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

Diabetes and Pregnancy Trying to Get Pregnant
1

Hi all,

I posted this in Gestational Diabetes and Diabetes and Pregnancy forum too so forgive me if someone has had to see this twice! Anyway, 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

Unfortunately, I can't help you on this, but am SUPER interested in what others respond to your post, since I am 43 y.o., diabetic 32 years, don't have a cardiac condition, but have leukemia, and would LIKE to conceive. I have not either gotten any straight answers on advisability of this from healthcare professionals. Am interested in real people stories, too. Thanks for bringing this up! Good luck in everything!

3

Hello GardenGirl... Sounds like a wonderful surprise, in spite of many uncertainties! I have never been pregnant, for numerous reasons, have had T1 for 34 years, and am a CDE. And, my first thoughts are that it is very possible for you to have a safe and healthy pregnancy. As always a challenge, and one to which you may not have knowingly committed. Certainly consider all the risks when you speak with your doctors... and then make a decision from your well informed heart... and by that I mean your intuition! I have come to believe that things happen for a reason, and staying in touch with your heart will inform what is best for you!

4

Apparently not crazy. I am 34 and I keep asking docs about having a baby and they all say I have loads of time! They don’t seem to be concerned about being over 40 and preggers at all. They keep saying that as long as I’m in range that it should be like any other pregnancy. Its the ‘in range’ part that makes me nervous. But, if the pros are not concerned, I wouldnt be. And I agree with the other lady who posted, that if it is meant to be then it will happen. So, good luck, no matter what you decide! This site is the best support, so keep in touch!

5

Hi Garden Girl,
I have been a type 1 for 37 years. While I did not get pregnant as late in life as you did, I did happily and successfully carry our son to 37 weeks. My blood sugars at least initially were not very good. And my A1C's were pretty crappy as well, but being pregnant forced me to take better care of myself. I would hope that now with the advent of CGM's, Pumps, carb counting, analog insulins etc that pregnancy would be at least a bit easier both from a blood sugar maintenance standpoint, but also from an anxiety standpoint. I was 127 pounds when I got pregnant and 180 at 37 weeks. I lost only 21 pounds giving birth so was 159 when I left the hospital. I am only just now getting back to my pre-pregnancy weight and my son is in college. But I'm not sure if the weight gain was entirely due to the pregnancy and my high risk ob was perfectly ok with it. Mark was 5 pounds 1/2 ounce when he was born. The strange thing is I didn't necessarily end up taking lots more insulin. Especially near the end because my son was pumping out insulin of his own. I think that is why they checked his blood sugar so much initially because he had been producing insulin for the 2 of us and his pancreas was in overdrive ?
While you have some risk factors that I didn't with regards to age and coronary issues, you certainly sound as though your diabetes is in good control. A1C's in the 6's are a good start. My best advice is get the very best maternal/fetal medicine specialist you can possibly find and listen very carefully to him/her. But this has to be your decision based on the professional advice and what you feel inside.
My son Mark is the absolute light of my life and living proof and that a successful pregnancy with T1 D is possible and the rewards are life altering.
Good luck with whatever you decide.
Clare

6

I'm 40 6 months along with my second baby. I had my first at 24 and he was perfectly healthy. I've been a type 1 for 39 years now..diagnosed at the age of 1. I know it can be scary but with all the upgrades in medical tech I think things are so much better for us. Every pregnancy is different and I'm not sure you can count on the same things happening in the first as with this one. I've managed to keep my A1C at 5.6 through constant monitoring, using sliding scales and carb counting. I adjust my own insulin rates as needed. With the pregnancy hormones, there are times where I have to be extra vigilant and not be afraid of my insulin rates being so high. I'm also on the insulin pump. Most insurance companies are great during diabetic pregnancies covering the pumps. I think the allowing myself to have as much rest time as I need is a hugh help too. I get caught up in the what if's but I have to tell myself I'm doing the best I can and go with that. Best of luck with you.

7

Hi Garden Girl,
I am 42, diagnosed when I was 11 months old. I have no complications of any kind. I was pregnant last year but miscarried at 9 weeks. The docs said that the diabetes had nothing to do with it. I had an A1c of 6.0 at conception and was able to maintain it through those nine weeks with only one carb ratio change. I weighed 160 when I got pregnant and was told by the high risk OB that I could only gain 15-20 pounds throughout the entire pregnancy. She also said that the hardest part would be eating/not keeping food down. She siad that if I couldn't keep food down then I would have to get into the clinic and they would have to feed me through an IV. What made the overall control a lot easier was the CGM that I had started on several months earlier. I was able to catch the highs before they happened and that made a big difference in my numbers. I'm on the Medtronic 723/CGM and the predictive highs/lows feature is what did it for me. In talking to all the doctors, my age was the biggest problem with the pregnancy, not my diabetes. I definitely think it's possible to maintain your numbers through a pregnancy. Hope this helps and good luck!!

