Type 1 and preparing for pregnancy- a bit scared, advice needed!

Hello dia’buddies,
I heard so many great things about this site, so I signed up and joined yesterday. I have been a type 1 diabetic since 1999. I am almost 31 {this summer} and have been married for 3 years now, we are so ready to have a baby. The idea of being pregnant with my diabetes + celiac disease {i eat all gluten free} scares me. I have met with the high risk OB-GYN’s at UCSF, and they have an amazing program there and made me less scared. I am now tasked with getting my A1C down to 6.0-6.5 range and losing about 20-25 lbs. I have added daily workouts to my routine but my blood sugars are still swinging all over the place. I get really high post meal, and no matter how hard I work out the weight won’t come off! I have actually only had issues with the weight since becoming a pump user. The dr explained this could happen but it is so frustrating! I also am extremely strict with diet. I eat no processed/fast food, 100% gluten free, and around 1600 calories a day. So hoping to ask you wonderful ladies for advice on the following:
(1) What was your pre-conception program?
(2) How long did you have your A1C at goal before trying?
(3) Any tips to keeping post meal sugars in control, and any weight loss/exercise tips?

Thanks in advance for your advice and support!


And might I add, this lovely lady is my wife! :slight_smile:

Hi Crystal… welcome to the site…my daughter was born in August and juggling diabetes with T1 with pregnancy was the most difficult thing I’ve ever done but HANDS DOWN the most rewarding…I think that you already have the first step down, which is confidence that you have great doctors on your side… that was the most important thing for me, being able to trust the team of experts that were helping me!

I didn’t have a pre-conception program because my daughter was a bit of a surprise so I can’t answer question #1 for you, and I don’t even know what my A1C was at the time, I’m guessing around 7… so right there, you’re already a step ahead of me! By the time I had my first doctor appointment of pregnancy I was down to a 6.6 and brought it down even further and was in the 5.2 range throughout pregnancy. Before pregnancy I would have never guessed this was possible for me, but it’s amazing what you can do when you know it’s for your baby.

Have you considered getting an insulin pump? I got the Animas One Touch Ping 6 months before pregnancy and it made all of the difference. I had a problem with post-meal spikes too and the pump made it so much more manageable.

Try not to be too scared, if you think of the whole picture it is very intimidating, but you’re already taking all the right steps and it becomes a matter of taking things day by day! Good luck! Kris

I was terrified too, but wanted our baby so badly. I was down to 6.5% for about 6 months before I started trying. it took only 3 weeks for us to conceive. The first 8 weeks are the most important to keep your glucose levels as stable as possible. No swings. Because that is when the baby is developing its vital organs. That’s right- that means having stable BG BEFORE you even know you’re pregnant because most pregnancy tests wont show a positive until you’re already about 4-5 weeks along.

it’s tedious and takes a LOT of work, but it’s possible.

I’ve had type 1 for 13 years, diagnosed in 1998 and am now 26 years old. My A1cs have NOT always been good. I was plateau’d at 8.5% for 2-3 years. Was stuck at 9% for a few years before that. The thing that broke my cycle? i took Metformin for 3 months. I had really bad insulin resistance. I actually thought that I had gastroparesis- started eating gluten free for a while, but it only made the swings bearable- didn’t get rid of them.

It turned out to be insulin resistance. Taking Metformin allowed me to lower my insulin intake. It also reduced the swelling I had - bloating- from taking too much insulin to compensate for the insulin resistance. I , too, was very strict with my diet and would only consume about 1200 calories per day- exercising about an hour per day and eating mostly no carbohydrates. Metformin was the only thing that helped me. I took it for 3 months and my A1c has been in the 6s since. It’s now been a year. I’m sure my A1c will go back up at some point, but for now, I’m content with my health and will stay off Metformin until the resistance goes back up. Plus side? Metformin also increases fertility.

I miscarried after 9 weeks due to chromosomal issues. They said it had nothing to do with my T1. We conceived 5 weeks later and we’re now 22 weeks with a baby girl.

So, to answer your questions:

1 ) We didn’t really have a “program”. I was lowering my A1c for my overall health. Wasn’t initially planning on pregnancy right away.

