Pregnant and very nervous!

Diabetes and Pregnancy Trying to Get Pregnant
1

Ok, so my husband and I have been trying to get pregnant. My A1c was 7.0 at last check and I thought my sugars were doing better. My gyn/ob put me on a round of clomid in march. Well I ovulated March 20/21 and saw my endo mar 22. Imagine my panic when I learned my A1c was 7.7 and the endo recommended waiting before trying to get pregnant. My husband and I had tried just days before. She recommended I fax my blood sugar logs after 1 week.

I checked my sugars more frequently and was trying to cover using my pump but Mar 21-28 my sugars were routinely 150-180 after dinner and would not come down unless I was taking 3-4 TIMES the correct dose my pump suggested. I faxed my results over last tuesday. Got a phone call Friday saying they got the fax and if I did not hear back I should call on Monday.

The next week was better. One low on monday (I often get lows during my period) and generally not over 140 after meals. Still If I ate more than 30-40 carbs after 5 pm my sugars would spike to 160 and stay there unless I covered x3 or x4.

Friday I had some spotting which stopped sat afternoon so i thought I was getting my period, especially with the cramping I was having. The cramping has continued on and off since Friday. Monday I had a positive pregnancy test and actually physically went to the office so they could download my pump with another week of data. Imagine my surprise when I was told my endo was on vacation. I explained I had a positive pregnancy test that morning and asked if another dr in the practice could look over my numbers. they said another dr can look but they rarely make changes in settings for other patients.

I left and when home quite upset. Mon evening the spotting resumed and I called my gyn Tuesay morning. Today she had me come in to see a dr who was covering (she was out of town caring for her sick father). he did a transvaginal ultrasound, but he said it was hard to read. there is a spot that could be the implantation site (he said it was very low and I would be high risk). The urine pregnanct test barely showed I was pregnant. He ordered a quantitative HCG and I should know later today.

He seemed to think there was a risk of miscarriage, but also I could just be SO early along I am 4 weeks and 2 days, he put me on progesterone just to be safe.

I see my regular gyn on friday. Oh and my endo finally got around to calling me back last night and lower my sensitivity by 4 mg/dl per unit. Of course last night I ate dinner and I spiked to 160 and got stuck there until I tripled the corrected regardless of the change in settings.

I am going to try to restart my CGM. I had a lot of trouble as my sugars usually spike about 20 when I first wake up so it never calibrated right.

I really think I need to switch endos. The office is a pain they never answer their phones. I teach and am in a classroom all day and there is only a 40 minute window where I am free to call and they actually answer their phones. But the only good recommendations are for dr that are at hospitals 1.25+ hrs away (and NOT taking into consideration Atlanta traffic) I am worried if now is a bad time for that or is it more important that ever.

Any and all advice is GREATLY appreciated. Especially what to eat such as carbs (how many, how often and how spread apart).

2

1st off Congrats! If you are that early your #'s will be low. HCG #'s that is. Try to stay relaxed & positive. I’d switch endo’s as well if you have a hard time getting a hold of them. My endo was great when I was pregnant. I could call her at 10pm & she’d call me right back. I think it’s very important to switch endo’s if you aren’t happy with them. You will need to speak with them once a week to report your #'s & do bloodwork & see them once a month while pregnant.

If you already see an educator/nurse get in touch with them. If not get in touch with them or find one to help you while pregnant.

When I became pregnant I was 7.5 A1C. 1/2 way through I got it down to 6.5. You can do it. Best of luck & happy & healthy 9 months!

3

Congrats! My very first sign of pregnancy was elevated bgs at just 9 dpo. Just stay calm and correct whenever you detect a high. Normal range for pregnancy is 60-120 - try to have fasting readings below 90. A few highs are not going to hurt anything. Good idea to get the CGM going again, I have leaned heavily on mine for the past 8+ months. I’m also testing 12 - 18 times per day. Perhaps try pre-bolusing to keep your spikes lower - I have to bolus almost half an hour before I eat my breakfast these days.

