Diabetic Moms to Be...OB/Endo recommendations?

[expatbostonians]

Hi Ladies

I'm a type 2 diabetic planning a 2nd pregnancy (but first in SG). I'm a bit nervous, as the OB that I spoke with (but ultimately decided not to see) said that there are no "high risk" or perinatologists in Singapore. In the US, my care was exclusively given by a perinatologist who specialized in diabetic pregnancies (peris are OB's with further specialized training). With insulin my A1c was well-managed and my daughter was born at a healthy weight.

I was hoping to hear from other diabetics who have delivered in SG...who did you see, did they provide the more extensive screens (the in-depth heart u/s at 24 weeks and the additional nonstress tests/fetal monitoring from 32-40 weeks) that are standard in the US? I was also told that standard procedure in SG was to induce diabetics at 38 weeks, which I am absolutely not okay with (barring other non-related complications) and will not consent to induction before 40 weeks without reason.

On a related note--any endocrinologist recommendations for endos who are used to working with pregnant diabetics? I'm specifically looking for someone who will largely let me manage my dosage on my own and just report in...which was my arrangement with my endo at the Joslin Diabetes Clinic with my last pregnancy as my insulin needs fluctuated and grew. When not pregnant, I am not insulin dependent, but with my first pregnancy needed overnight at 5 weeks and meal insulin starting at 12.

My doc in the US is urging me to come back to the US at 32 weeks and just deliver here, which I'd rather not do...I'd have to get a furnished rental, I have a 2 year old who I'd have to separate from her dad for several months, bringing my helper back to the US and hiring a temp for while we're gone, etc....significantly more hassle and a LOT more money...but I haven't taken it off the board.

thanks
C

[gravida]

I am also type II, but went through pregnancy without insulin, just on diet. I think here the care is different than in the U.S. Yes, you will have the detailed scan at ~12 and ~20 weeks, plus short scans on every visit, but nothing very specific, unless some complications arise. In my country of origin for example they do recommend detailed heart screening for children of diabetic mothers, here I did not have it done.
I was told in the beginning of the pregnancy that I will be induced, so this is what I've been prepared for, but at the end my OBGYN started to postpone to decision, as my son was growing well, the placenta was still OK... Thanks to that I've delivered my little one naturally, without induction at 38 weeks He is healthy.
I've been also seeing regularly my endocrinologist (every three weeks) who was checking the glucometer readings, my Hba1c and fructosamine, plus doing the fundoscopy. Towards the end of the pregnancy he wanted to see me on a weekly basis.
Generally, I am very happy with my gynea and quite OK with the endocrinologist. If you wish so, I may pass you their contact details.

[expatbostonians]

Thanks, but I'm insulin dependent. I seem to have found a decent endocrinologist, which I think is the critical part of diabetic pregnancy care in Singapore. I have to say, I think the lack of high risk specialists is appalling.

[JENIVAL]

Hi,

I am diabetic T2 and insulin depandant. Looking for a decent endocrinologist and a gynea in Singapore. Planning for pregnancy but very worried due to my diabetes and age. I am in my early 40's. Any recommendations.

Regards