Planning to Get Pregnant (T1D) & Terrified

Type 1 and LADA
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Hi fellow diabetics!

I am currently 22 years old and have been diabetic since I was 9. I have known since my first memory I have always wanted to be a mum (cheesy I know). Well, I have been with the most incredible man for the past 2 years and we have planned to have kids / married etc in the future.

But I am absolutely terrified. My blood sugars and controlled, but over the past 15 months I have struggled to gain weight. In March 2017 I went through bullying/harassment at work and as a result unconsciously lost 15 kg. I have put on maybe 6 kg since but struggle to gain anymore.

I want to get start trying to get pregnant in 2 years (2020). Is there ANY advice or tips you fellow diabetics could give me? I plan to go 80% vegan in my diet, and have began an exercise program as I want to be in the best shape / health before trying.

I feel like all I hear is ā€˜diabetic woman have MASSIVE babiesā€¦ they canā€™t give birth naturallyā€¦ you give into your cravings and that can kill you or the babyā€™ā€™ etc etc.

Just would like some real peopleā€™s experiences. :slight_smile:

Have a great day all!

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Another issue to consider is that your child will have a much higher chance of developing type 1 diabetes because of the genes you will pass on to it. That was the reason why I decided it would be immoral for me ever to have children. Since parents owe the highest duty to protect their children from all potential harms, I felt it would be wrong for me to begin by imposing an elevated risk on my child of developing a very serious illness with possible blindness, kidney failure, amputations, premature death, etc. I realize most people donā€™t see it that way.

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Thanks for your reply. However, I feel you should (whether youā€™re diabetic or not) should do some research before commenting on a public forum. Having type 1 diabetes does NOT mean your child will inherit it. I have diabetes and NOT A SINGLE PERSON in my family does.

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Good luck!! A lot of women have successfully navigated diabetes and pregnancy. Hopefully you hear some of those 1st hand accounts here.

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Work with your Dr. For what it is worth I had two healthy children 30 years ago. I was not on a pump and CGMS was not available. I did not have big babies nor did I need a c section with either. With a CGMS, todays insulin options and if you want a pump having a healthy child or children should be very doable assuming you are not dealing with other major health issues. Talk to you Dr about wanting to get pregnant and what they recommend for diabetes control before and during the pregnancy and any health checks they may want done.

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The relative risk of producing a child burdened by diabetes is higher than that for the general population if you choose to have a child when you have type 1 diabetes, which is partially genetically caused. The Joslin Diabetes Center reports:

Type 1 Diabetes Odds
Just who is at risk for developing type 1 diabetes? Hereā€™s a sampling of what Dr. Warram, a Lecturer in Epidemiology at Harvard School of Public Health, said is known:
If an immediate relative (parent, brother, sister, son or daughter) has type 1 diabetes, oneā€™s risk of developing type 1 diabetes is 10 to 20 times the risk of the general population; your risk can go from 1 in 100 to roughly 1 in 10 or possibly higher, depending on which family member has the diabetes and when they developed it.
If one child in a family has type 1 diabetes, their siblings have about a 1 in 10 risk of developing it by age 50.
The risk for a child of a parent with type 1 diabetes is lower if it is the mother ā€” rather than the father ā€” who has diabetes. ā€œIf the father has it, the risk is about 1 in 10 (10 percent) that his child will develop type 1 diabetes ā€” the same as the risk to a sibling of an affected child,ā€ Dr. Warram says. On the other hand, if the mother has type 1 diabetes and is age 25 or younger when the child is born, the risk is reduced to 1 in 25 (4 percent) and if the mother is over age 25, the risk drops to 1 in 100 ā€” virtually the same as the average American.
If one of the parents developed type 1 diabetes before age 11, their childā€™s risk of developing type 1 diabetes is somewhat higher than these figures and lower if the parent was diagnosed after their 11th birthday.

To say that the risk of the average American for type 1 diabetes is about 1 in 100 is misleading, since there are estimated to be around 1,000,000 type 1 diabetics in the United States out of a population of 320,000,000.

