Need Advice for wife with T1D trying to get pregnant

#1

Hi All,

I need some advice.
My wife was diagnosed with T1D when she was a child.

We are now talking about having children but she is so scared to even try. She is nervous that her Blood sugar levels have to be perfect for the full term of the pregnancy. She is afraid of even thinking that there may be a risk that she has a child with T1D. She thinks that she may harm the fetus.

As a husband without T1D It is very hard for me to give experiential advice. I want to help her but I just don’t know what to say.

To all the mothers out there with T1D, do you have any advice?

Thank you~

#2

Can you give an idea of her A1c the last couple checks?

That would help to understand if she is just being overly concerned or if there are issues that should be addressed first.

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#3

I agree with Tim, if you want to offer more information about where she’s at now, what’s working and what’s not working; you will probably get more meaningful answers.

In general, yes it is very important for pregnant women to be in good control. Also in general; yes it is very achievable to do so

#4

Tim35- thanks for answering. Her latest A1C was around 7.

#5

I have had diabetes for 32 years. When I had my first baby I was about six years into it. It was really hard but I did it, twice!! My kids are 24 and 26 years old. Totally doable.

I was a long time ago but I believe my A1Cs were around 6. It wasn’t that way when I first started out with my pregnancy but I got it down there quick. They also did a test on me called a fructosamine which was supposedly more accurate but I haven’t heard of that test being given to anyone since then.

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#6

I have two beautiful children and we did it 25 years ago long before CGMs were around. And I did see an endo that specialized in diabetes and pregnancy. I had to have three month of good control before we were given the ok to try. And of course it took a year. So my first was almost two years a tighter control than I was use to. But back than I was upper 6’s lower 7’s. It was a lot harder to manage than it is now with CGMs. My control now is far better than it was when I was pregnant. I had both by c-section as that was the norm back than but now, many have perfectly normal deliveries. Both my kids were not big, 7 pounds 3 ounces and 7 pounds 8 ounces.
I never thought I would have children because of my diabetes but am so glad I didn’t let all the bad things you hear sway me.
Don’t get me wrong, it is a lot of work. A lot. But being a parent is one of the best things out there. It sounds like you are completely supportive of her decision and that will be so great because you are as big a part of this as she will be. Yes, she has the hard work but you will be there through the scary highs and the scary lows and all the appointments and tests. It is done everyday and with a lot of work, you both can do this. Good luck and we will look forward to hearing both of you asking questions and advice. Yeah for parenthood!

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#7

**Using the word “you” in this to refer to your wife.

My best advice is to “practice” being pregnant. Make sure you have a pump and CGM and practice staying in tight control like you would in pregnancy so you feel comfortable.

I’m not going to lie, it is scary. I am currently 26 weeks pregnant and never ever thought I would carry a child because of my diabetes, but because I was able to achieve such great control for a couple of years I felt comfortable.

It is also important to remember that your blood will not always be perfect AND THAT IS OKAY!!! One high number here and there is not going to hurt the baby. It is just going to happen. Hormones make things crazy and sometimes unpredictable. All we can do is the best we can do and keep things as close to “normal range” as possible.

I am still in the midst of my first pregnancy so I can’t give you any certain outcomes, but so far I have had a completely normal and healthy pregnancy, and I am SO glad I made the decision to get pregnant!!!

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#8

I haven’t had any children but I do intend to someday and it is not like in the old days where diabetics were so poorly controlled that there were severe health consequences from pregnancy, both to baby and mom. My advice would be to find a really good Dr. which, I know can be difficult but having someone on your team that knows what they are talking about and is supportive can make a big difference to your peace of mind.
Your wife’s fears are not entirely unfounded because she has probably heard some horror stories in her years as a diabetic not to mention Steel Magnolias (arhhhh). Is she the only one in her family with type 1 or does it obviously run in her family? It is actually known that women are less likely to pass on diabetes than men (I don’t have this study, sorry).
Also even if one of your kids was to develop diabetes, the treatments are so much less traumatic than when we were kids. Everything from CGMs to pumps and much better understanding from the communities around us in general that diabetes for me at least has stopped being my personal ball and chain and if it is for your wife then maybe her treatment plan isn’t right for her even if her A1C’s are good.
Good luck!

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#9

Find either an endocrinologist with experience with T1D women or a maternal-fetal specialist (that’s what it’s typically called in the US; basically an OB/GYN who sees high-risk pregnancies) and go for a pre-conception consultation together as soon as possible, before trying for a baby. They would explain what the extra tests and other things recommended will be and give your wife guidance on what her BG targets should be for a healthy pregnancy despite the diabetes. (Yes, they are stringent, but it is that important for the developing fetus.) HbA1c of 7 isn’t bad to start with, but I would advise (this is the current best recommendation) that she tries to get it under 6. There are numerous other discussions on this board on how to work toward such a level. There is also a good resource for remote consultations called Integrated Diabetes Services (Gary Scheiner) and they work with women who want to become or a are pregnant.

Best of luck to both of you! Becoming a parent is so worth it! (I have a 4.5-month-old who is currently fighting her nap, but I still think so. :slight_smile: )

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#10

Advice:

See an endo she trusts
Wear a pump.
Wear a Dexcom G5 CGM.

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