Replies to This Discussion

Permalink Reply by Kim Nater on May 24, 2012 at 3:12am

I see the endocrinologist every 2-3 weeks, the OB once per month, and high-risk once per month. Now, I'm starting to see the OB every other week and it will bump to every week from 32 weeks until the end. The high-risk doctor also wants me to come in once per week from 32 weeks on. There are some weeks I've had 2-3 appointments, and then some weeks I'm "off." :)

Permalink Reply by Kristin on May 23, 2012 at 3:07pm

I have an 11 month old son. When I think back to the pregnancy, I remember that it was intense and all-absorbing (I was so focused on my blood sugars and the pregnancy and wanted to prioritize those things over say "work"), but actually it was not as "bad" as I had feared. I was genuinely afraid of pregnancy, but I found that being pregnant, I had a level of motivation and determination to take care of myself and my blood sugars that I had not experienced before (or since!!). So, I am NOT saying it is easy -- it was tough, especially the guilt and worry that I felt with every high blood sugar! -- but it was manageable and TOTALLY worth it!

I followed a strict diet and schedule that my endo has all her type 1 diabetic pregnant women follow. It really worked for me and I will definitely do it again in the next pregnancy. More details are here.

Permalink Reply by Ashley on May 23, 2012 at 4:02pm

THANK YOU! So helpful to see that mapped out! And thank you for your honest, yet encouraging opinion on pregnancy!

Permalink Reply by Super_sally on May 23, 2012 at 4:32pm

I was on MDI so no issue to adjust.

I also foudn out that whereever I was 2 hours after eating I would stay that way for hours (humalog seems to have most of it's action for me in 2 hours).

So if I was above 120 at 2 hours I would correct. At the beginning it was 1 unit of insulin to drop me about 20 points, by the end of the pregnancy it was 1 unit to drop me 5 points.

My endo's target for me was < 95 fasting and before meals and < 120 at 1 1/2 - 2 hours after eating.

Permalink Reply by Super_sally on May 23, 2012 at 4:32pm

I was on MDI so no issue to adjust.

I also foudn out that whereever I was 2 hours after eating I would stay that way for hours (humalog seems to have most of it's action for me in 2 hours).

So if I was above 120 at 2 hours I would correct. At the beginning it was 1 unit of insulin to drop me about 20 points, by the end of the pregnancy it was 1 unit to drop me 5 points.

My endo's target for me was < 95 fasting and before meals and < 120 at 1 1/2 - 2 hours after eating.

Controlling carbs was also critical. Very few grains, got my carbs mainly from veges, nuts and dairy.

My baby was born at 7 lbs 6 oz at 39 weeks by emergency CS which had nothing to do do with me being diabetic, (due to labor not progressing after 3 days dilated at 6 cm - I had wanted a natural delivery) and had not problems. Although my blood sugar was crazy during the CS (highs and low becuase they put me on IV insulin and then had to give me glucose to counter it) her blood sugars were finee.

My HBA1C was in the low to mid 5s the whole pregnancy. Started out at 4.9 and ended up at 5.5.

Permalink Reply by bethany on May 24, 2012 at 6:57am

Congratulations on getting the go ahead. I'm currently 13 weeks along in my first pregnancy. My a1c was 6.3 when I got pregnant. It happened a lot sooner then I expected so my diet/numbers were definitely not perfect. The last several weeks have been simultaneously the most exciting and most terrifying/stressful weeks of my life. I've found that if I eat smaller meals throughout the day I limit the blood sugar fluctuations for the most part. I'm quickly learning foods that I could eat before i can't eat now without hitting the 200 mark (ie. bread without any fat or protein, french fries, anything with gravy, etc). The stress of going high has been pretty rough and I worry constantly about what it's doing to the baby. Luckily I've been craving healthy foods.
Testing seems to be the key for getting tight control. Excercise helps a lot too. I try to walk 20-40 minutes five days a week. When my blood sugars get a little more unpredictable it seems to help. I also walk to treat highs before or after meals when life allows.
I hope this helps. It is really hard, but there is a major feeling of purpose. Good luck!

Permalink Reply by GlacierLily on May 29, 2012 at 7:32pm

I have had 2 healthy, full-term, normal weight babies. My A1C was never above 5.8 and got as low as 5.1. I found that the first trimester was the very hardest to control BG's. I had swings from 40 to 200. As I'm sure you've read, you want to minimize the highs and the first trimester is the most important time for BG control, as that is when the organs are developing. Sometime in the second trimester(it was a little different for each pregnancy) I had to double both my basal and bolus insulin. But, my BG's were AMAZING. It has never been so easy for me to keep great BG levels. I have tried to figure out why and I asked my OB about it, but I have not come up with any official answers. I, personally, think it's because my blood volume doubled and so the insulin was more dilute in my blood. One unit didn't affect me as much, so I could make a 1 unit error without as large of an effect. But that's just my theory.

And- I do very low carb, Berstein style. But towards the end of my first pregnancy, I realized I could cheat and eat a cookie (with bolus, of course) and by BG would only go to 110. So I ate cookies!
In summary, yes, it is stressful but totally doable. Be sure you have very good control when you start, because the first trimester will be hard. But beyond that, it was smooth sailing for me.

Permalink Reply by Sarah Kay on May 29, 2012 at 8:57pm

My doc said 6.0, but we (baby daddy and I) felt like I have been in pretty decent control, so we tried and conceived when I was at 7.1 which isn't horrible.

As for diet, I wasn't put on a plan. My main concern is/was tight bg control. The first 9 weeks I had terrible lows, but instead of lowering basals a lot, they lowered basals a little nit and allowed me to eat my way through the lows, as I had a really bad pineapple addiction/craving.

Honestly, it's very challenging to balance blood sugar checks/eating/working because I'm on my feet running around at a very fast paced and demanding job. It's doable though. It's expensive... Increasing insulin, test strips, etc. So that's a challenge. And then there's moments like now where a pump site change gone wrong and you'll get numbers like 337 and then 374 and freak the eff out... That's when I turn to twitter for support from other mommies and try to calm down.

Just test and treat as needed. Don't be scared.

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