Am I expecting too much?


Just wondering if anybody out there has any advice/words that may help me feel a bit better!

My son is 3. had great pre-conception care and got my A1c down to nearly 6% throughout most of my pre and during pregnancy. The placenta went and he was born at 36 weeks, was in special care for 2 weeks and was very ill and very big despite my close control.

I then had post natal depression for 18 months during which time my blood sugars were rubbish (8.9%). After 18 months I started fighting to get my blood sugars under control in order to try for another baby but couldn’t. all the health care professionals I saw had no suggestions - insulin doses, diet anything. I went on a waiting list for the pump and finally got one in november. My A1c is now down to 8.3% but this is nowhere near low enough despite very frequent testing, bolusing like mad and sincere effort.

We have moved areas and so i have a whole new nhs to deal with. Before my last baby I was seen at a pre-conception clinic and had quite intense input every fortnight if i needed it. Here I am seen every 6 to 8 weeks by the diabetes nurse (who never really suggests anything) and 6 monthly by my consultant. They keep talking about what will happen when i am pregnant but seem to be offering little help while I am trying to reduce my a1c in order to get pregnant. there is not pre-conception clinic here.

I have spoken to my gp about it and she just told me don’t even think about getting pregnant at this a1c. But the only other option i have is to not have another baby. I am well aware of the risks but i am not getting any younger and if we don’t take the risk then I will not get the intense help i think i need. i recently was put on metformin to try to reduce my random new insulin resistance and i have an unexplained B12 deficiency which nobody seems to be concerned about.

how much help have other people got pre-pregnancy?

Sounds like you live in Great Britain? I know nothing about the NHS, but is there any way you can see a different diabetes team? Has the metformin helped at all? It sounds like you are in a very frustrating situation–it’s hard not to have the support you need when you are trying so hard.

Best of luck and please let us know what we can do to help.

Hi Kat,

I feel your frustration! I’m in NZ and my experience here is that it depends on which area you’re in as to the intensity of pre-preg assistance. Talking with my GP about such things would be a complete waste of time - they don’t ‘get’ it. Have you had a blunt conversation with the hospital about the fact that you’re trying your hardest and that you want a baby and you want to take the responsible path?

I’m on metformin now too for resistance alongside the pump and agree that it’s a battle. I’m 8 weeks now with number 3 and have an a1c of 6.7 which, for me, is great and even the docs are happy. BUT I had, like you, a battle to bring it back down to that. Is your a1c result slow to move and reflect the hard work you’re putting in? (mine is, hence why I ask).

Any chance that you can ditch your current nurse in favour of a more helpful one? What about getting your consultant visit frequency increased? Here if we make noises about wanting babies they tend to do that.

Fingers crossed for some better care for you!

Thanks for your nice replies. The metformin has brought my levels back down to the pre-random highs. 2 months ago mysugars were just through the roof and I had doubled my basal and even that wasn’t touching them. the metformin has got me back to ‘normal’ doses but no other improvement. i have been making wanting baby noises for 12 months now. Options for a different diabetes nurse are none unless i move hospital which would mean I lose my pump!! I have a consultant app in a month and think laying it on the line is probably necessary although not convinced it will do much good. I honestly feel that unless I actually get pregnant then nobody will help. Not sure if my a1c is reflecting my hard work. haven’t had it tested since Feb!!! But based on last time round with my son I am getting tto many peaks afetr meals, there are no patterns that I can see, my monthly cycle plays havoc with things but doesn’t seem consistent every month so don’t think it will be near 7%…

Did anybody else find it harder to get good control for the 2nd or subsequent babies?

Are you able to do a lot of postmeal testing to see if you can curb the 1 hour postprandial highs?
And if you’re seeing those spikes, are you taking your insulin far enough ahead of the meal?
Those are the two biggest factors in my personal experience with high A1c’s.

Do you think you may still be struggling with PPD? (My best friend is pregnant with her second (her first is 2.5 yrs old) and still struggling with lingering postpartum depression and now, antenatal (during pregnancy) depression. She finds that therapy and meds are both crucial for her right now.)

I would not get pregnant with an A1c over 7.5. I know 6.5 is everybody’s happy goal, but you need to set a realistic, achievable goal for yourself, meet that, and then start trying. Don’t start trying now when you know your numbers are that far out of whack. You would just be overcome with guilt and have a hard physical/emotional recovery if you were to lose a pregnancy when you knowingly started TTC out of control.

I was 6.1 at #1’s conception, but 7.0 at #2’s and have brought it down to 6.3 just in my first trimester. You can and WOULD bring things under control if you found out you were pregnant, but I’d start by getting the medical team to give you the help you really need and see if you can strategize your way through some of the problems with your blood sugar management.

Thanks. You are totally right about not trying now. The PPD with my son was partly due to me feeling to blame for his ill health after birth (despite good numbers before and during pregnancy) so to go into it with my levels like this would be a recipe for disaster psychologically.

I don’t think i am depressed. i am frustrated and very very sad when I think about my diabetes and how it is stopping another pregnancy but elsewhere in life I am good.

My diabetes nurse has put me on a CGM this Thursday which is half depressing as it is showing how out of whack my sugars are but at least we are doing something to try and find out what is happening instead of nothing. I think my problem is that my basal rates are all wrong. as a result I am always playing catch up to try and correct highs and lows and never finding stability. Hopefully the CGM readings will show my HCP how much help I need (the pump is a relatively new thing for me and I don’t feel confident changing things myself but have been left with no option due to the limited input I have had).

Thank you again for your kind responses. Just talking/typing about it has helped to make me feel slightly less alone with this.