2) A1c was at 6.5% for about 6 months before TTC

3) I suggest looking into Metformin as a supplement to your pump dosages. I was taking one pill 500mg per day. The scrip has been around before insulin- back in the 1920s. It’s experimental treatment with type 1s, but some endos will write the scrip for you. You just have to find an endo who is willing to work with you. My BG came into target with less swings and lowered insulin dosages within a few weeks. Weight also came down 10 lbs without changing a thing.

good luck and keep moving forward. Everything will turn out.

HONEY, you are so cute and sweet. Thanks for the support.

Hi Kristina, Thanks so much for the response and advice. I am indeed on an insulin pump, have been on one for a few years now. : ) So during pregnancy to you credit the diet for helping you get the A1C down so low or was it a certain exercise program? I am trying to think of it one step/goal at a time, otherwise it is super scary and overwhelming. It is so nice to hear so many positive stories like yours though, definitely encourages me! Have a good weekend!
: ) Crystal

Hi Marps,
Thanks so much for taking the time to give me such thoughtful advice, and a big congrats to you on your pregnancy. Glad to hear you are doing good and everything is going well. : )

Sounds like we have been diabetic almost the same amount of time. I was diagnosed in '99 at 19. Def a shock since nobody in my family has it! My A1C has been good in last few years, it was just this year that it increased, after a big move and lots of life changes. I am working on getting it down not just for pregnancy, but like you for overall health. My diagnosis of celiac disease also didn’t help. For awhile I was not absorbing any food so my insulin and BS were all over the place. That is under control now though,and I am absorbing again so now trying to work on the A1C.

Good point about metformin. I actually took it a few years back and stopped cause of stomach issues (at the time caused by my celiac, which i didn’t know). It was just too hard to take. Now that my celiac is controlled though and I want to be aggressive about getting control it couldn’t hurt to try it. I see my endo again in April so I will def ask. Sounds like it will help with my BS control, and maybe even weight/fertility so that could not hurt. Glad to hear you were around 6.5%, that seems more achievable to me than 6.0. I think the best A1C I ever had was 6.8 and that was tough. What us your A1C like now that you are further along in the pregnancy? Can you still take the metformin when pregnant?

Thanks again for your support and advice, helps a lot!


Hey- figured I’d pop in here before I went home from work for the day.

Thank you!!!

My A1c is closer to 6.0% now, but I havent had it checked since January. It was 6.5% in January too. According to my meter, it is averaging about 129 for the past 30 days… That would put me closer to 6.0% I think? It’s hard to tell. I’m sure I’m having another blood draw soon.

I believe you can take Metformin while pregnant. Many Type 2s are on Metformin during pregnancy (if they’re not already on insulin injections). I was thinking about adding Metformin to my diabetes routin when I reach the 3rd trimester because it’s said that there is severe insulin resistance during the 3rd trimester. We’ll see what happens!

Hi Crystal,
I was originally at a 7.4 when I began to pre-prepare for trying and came down to a 6.0 when i actually conceived. This was done in part by getting on a pump and CGM, and making a lot of dietary changes - switching to low GI carbs and avoiding high fat foods (and other foods) that would send my BGs out of whack for hours. I began eating out less so I could be really accurate about counting my carbs, weighing and measuring what I could, etc. I also began to test more often (10+ times a day), and always waited 10-15 minutes to eat after I bolused (this really helped with catching my post-prandial peaks). The other component was diligent record keeping of all my basals, boluses, carbs, etc. so i could analyze what wasn’t working and make corrections and adjustments to avoid future highs, lows, and rebounding. From the time I got the green light, it took about 5 months to get pregnant and my HA1c got progressively lower over time throughout the trying process and the pregnancy. The whole process was a huge pain and a lot of work, but totally worth it in the end - I had a very healthy little girl (coincidentally, through UCSF’s high risk Diabetes and Pregnancy Program). If you have any specific questions about my experience at UCSF, I’d be happy to talk about that too - just message me.

Goog luck!

Thanks girl! That is an awesome A1C good for you! Thanks for the metformin advice to, I will let you know what my doc says. Have a great weekend!

Hello and thanks for the advice. Congrats on your baby girl!!! Love hearing how all the hard work pays off. :slight_smile:

I am working on getting a CGM and I think that will really help. Which one do you use? I am testing 8-10x a day now and rarely eat out ( I am also celiac, so eating out is a challenge). I must say I can be more diligent with record keeping, that is my next goal.

Would love to hear more about you experience at UCSF, will send you a message!