So whether you are a mother or father with type 1 diabetes, you are choosing to impose a greater risk of a serious illness on your child. Since imposing a risk is a harm, the moral question is whether you want to harm your future child. When Michael Jackson dangled his child over the balcony of a Berlin hotel in 1985 there was worldwide condemnation of that action even though he did not actually hurt his child, but just because he increased the risk of harm coming to the child. In my own life, the view I took of voluntarily increasing the risk of imposing the harm of diabetes for my own future child was that of the world in response to Michael Jacksonā€™s risk taking for his child, so I chose not to do it.

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The risk of a child inheriting T1 diabetes is only 10% if the father is T1, 4% if the mother does but is <25 and 1% if the mother is T1 and over 25. Very few people have absolutely no family history of any health problem at all. Thereā€™s always risk involved when you have a child.

FWIW, as the daughter and granddaughter of T1 diabetics, I harbor no ill will towards them for having me (or my mother) even after developing diabetes. (And my sister and none of my grandfatherā€™s 5 kids inherited it at all.)

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Iā€™m T2 or really early LADA (only on insulin for pregnancy) so my experience is different, but I did have a healthy, normal sized baby. Extra monitoring (like growth scans and NSTs towards the end) is typical. Some things will depend on how your pregnancy goes, but some depends on your doctors.

High blood sugars happen, especially as insulin requirements change throughout pregnancy, the more important thing is overall blood sugar control. I do know someone who had a stillbirth, but she was undiagnosed and developed T1 diabetes during pregnancy and therefore her blood sugar was very high and completely uncontrolled. She went on to have two healthy babies after her diagnosis, who are now healthy adults.

My Endo/MFM team last time were adamant that you need to eat 175g of carbs a day, my current Endo does not believe in carb minimums. Both my previous provider and my current one induce if you are on insulin and get to 39 weeks, my current OB prefers to induce at 38. If the baby had measured really big, particularly if their abdominal circumference was measuring ahead (which is more common in diabetics and can increase the risk of the shoulders getting stuck) they would have pushed for a C-section. My daughter was measuring ~75% with her abdomen measuring 2 weeks ahead at 95% and they let me do an induction at 39 weeks because she wasnā€™t huge overall, my blood sugar control was great, and she always did well on her NSTs (Non-stress tests). She ended up being a decent amount smaller than the estimate, so be aware they are not 100% accurate. The delivery/induction/C-section decisions do depend on the OB, so if you want an OB that is open to not inducing early you will want to look for that when you are choosing your doctor.

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I know how you feel, I started planning for a baby years agoā€¦thatā€™s what made me really begin to look after myself and my diabetes (type 1 21 years, on a pump). Itā€™s still really daunting though isnā€™t it.
If youā€™re concerned about your weight, Iā€™d recommend seeing if you can get in to see a dietician. It could give you some extra guided support around safely gaining what you might need to. Time is on your side too, so give yourself the gift of one you like and feel you can work with!
Time is on your side :slight_smile: reading through all the forums here around pregnancy and babies has helped me begin to get my head around everything.

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Iā€™m excited for you! Three bits of advice:
Use a CGM if you donā€™t already.
Use the search function on this site liberally, and start new threads every time you need new info.
Stay positive!

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While the diabetic individual contemplating having a baby may feel no ill will towards the parents with a similar diabetes risk for having him or her, the ethical issue to consider is whether the child, for whom you decide that the risk of type 1 diabetes is worth taking, will see it the same way, and whether you have a right to make that assumption for someone else. Generally, since parents owe the highest possible ethical duty toward their children to protect them from all the dangers and risks they can, undertaking a known risk of a serious illness for the child is a major step.

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I got diabetes when I was 30. Type 1. I wanted a baby so bad all my life and got pregnant when I turned 38!! I was so happy and even tho I had to shoot a lot of insulin, the doctors monitor you very frequently. I did have a c-section, not because of diabetes but because my hips were too narrow. I am really glad I had a c-section because my son was ā€œsunny side upā€ so it would have been a difficult labor. That was back in 1996 and no pump or CGM, just needles and a monitor. My son was born perfect and is 22 now
and the best thing that ever happened to me!! Good luck to you and if you have any questions ask away!!

