First Pregnancy with Type 1 Diabetes

Diabetes and Pregnancy
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Hello everyone!

My wonderful partner and I just officially found out earlier today that we are pregnant! We haven’t even told our family and friends yet so you all are the first to know :grinning:

To give you a little background, I’m 24 years old approximately 4 weeks pregnant (unplanned). I was diagnosed with Type 1 Diabetes when I was just 18 months old. As a child my sugars were pretty well controlled (A1C’s in the 5’s and 6’s) then as I progressed into my teens, they just got worse. Eventually, not checking my sugars and not giving myself insulin became a bad habit that was really tough to break. I’ve been in the ICU twice around my late teens for DKA. It got a little better when I got my pump around 2013 but my bad eating habits and not checking my sugars stuck around. Haven’t even seen an endocrinologist since last year due to insurance issues and my A1C was 10.3.

When I realized my cycle was 3 days late and I could possibly be pregnant (about a week ago), I’ve been checking my sugars frequently but it’s been really hard stabilizing them between 70-120. My whole life I’ve been told how difficult it would be to safely deliver a healthy baby. I’ve encountered MANY doctors and nurses through the years who have scolded me and judged me, but not anyone who could really understand and help me through these challenges. I don’t personally know anyone else with Type 1, especially someone who was diagnosed as early as me so I’m here today, looking for some guidance from people sharing similar experiences.

Would anyone be so kind as to share some insight into their experience with Type 1 DM and pregnancy? I’m trying, I’m terrified, and I have no one else to really talk to about this besides my partner but he isn’t diabetic. Can I give birth to a healthy baby and survive it?

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You absolutely can have a healthy pregnancy. I haven’t ever been pregnant but it’s not like the old days where being a diabetic meant having a baby was a bad idea. The first thing you must do however is get your BG’s under the best control you can. If you can possibly swing getting a continuous glucose monitor then do so, it will become your best friend.

If you are still having insurance issues you can get your A1C done at most community clinics for a very reasonable cash price (for me paying up front it’s about $25) and you probably really need to talk to a Dr. about your diabetes combined with your pregnancy.

I was diagnosed at 18 months as well and had poor control for most of my life and only recently managed to get my A1C under 7. Low carb combined with a CGM is what finally gave me the edge I needed to get there. Low carb will take away most of the spikes that as far as I know are the real danger with pregnancy, and do not beat yourself up every time you have a bad BG because that won’t help you or your baby.

Let us know if there is anything specific you are having trouble with and we’ll all see what we can come up with.

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Thank you so much for your response! I will absolutely inquire about a CGM at my Dr.'s appointment in 2 days. A low carb diet sounds like a good solution for most of my spikes and increased insulin intake. I know I’ll have to see a registered dietitian as well for more help with carb counting.

About 2-3 times a week I’ve gotten really low where I start shaking, sweating, and just eat everything in sight until I start to feel better. After that, my sugar spikes again because I’m not sure how to treat the low/horrible feeling without overeating. Then I get too afraid to give myself a bolus for the food I ate because of the recent low. How do you usually treat your lows when they happen?

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Are you testing your BG when you start feeling low? How low are you going? Is it possible that your basal rate is set too high? Pregnancy hormones will throw everything for a loop so you’ll probably have to adjust your basal and bolus regimen quite a few times throughout your pregnancy.

Treating the low should be pretty easy but getting rid of that horrible feeling for me just takes time and patience (unfortunately). I use glucose tablets which are absorbed by our bodies much faster than most other “low treatments” and you are not as likely to overindulge on those as you would with juice or candy. 1 gram of glucose should raise your BG by about 5 mg/dl so if the appropriate amount of glucose doesn’t get your BG back in range then you are probably dealing with a basal rate issue.

Until you figure out what the problem is then I would make sure to eat plenty of protein to help carry you over when all of the carbs have processed. If you are not having morning sickness yet then you may want to do a basal test to see if your basal rate is set too high.

As for carb counting get a scale and weigh everything and use an app like OneDrop or something to track calories, BG’s, insulin, and carbs. If you can, cook your own food for a while so that you know exactly what you are eating and can bolus for it correctly.