4

My hcg came back at 65. So far so good. Next appt Fri morning

5

Question, take tonight for example. I was 120 before dinner. . . do I skip carbs at dinner, delay the meal, bolus and wait 30 min? I am now terrified of carbs all together. it seems that it is taking more and more insulin to get my numbers down and I am concerned that if I wait for the numbers to drop that there will not be enough insulin on board to cover my meal.

6

Thanks for the info. I am really freaked out about possibly hurting the baby. I adjusted my basal yesterday, just 0.1 more an hour but I have been under 100 all day even after meals today! Looks like you have a beautiful healthy little girl which gives me hope.

7

Good news. Saw my gyb she said everything looks good. She will call w hcg and progesterone # on monday. She reccommended and a perinatalogist. Have an appt with peri for Apr 26. Will call again for in on Monday as.it was late when I called Friday. and i I have an appt w a highly recommended endo. They can not see me until may 2 but said to see my reg endo in the mean time. Let’s hope all continues to go well

8

Why don’t you try eating around 70 carbs per day test for ketones in the morning and if it is more than a small amount increase by 5 more per day until you only have trace ketones. Also, waiting 20 minutes before eating can really help your pp #'s. Also walking or doing some light exercise for 15 minutes after eating whenever you can will really help.

9

Thanks for the idea. Of course I somehow never thought of checking ketones I have been so concerned with the blood sugar readings. I have an appt w/ a new endo May 2 but will work with the old endo in the meantime.

I ordered a book on insulin pumping and pregnancy as well as a book on diabetes and pregnancy. I just wish they were hear already. They should arrive Mon.

10

Ugh. This is the hard part. All the waiting in between appointments! :slight_smile: Good luck and just keep controlled numbers as much as you can. Everything else should work out well enough. glad to hear things are going well so far.

11

Thank you for the support. It is good to know I am not alone.

Got my hcg back it is up to 97. My progesterone was 44. So reasonably good. Although the HCG did not double and it was almost 2 days so I am a little nervous.

I have an appt with an OB this friday but it is during state testing so I may need to move it to the following week. UGH!

I am having HORRIBLE insulin resistance though. I took 37.5 units for a piece of steak, a salad, some broccoli and squash and 1/2 a small baked potato and I barely managed to cover. SIGH! Today I must have rebounded (95 and 5 am and 130 at 6 am)

I am getting very stressed about how much insulin I am taking and my endo only saw that my numbers were reasonable stable and suggested no changes (even though I I noted I was covering for 3-4 times the carbs I was actually eating). She actually had the nurse tell me to only take what the pump says and then to call if my numbers are running high. I nearly flipped. . . seriously. . . let me sugars run high and correct after the fact so she “can see it in black and white”. I was in the 130-140 most of today despite taking plenty of correction doses. I am freaked if I am this insulin resistant now what about later in the pregnancy?

12

Got my latest hcg it was only 81. My gyn told me to stop my progesterone to allow the miscarriage to happen. She said it was too early for my diabetes to have caused it. It wad likely chromosomal. Needless to say I am heartbroken

13

Sorry to hear about this. Sending you hugs!

14

Sorry to hear this too. Grieve for this loss. Take your time. When you’re ready, you have the tools to feel more prepared. Your doc is right. It’s too early for this m/c to be related to your D management. Most women get through a m/c during the first trimester. I think the rate is 50% of women. I’m one of them. You’ll get through this and when you’re ready, you’ll try again.

15

I am sorry to hear of your loss. DO not blame yourself or your diabetes this happens to women all the time. My A1C when I started this pregnancy was 8.2 or something like that. I stil am crossing my fingers but I am now at 24 weeks almost 25 so I do doubt it was your diabetes that causes your loss. AS for insulin resistace I am the worest during this pregnancy especially in the mornings. I am currently upto almost 85 units of humalog to over 15 carbs in which I have to inject a min of 30 mins before I eat better for me to wait an hour but sometimes I am to low and then I spend hours trying to correct that

16

Thanks for the kind words. Last week I had adjusted several settings. My carb ratio was down to 1 unit for every 4 carbs. I am hoping they will eventual return to normal. . . for me at least which is much closer to 1 unit for every 6-8 carbs. So far my settings have not shifted back but I hope with time.