Type 1 for 40 years, 43 years old and pregnant. Crazy?

Diabetes and Pregnancy
1

Hi all,

My subject line pretty much sums up my question -- though actually I have quite a few. Please understand that I am consulting with all the appropriate medical professionals (endo, high risk ob, nutritionist, cardiologist) and I am not asking you for medical advice -- or any advice at all, really, I just want to hear from other type 1s who have had kids, thought about it, etc. And if you all think I'm taking a terribly high risk, please share that -- I feel like no one has told me honestly yet.

Anyway, I am 43 and pregnant. I was pregnant once before, in 2007, but I miscarried. After that, it turned out that though I am fit, active, (was) normal weight, had A1Cs consistently in the 6s, and have been pescetarian for 25 years (eat a variety of veggies and fruit, fish but no meat and low-fat dairy) I had a coronary blockage. I was devastated and in shock, given that I've done everything as right as I could, and also given that I'd had no other diabetic complications at all. I had a stent placed, and life has gone on, relatively problem-free.

My husband and I were certainly not trying to get pregnant this time, and at the moment I think we want to get excited but we have a lot of fear and anxiety and we haven't yet decided if we will risk proceeding with the pregnancy. We have a consultation on Friday with a high risk OB who knows my deep dark medical history, and she'll tell us more about options for terminating as well as the real risks of complications and abnormalities.

In the meantime I just would love some other human voices -- some words from people who know the fear of trying to do this while diabetic. If it were you, what would you do, given my geriatric age (child-bearingly speaking) and my history of heart disease? Kidneys are functioning normally and all else is in good working order. Though, honestly, if I had been trying to get pregnant I'd have lost 12 pounds first, but nothing I can do about that now.

If anyone has experiences to share, both good outcomes and not so ideal, I'd love to hear. Also, if anyone has advice for keeping blood sugars in the pregnancy target, I need all you can give me. Hormones have changed all the rules - namely, there don't seem to be any now.

Also am wondering: is it possible to be an insulin dependent Type 1 diabetic, keep blood sugars within the target range during pregnancy AND not gain a ton of weight? I really don't want to gain as much as I know just packing on the insulin will cause me to.

Whew. Long one. Lots of anxiety and fear here -- thanks for letting me share it, and I hope to hear from some of you.

2

we are so glad you've joined us. please join this group
http://www.tudiabetes.org/group/ohbaby

I seem to remember a few years ago we had a type1 member in her early 40s having a successful pregnancy. I'll see if I can find her.

3

First of all, let me say CONGRATULATIONS! God has sent you a miracle, and I hope you are able to enjoy life and health throughout your pregnancy with this little angel. YES, it is possible to "be an insulin dependent Type 1 diabetic, keep blood sugars within the target range during pregnancy AND not gain a ton of weight?". My Sis-in-law has been through this same situation (she does not have the heart challenges you face and is in her 30's), and while it took a lot of work to stay healthy during her pregnancy, she was able to do it! Lots of pregnancy safe exercise and eating healthy was the key for her. I hope all goes well at your consultation - and that you are able to keep this baby AND your life! Oh, a person shouldn't have to make such a difficult decision!

4

First, well done! 40 years of D and still fine! I had both my kids in my 30's and both came out great, neither have diabetes. That was back in the 80's, so the tools were way cruder and the expectations much less stringent. I'd been diabetic for almost 20 years at that point and my pregnancies were also a surprise, both of them (lightning struck twice?)!

40's is certainly older and double the years of D is significant. But I was not in nearly the tight control you describe, in fact mine was flat out lousy. I bet my A1C, which they didn't even have the tech for yet, was in the double digits somewhere. And I was maybe 15-20 lbs overweight. I did exercise a lot though, and ate really really well - organic, lots of veggies, fish and dairy only etc. I think, if you can calm your mind/heart and meditate on the situation without the external fear, maybe you can feel some guidance on this gift? Only you can know what to do.

Stuff I think of to share - Nowadays they want you to stay super low-range during pregnancy. Which often means lots of lows. I understand the logic, but I want to share that after my son was born, he could be in the other room sleeping in his crib, and if I went low he would wake and cry till my BG was up again. This went on for several months. Broke my heart thinking of all the lows he had endured. So take the doc's advice with a grain of salt as it were. My BG's ran mostly in the 150-180 range and both babies were perfect, not large, not defective in any way. With my daughter it took me 3+ months before I even knew I was pregnant! So much for pre-pregnancy tuning.

