When I gave birth to my first son, I had basically managed my blood sugars throughout the whole pregnancy, so it made sense for me to do it during delivery, too. I don't think my doctors even suggested otherwise. My husband helped me by checking my blood sugars every hour, and they let me drink apple and orange juice to keep it elevated when necessary. Unfortunately, my blood sugar rose during the pushing stage and was around 180-200 when I delivered, so my son was slightly hypoglycemic despite my best efforts. I attribute this rise to the extreme effort I had put forth and the extreme stress my body was under for so long on very little fuel (about 30 hours without eating).
Now that I am in a new city with new doctors at a different hospital, I am once again faced with the decision about how to do blood sugar management during delivery. If I don't do it myself, I will be on an IV glucose drip and IV insulin, administered by someone else (nurse or doctor?). Has anyone had a positive experience doing things this way (e.g., achieved better blood sugar management this way than if they had done it themselves)?
I'd like to do it again myself because I think I know myself better and will be able to respond to changes in my blood sugar more rapidly than a team of doctors and nurses that haven't lived with my diabetes every day for the last 17 years and two pregnancies. I won't have to wait for the nurse to come in to check my blood sugar or give insulin (since they have better things to do and don't always have time for it when the floor is active!). This time, as compared to last, I will be more vigilant when I see my blood sugar start to rise, and give higher boluses a little sooner to prevent the high from happening. As long as I can still drink Gatorade or juice, I should be OK even if I trend low. I will also try to eat at least a small meal before I go to the hospital and hope that I am not in labor very long after that! I might consider IV glucose and insulin only if I am nauseated and can't keep anything in my stomach.
I am learning that the more and more I rely on someone else to tell me what is going on with my body (e.g., why are my blood sugars doing this?), the more often I am disappointed. There are too many things about diabetes that we still don't understand, and every individual is too unique to explain according to the epidemiology. My experience has taught me that careful self-observation has led to the best results, since I am the only person in the world with my entire blood sugar management history in my brain. And sometimes that involves going with my gut, which even care based on the best epidemiological studies doesn't accomodate well.
Would love to hear if your experience during delivery has been different.