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I was terrified too, but I had a healthy (8 1/2 lb) daughter 12 years ago. When she was born she went in a 10 year trial (TRIGR) which resulted in us finding out (fortunately) she is only as likely as any other child to develop diabetes (she doesnā€™t have something that pre-diabetic children have developed by her age). Yay. Anyway, My HBA1C was 6.5 initially and I got it down to 6.0 for my pregnancy. I ate well, and exercised consistently and had very stable Blood Glucose for 12 months (3 months before you start trying you want to practice treating yourself like youā€™re pregnant). It is the formative first few weeks when spines and hearts cels are forming that are most important, I understand. Donā€™t worry too much about baby size; a little more growth hormone is not worrisome and wonā€™t effect your babyā€™s health. Unrelated to size, yes, I had a C-section (would NOT dilate after 12 hours of strong contractions), but had no problems with it. She was low when born thoughā€¦ 1.1 mmol (200 mg/dl). Her little body was making insulin to compensate for my blood glucose and when she was born of course the sugar was gone. They gave her an emergency breast milk replacement as my milk couldnā€™t let down fast enough (minutes!). Since my pregnancy my HBA1C has climbed at bit every year (now 7.0) and Iā€™ve often thought with the chaos that having a toddler I donā€™t know how diabetic women have SECOND children. Ha! One was just right for me! Looking forward to hearing other peoples tales. (For more mom stuff specific to pregnancy maybe also check out diabeticmommy dot com?)

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Thank you everyone for your responses! You have no idea how good it is to hear normal, every day, type 1 / 2 diabetics are able to do what iā€™ve been afraid the illness would stop me from doing!

Based on your experiences it seems a lot of discipline, control, and planning is needed to have a healthy pregnancy. Do any of you have any suggestions for me or tips on what else to do?

I am in a bit of a difficult/stressful period right now but things should be looking up come August/September time. I plan on then getting a schedule that gives me the right nutrients (im vegetarian also) and exercise so I can be my fittest over the coming 2 years. Is this enough time for a smooth pregnancy?

Sorry if I sound so inexperienced. I bet all you mummies are thinking I sound crazy.

Thank you all for replying I really appreciate your lovely words :blush:

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Well i had a twin pregnancy and a single pregnancy. My babies were never big! I delivered twins at 34 wks and single one at 37 wks. I love being a mom and im glad i decided to do it. It was hard work. Like a fulltime jobā€‹:grin: I take so much better care if myself since kids. They were my life savers. :two_hearts::two_hearts: And about not keeping weight on. Have you ever been checked for thyroid or celiac disease they both can cause weight loss. Well good luck with it all. Trust me you can do it.

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I have two wonderful healthy boys :). I was considered ā€˜high riskā€™ pregnancy because not only did I have type 1 diabetes (for 30 years at the time)ā€¦but also because I was 39 years old with my first pregnancy and 41 years old with my second.
I had a pump but did not have a sensor at the timeā€¦so I tested often. My insulin needs did increase during pregnancyā€¦thatā€™s totally normal and doesnt mean you will have a large baby. I found it a lot easier to keep my blood sugars stable probably because of all the work your body does to grow and feed a baby. My a1cā€™s were between 4.8 and 5.6ā€¦the best Iā€™ve ever had and I was eating wellā€¦maybe too much :).
My husband is a big guyā€¦tall and broadā€¦and my first baby was born by c-section at 39 weeks 5 days (no problems with placenta deterioration)ā€¦and weighed just under eight pounds. He started stressing out (his heart rate) in labor so we decided on c-section. My second child was a year and a half after my first and because I had a c-section less than 2 years agoā€¦i had the second that way too. He was 39 weeks and weighed 8 pounds. We had no problems and only spent one night in the hospital. After giving birth your body will very quickly drop the need for the extra insulinā€¦so look out for that. If you breastfeedā€¦that also makes your insulin needs less. I often had to have a snack before breastfeeding to prevent lows. Both my boys are in the 99 percentile for height and Iā€™m 5ā€™2" :). At 8 and 10 years old they are almost as tall as me.
At the hospital during the time I was thereā€¦i insisted on keeping my pump on. My blood sugars are always better when Iā€™m in control of itā€¦because no one knows me better than me :).
I worried a lot about pregnancyā€¦but it really was fineā€¦even at my age. :).
At birth, they tested my boys to see if they carried the link to type 1 diabetesā€¦and they do not. That means they are likely not to get type 1 diabetes.
I love my life and my boysā€¦type 1 diabetes isnā€™t a reason to not have children if you want.

