Tighter guidelines for BG control while pregnant?

Hi all, I recently tried a new Obgyn as I live in a rural area and their ad says “we treat high risk pregnancies.” Long story short, I don’t think I’ll be going back, and one thing that bothered me was that the doc mentioned that the latest info on her medical web portal is that blood sugar control guidelines are now much more strict than even the ADA suggests while pregnant. She told me that my fasting should be 50-55. I told her that I didn’t think that possible (as I can barely think or see at 55) and she mentioned “well, it’s different when you are pregnant.” Let me say, I am not pregnant yet, but on the road to getting prepared. I just found it odd that someone would suggest a BG that low, when her BG as a healthy non-diabetic is never that low…My DE doesn’t agree, nor my endo, but I just found this bizarre! Just curious if anyone else has had the same experience? I obviously know that the tightest control I can have is what I’m aiming for, but find her providing this info a tad irresponsible, as what if someone is new to diabetes, or uneducated, and aims for 50, and ends up at 20?

Wow! I don’t know what this “portal” is that she referenced, but that seems borderline malpractice to me. I’ve been TTC for two years, and during that time, my entire team has always said that my fasting should be under 100 mg/dl. No mention of anything lower than that.

I’d definitely ditch that OB/GYN!

I am TTC and had the same infomation given to me. However, I let it go in and quickly out. I felt like it was unreasonable and unsafe for me. I think it would be rather difficult to get numbers that low and cause myself so much stress from failing. I don’t think I would function normally at those numbers either. I am curious to see if those who have been pregnant find that it’s truly different once you’re pregnant. For now, I’m pleased when I’m below 100.

Thanks for the reply! Believe me, I’m not going back—for more than one reason. I figured I’d go back to my current one, and see if she can suggest a specialist in Denver that she can work with—I live several hours away but go there anyway for endo appts, and I figure I’ll just have to make more trips when the time comes. Will totally be worth it, I’m sure :slight_smile: I spoke to my DE who knows the other doc in this practice and she is totally going to try to have a discussion with him about this…we’ll see how that goes. Crazy business I tell ya!

I have a good friend in Durango who is having similar issues with finding a high-risk OB. I guess I’ve finally found a benefit to living in Baltimore!

Best of luck with everything!

Well there ya go! haha! I’ll keep searching, and am super happy for you to have more docs to your disposal :slight_smile:

Seriously, what are these people thinking annette!? I let go in and out as well. I’m just SO curious as to who thought up this info, and is providing it to docs, when as I said non-diabetics are never that low? Strange… Thanks for the reply :slight_smile:

We’re considering moving to Colorado in a few years. Where are you located? Because of my husband’s work, we’ll probably have to look at places near Colorado Springs.

I LOVE it there!

The only people who would recommend this are non-diabetics who have no idea how awful a low feels.

Sadists :wink:

My endo told me to stop treating 60s as low when I prepare for pregnancy. The reason that she told me was that NON-diabetic women have lower blood sugar during pregnancy (or only during the first trimester) than was previously thought.

I know that some of our type 1 mothers reported having lots of lows in the first trimester. Others not…

I still wouldn’t say that you should AIM at 50 because as you suggested that could easily end up at 20, but my endo wants me aiming at 80-90 fasting and that’s hard enough for me to do without waking with a low.

Holy moly! Heck no! Even my high risk OB (who I see once a week in addition to my regular OB) doesn’t want me below 60 and his expectations are otherwise really tight. Fasting, I’m expected to be 70-90. I’ve been asked not to treat 70s as low and to wait to treat until I’m 60 or dropping. (I’m 37 weeks pregnant, by the way.) The high risk (perinatal) doc doesn’t ever want me over 120 though - ever - and my endo and my OB both think that’s hogwash.

My endo says that people who deal primarily with gestational diabetics don’t understand the risks of lows. She told me a couple weeks ago that, with gestationals, they can push more insulin with no risk of lows. But she said that my perinatalogist wanting me to never be over 120 was completely unrealistic and that I’d end up on the floor half the time from lows. I agree. My A1c has stayed in the 5s throughout the pregnancy and my average is in the 120s most of the time according to my continuous monitor. A pregnant diabetic is going to have highs and lows - we just need to catch them and treat aggressively.

I think you’ve got a good head on your shoulders. Keep the post-prandials and the fastings a little lower than you would find acceptable under non-pregnancy circumstances and keep your standard deviation tight with as few dips and spikes as possible. You’ll have a beautiful pregnancy. I’m scheduled for my c-section next Monday. ACK! :smiley: So excited!!!

Congrats!!! I’m sure you’ll have a beautiful baby–and congrats on being so well under control!! Thanks for the advice :slight_smile:

I’m in Steamboat Springs. Kind of the sticks when you are diabetic and realize “wow, we sure have a lot of orthopaedic surgeons here!?!?” haha I’m sure you’ll love it when you get here :wink:

OMG - I didn’t realize you were full-term already. Congratulations!


Really? So even if you feel low at 60, you should treat it as normal? And did she give you any info on what it means that non-diabetic women have lower BG during the first trimester? Just curious as to how that works/benefits the baby etc. Thanks!!

Thanks. My A1c spent about 18 years above 7 (from diagnosis until TTC), so I should serve as living proof that the will to make babies is stronger than glucose. :wink: Not gonna lie - control feels great. I still stare in disbelief when I wake up in the morning and see a flatline on my CGM through the night or test and see an 87.

Another thought. My perinatalogist claims that the baby will always run at a blood sugar level that’s approximately 80% of what yours is. I try to keep that in mind when I’m high OR low. It helps curb the guilt when I am 190…but it also helps me keep those low lows (40s) from happening, which my CDE claims deprives the baby of oxygen-rich blood.

Thanks, Shannon. :slight_smile:

This was my thought exactly about being too low–that if my brain and body is feeling deprived of sugar, than what in the heck is the supposed “50-55” doing to the baby?!?

Congrats again! We’ll be waiting for details and photos of course :slight_smile:

Melissa, good luck and congratulations!