4 weeks pregnant, A1c mid-7's - freaking out!

My T1 wife just found out a couple hours ago. We're ecstatic as we weren't planning to start trying yet, but nervous because her A1c isn't where we wanted it to be before we started trying :-/ Likely still around 7.5. Email has been sent to Endo, and there are lots of great programs, probably Sweet Success, we'll be working closely with.

Anyone else been in this situation? What did you do when you first found out? My wife is deathly afraid of lows, so it's going to be an adjustment to think of 140 as high-- the past few weeks she's been constantly in the mid-100s, sometimes around 200.

Just as importantly, as a spouse, how do I keep her on track without being overbearing and freaking out when she's above 140??

My consultant was quite happy for me to start trying with Ac1 of 7. We had our 12 weeks scan yesterday and all is fine. I needed a lot more insulin in the first few weeks then the continual hypos began at 8 weeks. Would be constantly hypo. Like 2 or 3 times a day. Its starting to ease off now but that may be as I have another cold. Just keep in regular contact with your team and if she is high just correct it. Congratulations and good luck

If she doesn't have one already, I would highly recommend that you look into getting a CGM system. Trying to keep my numbers in the goal ranges for pregnancy ends up sending me low more often than I'd like, but with my new CGM alerting me to falling blood sugars, it's much less scary. The same is true for highs- you can set an alarm to go off any time sugars go above a set level (I have mine set to 140 for pregnancy), and that way you can catch sugars on their way up before they hit 200. (And it won't be YOU nagging, it will be the CGM, which is much easier to blame/be mad at! :) )

Whatever you do, be supportive and understanding of the struggles to reign in the blood sugars as best as possible. I had a couple 250's in early pregnancy that brought me immediately to tears, and my husband sweetly just calmed me down and reassured me that everything would still be ok. An A1c of 7.5 is still most likely perfectly safe for the baby; just take every day one at a time. Hope this helps!!

Jenn, T1 for 19 years, 19 weeks pregnant now with first baby!

Hi--I'm type 1 and 32 weeks along with my second child. I second the idea of getting a CGM. I love my Dexcom G4. It is really, really helpful for catching lows (and highs), especially at night. And it's nice because you can see the difference between being 68 and falling quickly or 68 and steady. You definitely need to make a mental adjustment in what you're okay with in terms of highs, too. I have my CGM high alert set at 120, which is the lowest it allows. You might find the article I posted by Lois Jovanovic on this forum a little while back to be of interest, too. Best of luck and congratulations.

Yes, 140 was my border line for high. We also dropped the cut off for lows to 65.

I had a really hard time getting my A1c down. I struggled to get below 7 before I was pregnant, but somehow being pregnant helped me to be more focused/disciplined about diet and insulin regime. So my numbers were so much better than they had been (or how they are now) My A1c was 6.8 when we conceived and it went down to 6 but never below that during the pregnancy.

Another change was measuring my blood sugar 1 to 1.5 hours after the meal and trying to eat in a way that prevents spikes after meals. Post meal spikes are something that we were mostly taught to accept (i.e. don't measure until 2 hours after the meal). This is not the case in pregnancy. Many of us benefited from bolusing early (15-25 minutes) BEFORE eating.

About "keeping her on track", the best recommendation that I could give would be that she join our group and the positive diabetic pregnancy group on Facebook/Yahoo groups. For many of us, support from the online community was vital during the pregnancy as so few people understand the pressure and struggle of pregnancy with diabetes. I really dislike when people try to micro-manage my diabetes (even my husband), but what he could do to help was COOK foods that were good for me and NOT bring food into our home that was not good for me (we had a 9 month ban on chocolate in the house except for minibars where I was allowed to eat 1 after meals). He ate much healthier with me, which helped me feel like we were in it together.

Don't freak out when she is above 140, as she is probably already doing that. You could go for a walk together or wait to eat until her numbers come down. The important thing is to wait to eat until her numbers are better. At some exhausted points of the pregnancy, my husband would measure my blood sugar during the night without waking me and would only wake me if I was below 65 or above 140.

See if she can overcome her fear of lows, perhaps by talking about it, measuring more frequently, ... also she need to be sure to not overtreat lows. I treated with a shot glass of fruit juice to ensure that I didn't have a rebound high.

I am sure the CGMS would be great, but I don't have one and probably won't for the next pregnancy.

Congrats to you guys! I echo everything that the other posters have said. Pregnancy is extremely motivating - I struggled to get my A1c to a good place pre-conception and then as soon as I got the positive pregnancy test, I wasn't nearly as annoyed with testing so often (now I test upwards of 14x/day), making certain decisions about food, etc. I agree with Kristin - there is no need to freak out if she is above 140, it is likely that your wife is already doing that. At that point, there is nothing she can do but correct, bolus earlier next time, etc. I never used to correct if I was over 150 - just the simple act of doing that has helped to lower my A1c.

My husband constantly checks and stocks the house with juice. I, too, used to be terrified of going low, but honestly, I think occasional lows are going to happen when you're trying to tighten your control. He makes sure I always have a few juice boxes in my purse (all of them, really), my car, by the bed, etc. Knowing that I will never been in a situation whereby I go low and don't have immediate access to glucose has made me feel so much more at ease and comfortable hanging out at 70.

For the most part I think all I would have to say has been said. Congrats though!

As far as her fear of lows goes, that may be a problem. I'm pregnant with my third atm and just like the last two times my insulin requirements dropped drastically. Somewhere around 8 weeks. I have an appointment with my endo on Thursday and we'll be adjusting my doses but right now I'm low almost all day. The key is really to have a doctor that will see her at least monthly while pregnant because her requirements can and likely will change several times.

In my opinion your role in this is to be supportive. Let her know she can ask for help when she needs it but please don't make her feel bad when her numbers aren't on target. She'll probably struggle with her own guilt in those moments.

Good luck to you both and again Congrats!

Thanks everyone for the awesome supportive responses, and sorry it's taken me so long to reply! I've learned I am terrible at social media these days... used to be way better, dunno what happened!

Anyway, things COULD NOT BE ANY BETTER. My wife literally brought her sugars down overnight after we found out she was pregnant. Her A1c turned out to be 8.6 when we found out, but 3 weeks later it was 7.2 and now that she's 13 weeks it's at 6.1!!!! NT Ultrasound went great and she has a wonderful OB at Stanford who's also an Endo. Couldn't have worked out better. We feel very very blessed!!!

First trimester was blessedly easy as well-- no sickness at all, just fatigue. After dealing with T1D and Celiac, it's so great that she finally got a break! :)

Thanks again all. More updates to follow. If it wasn't for reading everything on this site for YEARS before we got pregnant, I would've been way more of a mess.

PS we COULD NOT HAVE DONE IT without her Dexcom G4. This thing is incredible!!!!