is more information that is not being addressed. For expamle I take levothyroxine and I have found information that indicates it increases your blood sugar. I stopped taking the levoT and my numbers went down across the board. I understand the risks to the baby, so I started it back up again I feel like there is a connection between the hypothyroid and diabetes that needs to be looked at closer (maybe a decrease in my LevoT?). I am frustrated and scared. Has anyone delt with this before? Any suggestions?
I've been hypothyroid for years since before I was pregnant.
I took Synthroid through out my pregnancy and I was told it was important to keep taking it regularly so the baby would grow and develop properly.
They tested me for gestational diabetes, but it came out negative.
I had the same issue. Please go see a Reproductive Endocrinologist. YES there is a connection! The endocrin system is very sensitive and being pregnant complicates your health, but is treatable & controllable. Don't count on the recommendations of a midwife unless she's an MD specializing in the endocrin system.
I will say up front that my situation is a little different from yours, I have an autoimmune disease that has distroyed both my pancreas and thyroid. With the Dawn Phenom it is probably not about the medications you are taking. It actually happens to every person, it's just that if you are not a diabetic you don't see a difference. It is your liver releasing glucose to be changed into energy to wake you up. I don't know a single diabetic who has not dealt with this. I used to really REALLY struggle with it (so much that I had to go on an insulin pump). If it is decided that you need insulin to help with it, don't think of it as something horrible. Since it is just gestational diabetes it wouldn't be something that would go far past pregnancy, if you needed it at all after the birth. As for a connection, it usually goes the other way, as far as I can tell. Most people have problems with diabetes then their thyroid, but that being said, yes there are connections between the two. As for medications causing insulin resistance and higher blood sugars, that is also a major factor in the game. Depending on your medication needs they may not want to decrease anything that you need, but you may want to talk to your doctor/midwife about trying a decrease on the LevoT and see if they feel it would be a good idea or a bad one.
The only thing I can really suggest is don't fear the insulin. I know it's a needle, and it can be a little freaky giving yourself shots at first, but it wouldn't be the end of the world. I promise. With my first child I had to take insulin shots 5-6 times a day. (but again I was already a type 1 diabetic so it wasn't that much of a change)
Go with your instincts and push for more answers. Bring your ideas to the table. If your current midwife is still pushing insulin and you are still unsure consult another midwife practice or OB/GYN...
I wouldn't go off the meds - I tried that and my thyroid went nutty. It's more dangerous than the sugar issue. There is a nutritional product with clinical trials that showed a 30% reduction in fasting blood sugar level - it is all food, no drugs, no conflict with anything else. I've seen a huge drop in my sugar and my doctor is beyond thrilled. I can get you the info if you give me your email address, and you can show the info to your doctor. I'd avoid the insulin if you can.
Also, my pharmacist says they are new studies that show a decrease in absorption of thyroid meds if people take supplements with too much calcium, zinc and iron - so my medication says to wait 4 hours between the meds and the products.
Are you seeing an endocrinologist? Going on insulin is not a simple thing. I was on it for my first pregnancy, and I was admitted to Northwestern for 2 full days while they decided what the proper dosage was and taught me how to self-administer. Week 10 is very early in a pregnancy to develop GD -- have you had a hemoglobin A1C test performed? Is it possible that you were diabetic, or borderline diabetic, prior to the pregnancy? I do not think that a midwife is qualified to make these medical decisions. There are endocrinologists who specialize in pregnancy conditions -- I highly recommend Northwestern as a starting point. Good luck!
Call your doctor and request a change to a class B drug which is safe for the baby and you to deal with your hypothyroidism.
Diabetes is dangerous! You must take insulin if the medication cannot be changed. It is for your health and that of your child. If you are already having trouble with your blood sugar at 10 weeks, you are in for a long road of difficult health without it.
There are options for controlling the "dawn effect" besides insulin!!! I was a gestational diabetic with both my kids (didn't have the thyroid issue, though) and the SPECIALIST I saw at Hinsdale Hospital for both pregnancies NEVER put me on insulin even though I struggled with the dawn effect as well. There is an oral medication called Glyburide that is safe for controlling diabetes during pregnancy. Since I was controlling my daytime numbers with diet and exercise, they put me on a very small does of glyburide at bedtime and that took care of the fasting numbers in the am. They started me on the smallest dosage possible and we had to increase it one time as both kids got bigger, but it was still just one pill at night.
If you haven't already, please ask your midwife/doctor to refer you to a maternal fetal medicine specialist. They are experts at managing "complications" like gestational diabetes and it is SO worth the extra appointments to have a healthy baby.
If you plan to breastfeed, I would recommend staying on the meds at the appropriate levels. Hormones ( including thyroid and insulin) are very important in making enough milk, and preparing the breasts for lactation. For more information, I suggest reading "Making More Milk" by Diana West and Lisa Marasco.
K., IBCLC