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No direct advice or experience regarding gaining weight - my problem is always the other way around! Except that maybe I would look into the thyroid issue. Having one autoimmune disease does increase your likelihood of having more, and Graveā€™s disease could be a possibility (I have Hashimotoā€™s myself, but my cousin has Graveā€™s).

But here I sit, 32 weeks pregnant with our first child. I just turned 34 and like you, I was worried about how pregnancy with diabetes would be. I had a horrible boss who finally quit a little over a year ago, so the stress that I was under from him finally let up and I was able to focus on healing myself and getting pregnant starting March 2017.

RESEARCH IS YOUR FRIEND! I had done a TON of research on getting pregnant, how to work with your body, PCOS (I was afraid I had it for a while, even though I didnā€™t have many signs), eating right for fertility, and all kinds of things. I would definitely recommend the book Taking Charge of Your Fertility. You can start using the methods now while youā€™re planning. We successfully used the methods for several years while trying to avoid pregnancy (I had a bad reaction to the paraguard iud before that) and then it only took us 10 months to conceive this little man. Everyone is different, of course. I have a friend who just gave birth to a daughter who was conceived the same month they decided to stop using the methods to prevent pregnancy!

I am honestly not that worried about him developing t1d. We joke around a little when weā€™re talking about whose eyes we think heā€™ll have or whatever and I always say, ā€œWell as long as he doesnā€™t get my pancreas!ā€ But hey, you know what? If he does, weā€™ll deal. If he ends up with another disease? Weā€™ll deal with it. Thatā€™s life. There are no guarantees, especially with kids. If you donā€™t want them and donā€™t want to pass your ā€œfaultyā€ genes down, then donā€™t have them. But thereā€™s no call to judge others for wanting different things.

And I absolutely donā€™t think you should be terrified! For me, preparation and planning help a TON with taking the ā€œscaryā€ out of this whole process. Maybe youā€™re the same way. I found a group of great care providers that have been excellent at working with me throughout - and I had to go through SEVERAL who were not right for me before I found these. I got on a Dexcom and Omnipod about 6 years ago, so that has made my diabetes management much easier. I upload my numbers weekly to my team and they make tweaks to my basal rates and I:C based on what patterns they can pick out. First trimester I ran pretty low and it was hard to keep my blood sugar UP. Second trimester things evened out, and now third trimester is still going pretty well, not too much more insulin needed yet, even though Iā€™m prepared to see those huge bolus rates! lol. My a1c started around a 6 pre-pregnancy and itā€™s bounced back and forth between 5.4 and 5.2 for the last 7 months. My high risk doctor is a bit worried about how large the baby is at this point, but my endo just laughed when I told him that and said, well we know diabetics make big babies! He said, youā€™re doing everything right, youā€™re doing everything you can at this point! So that made me feel better. And those size estimates can be off by a LARGE margin too, which is why Iā€™m not allowing anyone to suggest a c-section or induction for me on the SOLE basis of his weight - if there are other concerns, ok, we can discuss. Barring any emergencies, I WILL have this baby naturally. Iā€™ve done my research. Iā€™m not going into this blind. I am planning and preparing. Itā€™s completely doable. I believe in the power of my instincts and my body. I am open to any changes that need to be made along the way. And honey, if I can do it, ANYONE can do it!!

Thereā€™s so much more Iā€™d like to share with you, but I wonā€™t bog down this thread, so if youā€™re interested, you can pm me.

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You say, if your child does inherit type 1 diabetes, ā€œweā€™ll deal with it,ā€ but the real question is, how will your child deal with it? Does he or she want to have to deal with it? Is it worth it to the child to carry the type 1 diabetes risk as the price of living? The problem is, you canā€™t ask in advance, and by having the child, you choose to impose life with the risk of type 1 diabetes on someone else who does not have the choice to refuse it.

You say that there is no right for others to judge if you want to impose the risk of developing diabetes on your children, but when you impose risks on other people, you enter the area of making ethical choices, and the ethical choices that other people meet are always the business of the rest of the community. If my neighbor, for example, chooses to beat his children or his wife, then that may well be his choice, but it is also my business, since as soon as he imposes harm on other people then that is an ethical choice which is wrong in the eyes of the community, and the law will intervene.

While the law does not forbid imposing the harm of a heightened diabetes risk on your own children, it does raise the ethical question whether that is the right or the wrong thing to do. As soon as an action affects other people, it is not just a matter of personal whim, but of public morality.

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