Advice for lowering A1c before pregnancy

Hi all-

My husband and I have been married 3 years and are starting to get "baby fever." We are working together to try and lower my A1c. I've been diabetic for 24 years now and still struggle with maintaining a good A1c. I got down to a 6.9 a year ago but went back up to a 7.3 after entering grad school.
I am wondering what others did to get their a1c below a 6.5 before pregnancy? Any tips, schedules, types of exercises are welcome!
Thank you!

Wow! I feel like I could have written this post myself. I have also been married almost 3 years, have been diabetic for 24 years, and am in the process of trying to lower my A1C in order to have a baby. It's nice to know there are other people in the same boat! :-)

I am in the process of re-doing basal tests, because I last did them a few years ago. We also recently bought a scale called a Prep Pad - it works with an ipad, you weigh your food, pick what it is from a list of thousands of foods listed in its memory, and it tells you how many carbs (and protein, fat, etc) are in it, which is helpful for insulin dosage.

I still have a long way to go, though, so I will be keeping an eye on this thread!

Hi my husband and I have been having baby fever too. I've lowered my A1C by taking my insulin 15 minutes before I eat (it prevents the sugar spike). I also am using the T:Slim pump which has been great and I'm going to look into getting a CGM because it will help with overnight monitoring and it's pretty much required by High Risk Ob's during pregnancy as a Type 1. Another thing is diet, I just don't eat white processed flours I bake most foods from scratch which gives me complete control over it's carb content. I use Whole Wheat Pastry Flour to replace white flour and it's worked great.

I had the same situation- finally got it under control and the only way I did it was with the cgm. It is a life saver- it shows you patterns and what is happening every five minutes and over night to catch highs and lows you might miss. Also I wrote down everything (huge pain in the butt) but my RN was able to help me adjust carb ratios and basals throughout the day. Also, for me personally, hard exercise would make my blood sugar rise and then crash hours later- so doing something like walking or swimming always worked better for me. Last thing that really helped was taking insulin a half hour before meals for things with a lot of carbs but little fat like greek yogurt. Although pasta I used a square wave bolus to prevent the 2hr post spike. It's exhausting but well worth it! :)

I have never had a CGM, but I managed to get below 6.5 by measuring 10+ times a day and bolusing a bit early (waiting 10 to 15 minutes after the bolus before starting to eat). When I lowered my carbs that worked much better. I still eat a lot of carbs, but in smaller servings and then don't need to bolus early as much.

Also, I took a policy of never eating carbs when I was high. That was tough, but I would nurse my highs down before eating.

Getting your nighttimes sugars right is also a big help as that is one third of the day when you don't eat!

Good luck! I actually only got to 6.5 and then they let us start trying. You will be amazed how quickly it will come down once you know there is really a baby in there depending on you. For the second pregnancy, I was not able to get it down UNTIL pregnant. But my numbers were great as soon as we started trying. So try pretending your pregnant :)

Good luck TTC!! I will say that, for me, the quickest way to lower a1c is to get pregnant. :) There is just something psychological about knowing that your growing baby's health is dependent on your blood sugar. For me, I went from "trying" to get it down to actually doing the hard work once I got the positive pregnancy test. If you're a better diabetic than myself (hehe) and you are willing to do the work in advance of the BFP, here are my tips:
- Bolus early. When I'm pregnant, I bolus 15-30 minutes before I sit down to eat.
- Cut out your trouble foods completely. Some people are able to eat simple sugars as long as they have fat/protein/fiber at the same time. However, for me, there are certain foods that make this impossible, no matter what, so it's better just to not bring them into the house. I personally don't eat ANY white rice, pasta, bread, cereal, chips, etc... while pregnant. Your trouble foods may be different though.
- Eat consistent foods. If you know you have one or two breakfasts that keep your sugars level consistently, then limit yourself to those meals and don't experiment or guesstimate. With my first pregnancy I ate the exact same breakfast for 9 months. Then I couldn't even look at an egg for 6 months after my son was born. ;)

So all of that being said, TRY not to stress too too much. Even with my little rigid set of rules, I still had wacky blood sugars. Like, range of 30's to 400's over the whole course of pregnancy. It's about having lower patterns of blood sugars. Not having sustained highs or lows. I really think that, once you get the positive test, your a1c will magically drop. :)

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