HELP--Insulin management before egg retrieval???

[wannabebe2]

Any diabetics out there? I'm on 34 units of Humulin NPH (intermediate acting insulin) at 9pm daily... but my retrieval isn't scheduled until 11:30 a.m. tomorrow... I can't eat after midnight, so I'm concerned about hypoglycemia... the nurses at my clinic say "use your best judgement" as they have not worked with insulin-dependent diabetics before. BUT if I skip it and my blood glucose is too high, will that affect egg quality/retrieval? Yarg... any advice gladly appreciated!

[milo]

wannabebe - you should ask your endocrinologist (or whoever manages your insulin). They may have you do a lower dose of insulin, or tell you to skip it. You have to take into account also that you may not be ready to eat anything substantial until a few hours after the procedure too - you'll want to be checking your levels frequently and have some juice on hand. I don't think high blood glucose levels will affect your eggs substantially, but they can be dangerous for *you*.

[wannabebe2]

Sadly my endocrinologist can't speak to me/see me until one week AFTER egg retrieval. Hooray for free appointments with specialists in lovely Ontario, Canada... but unfortunate that this means that I'm on a waiting list for 3 months every time I need to see her/speak to her! I had one nurse at the RE's office say maybe take nothing or maybe a 1/2 dosage when I called today, but that she really didn't know and to "trust my own judgement" (i.e. she doesn't want to be sued). LOL... so I'm going to skip the night dose to be on the safe side, eat a snack at bedtime with a good deal of protein to pack a lasting punch, and packing my juice boxes, little mandarin orange slices (the kind you put in kids' lunch boxes), and bringing the glucometer to check while I'm there. Luckily they are only doing conscious sedation (not knocking me out) so the recovery time is very short. I told hubby to barge into recovery with the juice box and glucometer as soon as the eggs are out--just in case!

[milo]

That seems crazy to me that you can't even get to talk to a nurse or something about this. I guess if you have to choose between being too high or being too low, higher is better. Good luck!

[Adrienne]

Do you typically bottom out if you don't eat right away? SInce your retrieval is at 11:30, can you eat a meal at midnight? That is what I would do, get up and eat a protein heavy meal at midnight.

I would be leery of just skipping it all together because a high blood sugar can be a problem during retrieval. You want everything all lined up nicely for any sort of invasive procedure.

Take some liquid glycerin packets with you ad have them check your BS at the time of the retrieval. Have stuff ready to eat right after you are done.

Best of luck to you!!!

[WhitneyAtFertilityAuthority]

Wannabe: What a tricky situation. It's not likely that your eggs would be impacted by your glucose levels, but my fear is that often times any procedure scheduled for 11:30 (or any hour), is often delayed by 45 mins or an hour. It just happens. If I were you, I would dose as usual. The conventional wisdom before retrieval is don't change your routine at all............ So unfair that your endocrinologist can't be reached as an on call emergency situation....have him paged for goodness sake. He needs to get back with you!! If you skip your 9pm injection and your ER is delayed by an hour you might tank and have to cxl. We don't want that!!! Let me know what you decide. Have your doc paged....seriously!

[KimAtFertilityAuthority]

Very tricky situation like Whitney said! I don't think I would skip any doses. Just pack lots of snacks and like Adrienne said, have them keep checking during ER. Good luck!