I'm type 1 and 25 weeks pregnant with baby #2. As I've mentioned before, baby #1 was 9lb 13 oz despite good control, so I'm trying extra hard this time around--eating low carb, walking almost every day, using a CGM, etc.
My A1c at conception was 6.1, about 6 weeks ago it was 5.5, and last week when they checked, it was 4.7. While that number sounds amazing, I definitely have been having lots of lows. I have 2-3 low numbers a day, but almost all of them are in the 60s or high 50s, nothing crazy.
I hadn't been too worried about this, because I figured that a)low is better than high b)I've got a CGM that alerts me when I'm low c)I live in a very walkable area so don't have to drive much and d)according to research, non-diabetic pregnant women's blood glucose is pretty low, with their fasting number averaging around 55.
My doctor, however, of course told me that 4.7 is "too good" and that I need to "relax my control."
I'm just curious what other people's takes on this would be. Since I talked to my doctor, I have been taking steps to try to limit my lows, but that means I've been seeing more numbers in the 140s-150s again, which I'm not happy about.
My endo was also very adverse to lows, but mainly because she argued that they usually involved rebound highs, which it seems that you are not having. I guess one worry is losing your ability to feel them, but the CGM helps there.
Another thing that I read was that A1cs can seem "artificially" low due to hormones during pregnancy. (I never found this encouraging as I wasn't able to get it below 6.0). But perhaps check your blood work and see if they measured a fructosamine level as well and whether that shows such a low average. (The difference there could also be due to the fact that it is a 3 week rather than 3 month average.) But my endo focused on my fructosamine levels throughout pregnancy since we did blood work every month.
By the way, AWESOME job and congrats! I'm hoping to take a similar approach with a second pregnancy as our son ended up over 9 lbs as well even though my endo and OB-GYN agreed that we did everything we could.
I do have rebound highs sometimes, which are super annoying. It helps if I try to be really disciplined about how I treat the low, like if I only have maybe 5g of juice instead of the recommended 15g. I'm not always that disciplined, though!!
And I think I have become slightly less sensitive to the symptoms, but I still feel them. I guess I'm telling myself that since low numbers are more normal during pregnancy, it's okay if I don't feel horrible at 65. But, yes, it is scary sometimes to not feel symptoms and have my CGM suddenly start alarming.
According to my NP, who is German, fructosamine levels are commonly measured in Europe but hardly ever in the US. I hadn't even heard of it before she mentioned it. So they don't measure that for me. I actually had to ask my OB to check my A1c, and then he said he didn't really care what it was, he cared more what my fingerstick readings show. (You may be able to tell by now that I'm not totally sold on his approach! :)
And thanks for the congrats and encouragement. Despite all I'm doing, this baby is probably going to be big, too, and I'm trying to resign myself to that now. But we'll see... at 20 weeks her abdominal circumference was in the 92nd percentile and at 24 weeks the 75th... so we'll see. My hope right now is just that maybe this baby will be small _enough_ that I'll be able to try a VBAC. Fingers crossed and I'll just keep trying! Good luck to you whenever you start trying again.
I agree with you about not being worried about not feeling 65. I definitely didn't feel those during pregnancy. My threshold lowered, but it is likely due to better control. I just wanted to keep feeling them below 60.
What worked for me what treating lows with a shot glass of juice. It was the only way that I used a shot glass during pregnancy ;) This was when I was at home. On the road I used only glucose tabs.
Interesting about fructosamine. I didn't know that. My endo (here in Hungary) measures both.
Hoping for the VBAC!! I will be hoping for one too...
The shot glass is a great idea--I will try that. What did you do in the middle of the night? I almost can't stand to eat glucose tabs anymore, I think because I've been eating less sweet things in general and my taste has changed somewhat. I found some juice boxes that are fruit and vegetable juice, so they're only 7g of carb, but they're kind of big--more liquid than I want to be chugging at 3AM.
I agree, I definitely want to feel any low below 60. For the most part, I do, so I'm not too worried.
I drank juice during the night too. I also got really sick of glucose tabs and carried a bottle of juice with me and marked where 10 mL was (that was how much I drank for a borderline low and 20mL for a more severe low).