As for having a child at your age, 40's turns into 50's and 60's before your child is raised... Child rearing takes SO MUCH ENERGY! You sound like you have plenty. Do you have a pretty good support network around you, people who can help? I have friends who had their first child in their forties - They found it difficult to go from doing what they wanted when they wanted to being "in service, on duty" 24/7, which made them feel selfish and guilty. Probably an easier change when you are younger? I know I deeply wanted children and felt so lucky to receive the two characters who came through me. It is a HUGE change, motherhood, but I gotta say, they light up my life every day (now 25 and 27, and off on adventures of their own!) If all your fears are medical and you and your husband's hearts deeply want this child I'd say go for it! Things happen for a reason, right? If you go for it drop the fear and go for it with full on joy. We are creative beings (in more ways than one, right?) and attitude trumps science more than most of us realize. How's that for a big fat opinion! -Only mine, of course, and no medical advice intended. Keep us posted on what you decide. And best wishes either way.

-Linda

5

I think any decision like this is a real personal one, and you have to make the decision that is right for ALL aspects of your life (your health, your relationship, etc). Kids are demanding, and so is T1D. Pregnancy with T1D is super-demanding. I'd rather not go into my personal experiences on this topic, but I'll just say that I have experience and, in the end, I have made the decisions that were right for me at that point in my life. I have absolutely no regrets.

The good news is that with your A1Cs and generally healthy background, you have a good chance of having a healthy baby. My endo has assured me that, at this point in my life, I can have a healthy pregnancy, but that it will take A LOT of work on my part. It would mean lots of doctor appointments, lots of adjustments, lots of tracking and stalking BGs. Insulin requirements generally go down in the first trimester only to go up steadily in the last two trimesters.

IMO, yes, you are taking a risk, but ANY pregnancy is a risk, even if you're completely healthy. There are always the risk of complications and disabilities. Your age makes these complications more likely (although women have been having babies at your age for centuries and many are born just fine). T1D increases that risk a bit more (but again, women with T1D have been having healthy babies for a long time, despite what Steel Magnolias has led everyone to believe). I would recommend that you seriously consider what you would do IF your child was born with (or diagnosed with) some sort of disability (regardless of the cause). Are you capable of caring for yourself and for a child who potentially needs a lifetime of care? I spent years working with children and young adults with developmental disabilities and I can tell you - it's hard. Very hard. Make sure you and your spouse are on the same page there. Genetic testing/amnios can detect some disabilities during pregnancy, but not all.

In the end, whatever you and your spouse decide is the right decision for the two of you. Just remember that. I think some members of the medical community tend to downplay risks like this, or they won't come right out and say, "Yeah, this is a big risk." Sometimes I think they just like the challenge. But, in the end, you have to gather the information and make a decision. It is ultimately a decision that you and your spouse must make together.

And don't forget that there are plenty of people here to support you!

6

Congratulations! Here's wishing you and your child a happy, healthy pregnancy and life!

7

Wow! And wow! Amazing and congratulations. I can't give you info about being pregnant with Type 1, as I have not had that experience, but lots here have and can give you tips and support. I will echo what SuperSally said and suggest that low carb is a good way to achieve greater blood sugar stability. My absolute best to you!

8

Hi gardengirl, first of all congratulations on your pregnancy.

I understand exactly how you feel. I was dx age 38 and gave birth to my first child a few months after my 40th birthday. I remember well the sheer joy and yet the sheer terror at that first positive pregnancy test.

Technically I was textbook-perfect for complications - T1D, geriatric, hypertensive - but everything turned out to be more than fine. Yes, statistically folks like us have a higher chance of things going wrong, but with a lot of hard work, you can cut down your risk to no higher than the average pregnancy. And face it, every pregnancy carries some risk.

I won't kid you though, keeping blood sugars in target during pregnancy is a lot of work. Many women also find that their insulin needs go insane, especially in the later stages of pregnancy. But don't worry too much because if you need the insulin, you need it. I was on a crazy ratio of 1 unit insulin to 1 gram carb (yes, you read that right) and on bad mornings, needed insulin just for oxygen. But by keeping lowish carb and not eating for 2, I only gained 7kg, despite using bucketloads of insulin.

Good luck, keep well, and feel free to send me a personal message if like!

9

Hi all is there any update on how the pregnancy at 43 all went? 42 and think i might be in the same boat. Thanks

10

I am right there with you. I am 42 and have had diabetes since I was 3. Just found out I am pregnant tonight and I am so happy but panicking a bit!

1 Like
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Although I am not the designated PWD in our family (my 13 year-old daughter has Type 1), I am an older mom (I was 44 when she was born; didn’t need any intervention to become pregnant, other than having her father switch from tightie-whities to boxers). I love being an older mother! Didn’t love the “What a beautiful granddaughter!” comments when she was a baby, however! Her 13 years older sister loved taking her to the mall with her friends and pretending she was a teen mother. Hmama143, congratulations on the great news!!! :baby: