Advice needed from moms

Hello! I got the okay from my doctor to start trying to get pregnant! My last A1c was 6.4 (I had started my pump only a couple months prior so I'm hoping it is lower at my next appt). I would SO APPRECIATE any/all advice from other diabetic moms!

I know my doc said 6.4 is safe to conceive but did your docs recommend lower?
How strict is strict enough?? Did you cut out all foods that may spike your BG?
Did you stick to a specific diet/meal plan?
How hard is it...seriously I need the non-sugar coated this the hardest thing you have done? Was it easier than you had expected? Were you terrified you would screw something up?

I am seriously up for any advice you ladies have!! I have researched online, looked in books, etc but it just seems more comforting to hear from real people who have been there and who understand.

Thank you all!!

I conceived on accident and I just got put on a meal plan today. I'm sure it's going to be tough, only 30 grams of carbs for breakfast :'[

Hi Ashley,
my endo also said that an a1c below 7 is safe, but lower is better. My BG goal is to be below 130 about 1 hour after a meal and around 100 two hours after a meal....if you are able to do this, though, your a1c would probably be around 5 or lower (which mine isn't) ;). I just try to take it one day at a time. I think the key for me is to pre-bolus before meals and to eat a low # of carbs per meal. I don't cut out high carb foods, I just eat smaller portions and have snacks throughout the day.

For baby #1, I was terrified of hurting my baby and BG control seemed very hard. But for this pregnancy, I've relaxed my expectations some and things seem much easier. My peri said that he has patients that have BG levels that go up to 300 after each meal, so that kind of puts things in perspective for me (I guess my 160 isn't so bad after all)!

Good luck, you can do it!

Thanks for the reply! When you say low-carb, did they give you a specific amount of carbs to eat?

Thank you for the reply! Yes, the pre-bolus is hard for me. I never seem to know when or how much I am going to of those things I will just have to get really determined about I suppose.
Thanks for the encouragement!

Congrats on being pregnant! Let me know what your meal plan looks like-- I'm hoping to kind of get started on one. Thanks for the reply!

Hey! My A1C was 6.8 when I conceived. I tried cutting out a lot of carbs in the beginning, but the nutritionist said I would need to stop doing that later on. I basically follow the same diet I always have. I still eat things that might spike my sugar, because it doesn't seem to matter what I eat! My numbers get a little crazy no matter what. I was terrified at first...I've gotten better, but I still get nervous. I'm almost 29 weeks along now. I've had a very easy pregnancy so far...just plan for lots of doctor appointments and extra insulin and test strips!

So glad it is going well for you!! It is always encouraging to hear the good stories rather than just the bad. How often are your doc appts? Unfortunately my doc will be 2 1/2 hrs away since my little border town has no specialists.

You should see if you can fax or email blood sugars every week or every two weeks. Although I usually did my own insulin adjustments, during pregnancy, I was really thankful to work closely with my doctor. I met her every week (which is rare in the USA but a requirement in Hungary where I live) and emailed her in between meetings during the times when things were changing quickly.

When you all say you adjust aggressively what exactly do you mean?? Like for instance this morning after breakfast my BG was 175...I put this into my pump but it wouldn't give me any insulin because I still had enough active insulin to cover it. In this case would you over-ride the pump and just standby for a potential low in the next hour or so?? Thank you for all of fielding my millions of questions!!

Thank you-- will definitely talk with this about this!

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.

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

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." :)

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!

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.

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.