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I have had two healthy children. They are 24 and 26 years old. So it is totally possible for you to give birth to a healthy baby. I want to be honest though. I did also have one uncuvcessful pregnancy that ended in stillbirth. I don’t know what happened to that baby. I never got any definite answers.

I wasn’t in the best control either when I started out but I got in control pretty quick. Not many people had pumps back then. I didn’t have one. I had never heard of a CGM either. I checked my blood sugar 7 times a day and took more and more insulin with each passing week.

Having a baby as a diabetic is not the blissful picture of the expectant mom with her hand rubbing her tummy. It’s a lot of hard work and a 24 hour a day job. Oh, and worry. Lots of worry.

It’s worth it!! It’s totally worth it once you have your baby in hand. Your diabetes will return to a normal level. It might be a new normal but your insulin will level off and become more manageable. You may even adopt some better habits while you are pregnant. You want to be in good shape to live long and take care of your child so 10.3 won’t cut it any more.

The whole thing is scary, I know. You need a high risk OB/GYN and a Hospital with NICU. You’ll most likely find both of those in or near a large city. I had to travel to see my dr which required some over night stays.

Best of luck with it. So much new technology since I was having babies. We are here if you need us.

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Hi there!

I have not yet given birth, but I am 28 weeks pregnant with type 1 so thought my experience thus far might be somewhat useful to you! I have been type 1 for 18 years and didn’t experience great control until the last few years. I completely credit my Dexcom CGM for that. My a1c at conception was 5.4 and since then it has been 5.1, 4.9, 5.1, 5.2, and 4.9. The insulin resistance has gotten CRAZY over the last few weeks. I’m now using almost 3 times the insulin as I used pre-pregnancy (in my Tandem T slim pump).

I see my endocrinologist once a month and have seen the high risk OB (MFM) a few times. I am about to see them weekly for growth scans to make sure he’s not getting too huge! The MFM put me on baby aspirin once a day to strengthen my placenta and prevent preeclampsia, but other than that he hasn’t had much to say.
I am also about to start weekly NST’s later this week. They also sent me for a fetal echocardiogram last week but it was totally normal.

I think the most frustrating thing is just the pressure - you feel like if you make a mistake you are hurting your baby. But we can only do the best we can! I asked my OB, “Should I call you if I have one really high blood sugar?” and she literally laughed at me and said, “a high blood sugar here and there is not going to hurt anything.”

Insulin resistance is also rather frustrating. For me, I have NOT been able to go low carb at all. I have had terrible morning sickness and am still throwing up almost every day. The doctor says it’s from the diabetes combining with the pregnancy hormones to create severe gastroparesis. Unfortunately, I HAVE to eat bland carbs every few hours or I become violently ill. Again, we just do the best we can!

At this point (depending what happens with the NST’s and growth scans) the plan is to try to be induced at 39 weeks exactly. That’s the goal. If they find that he is going to be abnormally huge, then we will schedule a c-section, but I am hoping to avoid that.

Sorry to just ramble on! I’m happy to answer any questions you have. YOU CAN DO THIS!!!

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My low’s have run between 38-78 (78 is probably an optimal number but around then is when I start feeling the symptoms). I have an endocrinologist appointment in 2 days so I’m thinking she might adjust my basal rate to increase/decrease at different times of the day. For example, I’ve noticed my BG increases between the hours of 4 am-7-am even when I’ve eaten nothing.

Another issue I have is that I work full time night shift 8 hours/5 days a week. Before I got pregnant, my endocrinologist has said that that shift isn’t recommended for me as it can really mess with my sugars - and now that I’m testing more often, I’ve noticed it too!

Thanks so much for the advice! Definitely taking all of this into account.

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Thank you so much for sharing! Bless you and your family! And I’m so sorry to hear about your unsuccessful pregnancy. If you don’t mind me asking, was that with your first pregnancy?

I do consider myself very lucky to have all of this new technology available to me living with diabetes, especially now that I’m pregnant. So I salute you for being in such control and bringing 2 healthy babies into the world even without pumps, CGM’s, or health apps! I’ll get anything I can to help with this pregnancy.

We also live in Chicago so we’re very fortunate to be surrounded by great hospitals! Just had an appointment with my midwife today and she faxed over a referral for a high risk OB/GYN that I did some research on prior to choosing.

