Joining this Group

Diabetes and Pregnancy Trying to Get Pregnant
1

after much hemming and hawing, I’ve decided I need to join this group. Have very recently decided to try to have a baby. Am over 35, have had D for almost 30 yrs. I met with a high risk OB this week, and she went over some of the risks, but overall seemed positive, and happy about the 6.7 a1c (which I want to be lower!)

My question…how in the world do you keep your #'s so steady throughout?? I am now watching my post-prandial #'s, and no way am I ever in range 1 or 2 hrs. post. On the rare occasion that I am, I crash later on. How do you do it?? I am on a pump, BTW.

2

I used a CGMS during my pregnancy and maintained an a1c of 5 through out. I checked my blood sugars often and if I was just barely over 110 I would correct. I maintained between 80-100 pretty much through out my pregnancy. During labor I stayed in the 80’s for the entire 12 hours. Be diligent about checking and making adjustments. Good luck.

3

The trick I took to heart that I learned from members here is to bolus 20-30min before the first bite of food. The insulin peaks more slowly than we give it credit for. While it will start to bring your blood sugar down within a short time, the peak of the insulin needs to match up better with the carb-to-glucose conversion that happens much later. I have seen my post-prandials come into range beautifully doing this. Occasionally, I’ll overshoot my time estimate and start the meal a little low, but most of the time I manage it just fine. Lowering my 1 and 2 hour pp’s has helped me bring my A1c down from mid-7s to 6.1%. I swear by it (obviously).

4

Welcome to the group Di!

I would second Melissa about the early bolusing. This is also what improved my A1c. Once I started bolusing 25 minutes before meals, my A1c dropped from 7.6 to 6.4.

(When I got stressed and busy, I stopped bolusing early most of the time and I think that it was one of the reasons that I saw the A1c back up at 7.9).

Here is a discussion with many members tips on early bolusing.

I see that you are on MM722 as well. I use one feature of their pump to help with my early bolusing. When I give the bolus, I use the glucose check reminder available in the bolus wizard. I ask the pump to remind me to “check my blood sugar” in half an hour. This is really my EAT NOW signal. If I am above 100 mg/dl when I give the bolus, then I find it is OK for me to even wait until the half an hour. If I’m below 100mg/dl, then I only wait 15 minutes (and use the kitchen timer). Like Melissa said, I often start the meals out a little low, which can be annoying (or emotional), but I find that it beats post-prandial highs. Just need to find the habits so that you do NOT forget to eat in time.

5

Hi Di
I am 33 years old, pregnant with our first. I have had Type 1 for over 27 years. I have no complications. I do see a high risk specialist, but so far absolutely no complications or concerns. At week 28 this week. I had an A1C about 3 months prior to conception at 7.2 which I don’t know why (I check all the time and have a CGMS). The month I did conceive, it was 6.8. Then it went to 5.7 and 5.9 respectively. It was 5.9 as of this week, which surprised me, but I’m very happy with!

I have pretty big swings, especially post prandial. they will go up to 180’s on average, but during last part of 2nd trimester, I had some swings in the 300’s. I have been working with my doctor very closely. However, he has told me that overall I’m doing excellent and that you just do the best you can do.

With experience in yourself, you just start to realize what foods will spike you no matter what your bolus is. In pregnancy, some foods you just can’t handle even with all the insulin in the world. The biggest challenge for me is to eat a more balanced breakfast instead of majority carbs. I ate same thing day in and day out pre pregnancy and had fine numbers, but with pregnancy, breakfast has been a challenge. However, when I do have a balanced meal with fats, proteins, and carbs, it is pretty controlled.

I have had several significant hypos’ (20’s, 30’s) but you just have to watch it closely.

I do have a CGMS, but I also test on my monitor all the time. Like Melissa said, I have noticed I have to bolus way before I eat to get best results with post prandial swings. Rapid insulin takes a lot longer to start acting in pregnancy.

It can be done, and the more and more women my doc sees who have Type 1, she says that most cases turn out just fine, if that helps.

Feel free to contact me anytime.

Amy

6

My whole pregnancy, I have been using a MM CGM. I bolus immediately after eating just in case the food doesn’t stay down, I can prevent hypos.

My first trimester I had yo-yo blood sugars, and now I’ve been stable. Few more weeks and they’ll be here … I wish you the best! Good luck in the baby race!

7

Thanks for the great advice everyone. I am going to try the early bolus thing tomorrow. I may start out with 10 minutes, then add on if necessary.
Today I was pretty good after breakfast. 2 hours later I was 120, which is the target for me, but oddly enough, an hour after that I was 188!! I was 139 50 minutes later, with no correction. Don’t know if my hands were dirty or what, but I found that odd!

8

Hi Di. I posted about my pregnancy in a myspace blog. You can see it here. I don’t know how far along you are but lows are common in the first 3-4 months. If you read in my blog you see that I ate more often and bolused accordingly to help balance things out. It helps that you have a pump because you can make changes quickly. Adding protein to your meals or between meal snacks will help with the post meal lows. Peanut butter worked wonders for me! lol. PB with sliced apples was like my constant snack - or peanuts on low carb ice cream OMG! I always wanted that stuff when I was pregnant!