How long did you maintain a good A1C as a T1D before trying to get pregnant?

Hi friends!

My husband and I want to start a family, and I’m trying to get my A1C under control. I’ve been a T1D for most of my life (since I was almost 3 y/o) and A1Cs have been consistently around 8.0-8.1 (despite my attempts to lower them.)

I’m already on a pump and CGM, and after meeting with an MFM doctor, who deals with high-risk pregnancies, I was able to lower my A1C to 7.3 - I almost cried I was so happy! I know it should be lower, but I having an A1C under 6 seems impossible to me, and I’m freaking out. I’m hoping to get it under 7, but I’m still working on that…

How long did you maintain a lowered A1C before TTC? I’m about to turn 35, and am freaked out about putting off having children for much longer… Especially because we want more than one! …at least for right now! :wink:

Thanks for any tips, tricks, or words of advice! :slight_smile:

1 Like

Hi,
I only found out I was diabetic when I got pregnant. Good thing my endo of the time tested immediately and things were under control from the beginning.

My tips, after 2 diabetic pregnancies:-

  1. I would reckon at least 1 full cycle of good control before getting pregnant (so that the eggs will grow and be released in an ideal environment.
  2. Repeat basal and bolus testing to make sure your dosing rates are ideal.
  3. Eat low carb, test blood sugar frequently, and don’t be afraid to correct.
  4. Get a CGM, if you don’t already have one (That is the only wish item I would want if I was pregnant again).
  5. Check which insulins you are taking. Not all are approved for pregnancy. Levermir and Humalog are considered pregnancy safe, and of course Humalin-N and R (but I wouldn’t wish these old insulins on my worst enemy, and though they are useful as a last resort and in certain circumstances, the new insulins are much more stable than the old ones).
  6. Get your thyroid properly checked and supplement if necessary. Low thyroid is very common comorbidity with diabetes (in my case hypothyroid came before diabetes), and may affect your ability to conceive.
  7. Take a good quality prenatal (look for ones with methyl-folate, not Folic Acid. For people with MTHFR genes, FOLIC acid will block the proper uptake of methylfolate).
  8. Eat plenty of healthy fats, and vegetables.
  9. Have fun trying…

Btw, I had my 2 girls when I was 37 and 41. Aside from appendicitis at 3 months in with Baby 1, the pregnancies were remarkedly uneventful and not difficult (aside from managing diabetes), they both came out at about 7 1/2 lbs and with no complications whatsoever…

Please remember every one is different and what works for one person may not be the best choice for the next.
My children are now 19 & 24, so it was awhile ago. But I remember it took about 6 months before I got the go ahead to try and get pregnant. I was not in the under 6 range. Back than it wasn’t talked about being that low. I’m not completely sure but I was probably around that 6.7-7.2 range. Both pregnancys were perfect. No problems. Big problem for me was my first took forever to happen. I got the go ahead but it took us about a year to get pregnant. So it was almost 2 years of tight rope walking that fine line. I’m hoping and praying it doesn’t take that long for you. And side note, I was 30 with the first and 35 with the second. You can do this!

I’m just about in the same boat as you. 35, diabetic since age 7, A1C generally in the 8s…until this past January or so. I switched pumps and CGMs. This new CGM was much better and so I actually wear it consistently. This made a big difference in how quickly I was able to treat highs and three months later, my A1C dropped from an 8.2 to a 6.6. I’m headed to the doctor next week and expect it to be similar or hopefully a bit lower.

My husband and I recently had a talk about considering pregnancy and so, in anticipation of this upcoming doctor’s appointment, I started researching tips on how to better manage my blood sugar. I stumbled across Dr. Bernstein and his low carb diet. After finding a YouTube series of videos from a pregnant diabetic who is on a low carb diet and has had an A1C of 5 for the last few years, I decided to give it a go.

In the last two weeks, my BG hasn’t gone above 150 and that feels really high to me in this new state. I’ve been tinkering with my basal rates, but my BG hovers between 70 and 90 the vast majority of the time. And, I’m not starving or craving foods and I have way more energy.

Anyways, I’m hoping for optimistic news from the doctor - both about the potential for pregnancy and about adopting the low carb diet. I will also send good vibes in your direction. :slight_smile:

2 Likes

I believe it is recommended to be at 6.5 or lower before conceiving - especially because early pregnancy is when a lot of neural development happens. Plus, keep in mind that pregnancy hormones make bg that much harder to maintain.

My A1C was 6.4 when I conceived. First trimester actually caused me to go lower and I got all the way to 5.4. I’m in the third trimester and now at 5.6. Both my endo and MFM are happy with that!

2 Likes

It’s a crap shoot. I’ve had my A1c at 6 and I’ve had 5 losses.
I didn’t think I could get it down to 6 either but what worked for me was I upped my basal a lot, and I do a dual wave bolus when I eat. Then I try and bolus before I eat to have time to keep it low. That keeps me pretty flat. But there is a mental piece because I was nervous to be 80 or 90 all the time but now I feel pretty good there. I also started metformin too. I’m a T1 but it seemed to help me get pregnant. They do it for women with PCOS, which again I don’t have, but with my age, I have some insulin resistance.

The other thing is, you want to be in control and tight so when you first get pregnant and your sugars shoot up, you can see it right away. I know before I take them test becuse suddenly I’m 180 and I can’t get down. My doctors at the Barbara Davis center also said, don’t freak out if you get a high when pregnant, just get yourself down again. It’s the long maintained highs that seem to do the damage. But like I said, it’s a crap shoot. Women who have an A1C at 8 or 9 have a healthy pregnancy and women who are in tight control like me don’t. They don’t know. But they have a guideline to have a low A 1 C in the beginning to give you the best chance. My suggestion is go for it, or wait a month. There is no perfect time lol.

1 Like

When i first got pregnant with twins i was at 8. But got it down very quickly and babies didnt have problems from diabetes.

I didn’t. I found it difficult to be so diligent before I actually got pregnant. I was 7.3 at conception. But today I am at 5.4 (25 weeks along).