Before I met my partner, I always thought that if I met the right person and I were to give him children, THAT would be the thing that saves my life. Living with diabetes your whole life and comparing yourself to people without it really took a toll on my self-care, especially when I was a teenager. Those bad habits just carried on into adulthood. I had no discipline and no motivation to better care for myself.

Now, I’ll do anything and everything to make sure this baby and I are healthy. You’re so right, what I was doing before isn’t going to cut it at all. I want nothing more than to give my soon-to-be husband healthy children and I want to be around to love them all for as long as I possibly can.

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Thank you so much for sharing your experience! And congratulations!!! :star_struck: On the baby and for such great glycemic control which I’m desperately hoping to achieve now!

I have my first endocrinologist appt in 2 days so I’m definitely going to inquire about getting a CGM because my numbers fluctuate so much throughout the day. I have a Medtronic Minimed pump right now and it’s helped so much with giving myself insulin because I really hated sticking myself 6 times a day in the past. I’d like to have something that catches my high/low BG levels before they start getting too extreme though!

Yes you’re so right about the pressure. Whenever I have a high reading I just get so worried.

Wow, I can’t believe you’re using 3 times the insulin you used pre-pregnancy. I get worried when I have to use more than 10 units :sweat_smile: What kinds of foods do you usually eat to address the morning sickness??

Oooh! Omg you’re almost there! This is kinda out of left field but my coworker said she purchased a home fetal monitor when she was pregnant and it gave her a lot of peace of mind. Do you happen to have one of those?

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Following this post! I just found out that I was pregnant (5ish weeks) and I just recently got my a1c down to 7.1. So I’m worrying about how to keep my blood sugars down. I have a CGM and I think it definitely helps. But when I eat I always have a low carb meal and I just recently read that I’m suppose to actually eat more carbs since we’re pregnant. I’m needing help with meal plans and trying to get my sugar where it needs to be. The more carbs I have, the worse my sugar is in 2 hours.

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Feel free to ask me anything. I’m happy to share my experiences. If it will help someone else, then all the better.

Yes, it was my first baby that was lost, my only boy. I carried him eight months. He had been a very active baby but one day I noticed that he had stopped kicking. I called my local dr (not even the high risk one). I went in to see the local dr. No heart beat. Nothing. I was induced and delivered in the wee hours of the next morning.

We had that baby examined post mortem. There was absolutely nothing wrong with him. My A1c throughout the pregnancy was down around 6. We never got any definitive answers as to what went wrong.

I’m not telling you all this to scare you. I’m just being honest. The good news in all this was that my oldest daughter was born a year and two days later. She is now 26. With her, and my second daughter, I went into the hospital in the 8th month and sat there for several weeks waiting for them both to be born. I was strapped to the fetal monitor four times a day, every day. As soon as their lungs were mature, they were out. They were both incubated a few days and both went under the “billy” lights. Other than that, they were, and are, both fine. My youngest daughter is 24.

It’s too bad we lost our only boy but we didn’t give up or take no for an answer. We kept going until we got what we wanted, which was two healthy children. After that I was done, tubes tied, factory closed. I couldn’t put us all through that again. No regrets.

It was wonderful to give birth to my own children. No one should be cheated out of the experience because of diabetes. You can do it.

Again, don’t be scared because of my personal story of loss. Stuff happens whether you have diabetes or not. My story has a happy ending.

Best of luck.

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Thank you!!

Yeah the CGM is so great for alerting BEFORE anything bad happens. I have it set really sensitively so I can catch any problems before they come up. Definitely a game changer.

Unfortunately, the only foods I have found that really help the morning sickness are things like white bread and crackers. Basically the opposite of what I would ideally like to be eating. BUT even with all of those foods my a1c is still 4.9, so I hope that makes you optimistic!

I don’t have a monitor at home. Now that I’m far enough along to feel him move all the time (he’s VERY active), that gives me all of the reassurance I need.

I had an OB appointment this morning and since they don’t have any concerns at this point they are letting me wait until week 32 to start my NSTs, instead of starting this week at 28 weeks. I will be getting a growth scan next week so cross your fingers that he’s not a huge monster baby haha!

Keep us posted on how your endo appointment goes. I hope you get lots of reassurance and information!

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So just had my endo appt on Friday… some good news!

My A1C went down from 10.3 to 7.8 since my last visit. Still some work to do but I’m confident I can get it down some more! My endocrinologist slightly increased my basal rate on my pump too. She also changed the bolus ratio from 1:6 to 1:7. Honestly since then my sugars haven’t been as low as I’d like them to be (mostly around the 130’s-180’s) but I think that has more to do with my current diet. That’s my biggest challenge right now.

I also spoke with a diabetes educator about getting a CGM so she’s put in a referral for me and hopefully I’ll have one within the next month.

Just had our first ultrasound earlier today and we saw the baby’s heart beating :scream: sorta looked like if you flicked a bean sprout over and over again lol. Anyway, seeing it just made it even more real and gave me even more motivation to better care for us.

Thanks again for sharing!

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Hi congratulations on your pregnancy!!!

It looks like we’re pretty much in the same boat! I’m about 6 weeks along and my A1C is 7.8 right now. I actually just spoke to a diabetes educator earlier today about getting a CGM so hopefully I’ll have one as well within the next month!

I have the same problem with carbs and spikes in my BG after a couple hours. My main problem is, I loveeee carbs lol and even with my insulin coverage my sugar isn’t where I want it to be after a meal.

Do you see a registered dietitian/diabetes educator about your meal plans?

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WOW!!! What amazing news about your a1c! You have to feel so great now!!!

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Hey CEMedz,

It is very nice to hear that you are pregnant. Congratulations:) Visit Doctor regularly and take at most care of your self because it directly effects the baby.

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Omg the nausea has definitely begun lol. I’m about 7 weeks along now and I feel nauseous allll day especially when I’m in the car. Even in the middle of the night when I just happen to wake up! Then I can’t go back to sleep because I’m so nauseous ugh.

Haven’t had any vomiting just yet but it’s kind of scary for me because this nausea reminds me of how I felt years ago when I was in DKA and I was also nauseous all the time. My sugars now are ok and I know this is totally normal for pregnancy but wow I’m having some terrible flashbacks and it’s scary so now I’m even paranoid about my sugars :disappointed:

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Thank you!! :blush: yes I have several medical professionals that I’ll be visiting often. So far I have a primary care provider, midwife, OB, diabetes educator, endocrinologist, I’ll be seeing an eye dr soon for a diabetes during pregnancy check up, and I’m pretty sure they’ll be referring me to a high risk OB soon haha. Thanks for the support!

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@CEMedz congrats on your pregnancy! I am almost 18 weeks along myself and just wanted to share how its been for me.

First trimester you tend to run low, and I did. My a1c before pregnancy was in the 6’s but during my first trimester it dropped to the lowest I’ve ever seen it - 5.8 and then 5.4. The thing is, I could never FEEL my lows anymore! I use a Dexcom and I think it was struggling to keep up with me. It would alert that I was at 70, but when I would check on my meter, I’d already be in the 50s and not feel a thing. That definitely threw me for a loop and I started carrying all natural fruit snacks in my purse (they’re lighter weight than juice boxes and I absolutely HATE glucose tabs!) and keeping juce boxes everywhere else - car, coffee table, kitchen, office, bedside table.

Thankfully I never had bad nausea, just low-grade stuff, and I never got sick. Sometimes I would have weird moments of “am I nauseated or am I hungry…hmm” which is definitely a strange feeling! Usually it was hunger!

I’ve been trying to eat low carb/keto and before I got pregnant I did really well, even through the first trimester I did really well and hadn’t gained a pound (this girlfriend doesn’t need to gain ANY weight, baby can have ALL my fat reserves, lol).

Second trimester now and things are haywire. I’m up to 1:3 carb ratio most of the day. I went from bolusing like, 4 units for breakfast of coffee, a few spoonfuls of peanut butter, and a few bites of cottage cheese, to bolusing 15 or more for the same meal. It honestly freaks me out and I’m worried my a1c will have jumped way too high at my next endo appointment on Tuesday. And of course I have to see a strange doctor I never met before instead of the PA I’ve been working with for years…not bitter about that at all.