I’m also 31, diagnosed at age 10, and I’m about to start TTC baby #2.

  1. My pre-conception program was to take pre-natal vitamins and set my blood sugar targets to be the same as early pregnancy, such as treating lows only below 60 and/or trying to stay under 140 at the 1-hour postprandial mark.
  2. We were released to start trying as soon as I got below 6.5%, but it took us 9 months to conceive, so I had to float it at 6.1% for those 9 months of TTC. Then we consulted a reproductive endocrinologist who helped us along and we got pregnant on Clomid.
  3. I used Weight Watchers to lose 25 lbs during the time I was trying to lower my A1c from 7.0% to 6.1%. And bolusing 20 minutes or more before a meal is my best tip. Learned it here on TuDiabetes a few years ago and it changed my life. My daughter is now 14 months old and my A1c has just crawled back up to 7.0, so I’m doing Weight Watchers again and tightening my BG targets once again in the hopes that my next couple of A1c’s are in range to TTC #2.


Hi Crystal–
I was diagnosed in 98 at 15:)
I feel like having a baby was always in the back of my mind, "will i be able to do it"
I went into my endo with an A1c of 8, and she said she wanted me to wait a year because she didn’t know if I’d be able to keep my sugars down for a pregnancy and we both knew an 8 wasn’t healthy! a1c hadn’t been that high since high school:) I cried, and cried! She wanted my goal to be 6.5. I had my a1c at 6.9 for a year. I just checked more often and watched what i was eating and stopped guessing:) At that point she said I was stable enough to try. I was pregnant in a month. My first a1c a month after finding out I was preg was 5.8. Throughout preg my a1c’s ranged for 4.8 to 5.8. All it takes is getting preg and then somehow, you just do it!
I had to stop working out as soon as I got preg because I had a little bleed so I walked alot but stopped running. I would go for a walk almost after every meal to help with the post meal sugars.
I had A1c’s monthly, just to keep me motivated. I talked with my endo and her NP weekly.
I had a VERY healthy baby boy. I had a c-section because I wouldn’t dilate but his sugars were stable and he didn’t require any extra care! It is def my biggest accomplishment and although it was stressful and alot of work I can’t wait to do it again!
You will do great because your already reaching out and talking to people, which helped me alot! It helps to hear people say that you will have a 300 once in awhile and it won’t kill that baby! I was sooo worried about all of those things! Keep doing what your doing and you will get there! The hard work is worth it!
Let me know if you have any other questions and good luck!!! You can do it!

Congrats on baby 1 and baby 2 Melissa! : ) I have also started to take the vitamins. That is a good tip about the bolusing, I always do it as I eat and bolusing before could really help combat some of the highs. : ) I tried weight watchers before my wedding with no success. Was on the program for 6 months and recorded everything. My husband did it at the same time and actually lost almost 20 lbs, I ended up staying the same and gaining/losing the same 5-8 lbs the whole time. I was undiagnosed celiac then though and had a lot of issues with food absorption, etc so it might work better now. Happy that it is working for you and your A1c is coming back to goal. : )

Thanks for your support and advice!

Hi Sarah,
Very reassuring to hear stories like yours. : ) Congrats on your baby boy as well, so exciting! I have always had those thoughts in my mind too, and I didn’t worry as much before, but after I was also diagnosed with celiac in 09 it has been a big worry for me. The drs reassure me it is fine, I just get scared. It is so nice to connect with other women though, see what has worked for them and that others have had those high A1c’s too. Mine is in the 8 range too which is so discouraging. It is amazing how your A1c got lower with being pregnant, I have heard that from many ladies here. I guess the baby is the best motivation. : ) I do notice lower bs after walking so walking after each meal is not a bad idea. How long do you walk for?

Thanks again for taking the time to reach out. I am sure I will have lots more questions as I go along this journey. Have a great weekend!

I am in the exact same boat you are in. Simultaneously, I am trying to bring down my A1C AND lose roughly 20-25 lbs. It is extremely difficult. I have managed to bring my A1C down from a 7.7 to a 6.4 in a 6 month time frame. However, I am not having as much luck with the weight loss. I have only lost about 6 lbs in 3 months so it is coming off SLOWLY (which I know is the healthy way…but shouldn’t it be more?). I eat around 1400 calories of a balanced diet a day and work out everyday with cardio 60-90 min and weights every other day for 30-60 min. in additiont to the cardio. I don’t know what the deal is. When I focus on weight, A1C goes up, when I focus on A1C, weight goes up. I get frustrated and wonder if pumping insulin just totally prohibits you from being able to lose weight (since insulin stores fat). I have decreased my daily insulin intake from about 80 units a day to about 60 units a day which is great, but I haven’t had to decrease my basal and bolus rates. I don’t want to give up but I wish this weight loss would speed up so I can start trying with a 6.4 A1C. 20 more lbs seems like forever away! Good luck with your progress and maybe we can get some good tips on here.

Hi Crystal,

Good luck with everything. I too wondered how people with type 1 had healthy babies when I first started thinking about it. Doctors always told me the negatives, but I knew positive stories were out there. I ultimately blogged about my pregnancies and wrote the book “Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby” which covers just about everything related to type 1, type 2, and pregnancy.

To answer your questions, (1) it took me a year to get pregnant with my son, and even more time to get pregnant with my daughter. I saw my docs every six weeks to follow my A1cs, ate very similar breakfasts and other meals, and tested my blood sugar all the time (sometimes 12-14 times a day). With my daughter, I was on a CGM so I could catch highs and lows before they went too high or low. And I was on an insulin pump for many years before trying to conceive. (2) Because of infertility, my A1Cs were always in the low sixes while trying to conceive for many months. (3) Definitely bolus for your meals 15-20 minutes before eating, stick to whole grains and cut out or avoid white carbs (rice, potatoes, bread, etc) as much as you can, and figure out what foods affect your blood sugars in which ways. I also got pregnant, both times, well over a weight recommended for my height, and honestly never tried actively to lose weight. (Keeping sugars tight meant treating a lot of lows for me, which put on/kept on weight). However, I went on Metformin at my infertility doctor’s suggestion (not my endocrinologists, as I never showed signs of insulin resistance or polycystic ovarian syndrome) and it helped me lose a bit of weight (and conceived my daughter without extensive infertility treatment.

My kids are now 4 and 4 months and both are healthy and happy.

Good luck–and feel free to email me if you want more details about my book or blog.

All best,
Cheryl Alkon
author, Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby
creator/founder, Managing the Sweetness Within (www.thesweetnesswithin.blogspot.com)

That may be a reason I am not losing weight as I would like. I’m working dligently at bringing my A1C down so I get a lot of lows (especially during work outs even though I decrease my basal an hour before) which requires me to pop glucose cubes for treatment which adds more calories and probably counterproducts my workouts…ugh, so frustrating! I would love to do both lose weight a drop my A1C but doing both at the same time is very difficult!

Hi Anna, So nice to meet people in the same situation, glad I am not the only one who has these frustrations. I never had a problem with weight until the pump. Once I got on it, I gained around 50-60 lbs in less than 6 months and i have not been able to get it off ever since. I maybe lose 5-10 lbs here and there but it always come back. Working out is just a vicious cycle, i do it and often go low and have to eat, which defeats the purpose of burning the calories in the first place. I just try to tell my self the working out is good for heart and mental health, as well as my A1c and I am doing the best I can do. Unfortunately, it is one of the negative side effects of the pump- the constant insulin helps store fat. Sounds like you have done an amazing job with your A1C, that is half the battle. The weight will come off eventually, just like everything else we have to deal with it is 3x harder for us! Would love to keep in touch, exchange tips and help support each others progress! Good luck with everything!
: ) Crystal

Hi Cheryl,
Thanks for taking the time to reach out and give me some advice, I really appreciate it. I will definitely check out your book, seems like a great resource. : )

I am going to start doing the bolus trick, that seems to work for a lot of people. I also see my endo in april and I am going to ask about the metformin. I was on it in 08/09 but stopped cause of some stomach issues. I didn’t know it at the time but those issues were caused by undiagnosed celiac disease. I got that diagnosis at the end of 09 and have been gluten free ever since and my stomach is doing much better. That is the frustrating part about the weight for me. I don’t eat any fast food, or processed food. I eat very bland and plain, around 1500 calories or so and the weight just sits there. I can’t eat most grains since I can’t have gluten so I primarily eat quinoa, or brown rice for carbs when i have them. I just have to take it one day at a time.

Congrats on having two healthy little babies, that is awesome! :slight_smile: I am going to check out the blog right now.