I was ridiculous about my diabetes control when I went to college. I basically did my basal shot at night, but never bolused or checked my blood sugar. So many nights spent binging with the girls on raw cookie dough, I literally have no idea how I survived. Then after college of course it was a struggle to get back into good habits. It wasn’t until we got married (Nov 2011) that my husband gave me the guilt trip talk and told me he wanted me to take care of myself so I could be with him for a long, long time. Of course that got me back on track. I wasn’t super strict, but I tried a lot harder. Then in April 2013 irony of ironies, I went into dka after a bit too much to eat at a friend’s wedding shower. I had no idea what dka was supposed to feel or be like, so my blood sugar was off the charts by the time we made it to the ER and they were able to triage me. I was in ICU for 2-3 days before they put me in a regular room for observation one more night and then I was released. No one at that hospital had any idea about new analog insulins or basal and bolus rates or pumps or cgms. I was still cruising in the 200s when they finally released me. So it was a learning experience for sure, and the only time I’ve ever been admitted to the hospital! My poor husband was so traumatized that he didn’t want me to get pregnant for years.

Finally we were both ready for kids, but I think we’re both a little spooked about being in the hospital and under a doctor’s care who knows nothing about my daily t1d management. I’m ready to fight for what I need, and we’ll be hiring an experienced doula to help us out as well.

I’d love to hear how you’re doing!

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@KCCO Congrats on your pregnancy as well! It sounds like you’re taking such good care of yourself now! Which is saying a whole lot because of the bad habits you came from in college, which I’m actually still trying to break now :disappointed_relieved:

I’m currently in my first trimester. They tested my A1C about 2-3 weeks ago when I confirmed my pregnancy and it was 7.8…which is actually a huge improvement from the 10.3 I tested at about 6 months ago at the last endo appt I attended due to insurance changes. Right now my BG levels are ALL over the place. Throughout the day, I run from as low as 47 to as high as 240’s. My diet is the biggest factor affecting my sugars. I’m always craving fast food and when I’m not, my home cooked meals are loaded with carbs, particularly white rice. I also work 11 pm-730 am about 5 nights/week so my basal rates vary from hour to hour. My boluses for meals are usually always around 12-20 units now, which is scary because I know my insulin resistance is going to increase further into my pregnancy!

I just got my CGM and new Medtronic pump in the mail yesterday so I’m supposed to attend a class on 4/23 to adjust to the new tech. So hopefully that’ll help keep my BGs down and more stable, definitely including a change in diet. I’m so terrified because I’ve read that the first 8-12 weeks of your pregnancy are the most crucial time for the baby’s development and my sugars are out of control.

I’ve been having a ton of nausea and I’ve been getting carsick if I’m not the one driving. My OB prescribed some Diclegis, which is supposed to be safe for mother/baby to address the nausea. I’ve been taking it as needed. Plus some diet ginger ale from time to time. But I definitely know what you mean about those weird moments where you don’t know if you’re nauseated or just hungry! I feel like being hungry makes the nausea worse actually. And I’ve read that skipping meals can make you feel more sick.

:smile: It’s so nice to hear your story about your habits in college and how it all changed when you met your husband. I feel like our stories are very similar! I almost never checked my BGs and only bolused with my pump for carbs I ate, but even then I would under bolus because I hated how low BGs felt. I’ve been in DKA twice at 13 and 19 years old. It wasn’t until I started dating my fiance that I really felt the need to take better care of myself. Before him, I sort of hid and ignored the fact that I had T1D so in turn, none of the people I dated or any of my friends were really concerned about it because I looked fine. So it was such an eye opener when I finally had someone that wanted me to be as healthy as possible so I could be with them for the long run. And now that we’re expecting our first baby, my eyes are as open as ever! Lol.

This was an unplanned pregnancy as I would’ve liked to have my blood sugars under better control before conceiving. But now I’m willing to do whatever it takes to keep my baby healthy, safe, and free from anything that might cause him/her any pain or distress in the future. I’m so scared though! And the worry never goes away!

What do you usually eat for your low carb/keto diet? I need to make some big changes in my eating habits. Sorry this was so long haha, but thanks for sharing!