8

Hi everyone,

Thank you all so very much for all your insights, supportive and encouraging words, wisdom and honesty. It has meant a lot to me, and I'm thinking a lot about what each of you has said as I weigh this. My husband and I have the OB consultation today to find out all the risks, likelihood of those risks, options, etc. At this point we're very early in -- end of the 5th week -- but I'm feeling changes already, including a need for higher insulin. Anyway, I wanted to touch back in, and I'll let you all know what we learn today.

Jackie, I'm curious -- why did you have so much difficulty keeping food down? I'm very sorry about your miscarriage -- when I went through it I was surprised at how traumatic and painful it was, emotionally. It sounds as if you were doing everything beautifully. Will you try again?

9

I never actually had any problems keeping food down. There was no morning sickness. I got tired very easily and my numbers could drop very quickly though. Highs were never a problem. The reason that the high risk OB thought I would have issues with food was because my eating habits are a little different-I only eat when my blood sugar says that I can. I have never adhered to a consistent or set eating schedule. Twenty years of retail and not having a set schedule made me manage my diabetes a little different than most. The OB said that I should be eating multiple small meals a few hours apart. She said that if I did have morning sickness then I would have to be IV fed so that my blood sugars didn't drop dangerously low. The baby never actually developed a heartbeat. My HCG numbers were consistently going up, but they weren't doubling. But the numbers were very high. The doctors finally said that the pregnancy was not viable and I would eventually miscarry. We waited an extra week and a half and did a final ultrasound to be sure. This was when they found out why my numbers had been so high-I had been pregnant with twins. One had never truly developed and was hidden by the second fetus. The D & C was done at nine weeks. My OB said it was better to do it this way because I was that far a long and he was worried that I would have a natural miscarriage on Christmas day. So the D & C was done on 12/23. As for trying again, we waited 3 months and started again, this time with Clomid-no luck. We went back to the fertility doctor (we saw him last year to start IVF but didn't know that I was already pregnant when we saw him.) We are actually starting IVF now. I start the Lupron shots on Monday. Throughout all of this, all the doctors have said that my biggest problem is my age. All these years I thought it would be the diabetes. My A1c's have always been good and I have no complications. I am actually abnormally healthy. I'll probably be posting a separate thread soon about this. Hopefully you had positive news at your visit today. I'm sure that you were warned about your age, keeping your numbers in line and all the other warnings that are thrown at diabetic women. Just remember that diabetic women have healthy kids all the time and that you are probably in better shape than most BECAUSE of your diabetes. Forty years with this disease and your doing as well as you are is certainly proof of that! Good luck with everything and keep us all posted!!

10

I am so glad you posted this one! I am about to turn 38, T1 for 2 years now and starting to try to conceive... I too have worries and such about what to expect and a million questions that I don't know where to begin. My endo told me that women in our age range are higher risk for multiples... are you having twins? I cannot blame you for the anxiety... just thinking and getting started has created anxiety for me! LOL... Best of luck and I will be following your posts on this one. Best of luck and breathe! I wonder if yoga could help or is it not encouraged for high risk pregnancies??? Yoga has always helped me chill out when needed. :)

11

I'm 40, diagnosed T1 at 38, and have a PERFECT 5 month old baby girl. 7 pounds at birth.

Nothing wrong with prenatal yoga; I did it throughout the pregnancy. I also ran until it got too uncomfortable, somewhere in the 20's weeks. I walked and lifted weights throughout.

You have to be hyper vigilant about your BGs, and change your basals and carb ratios constantly. By third trimester, going to doctor appts will be a part-time job. But you CAN do it!

12

Hi,

I am age 39 just got married 4 months ago and my husband and I are also planning to have a baby. We spoke with the OB and he told me the consecuenses that can occur, but besides that me and my husband are willing to try. If it’s meant to be it will happen. I know I have to take much better care of myself, and do everything the doctor’s say. I have not been taking very good care of myself with my diabetes, but I believe probably this is the best time to start. Keep me posted. I am also a little bit scared.

Best Regards,

Eugenia

13

Hi,

Well to keep you posted...I went yesterday to see a new doctor (endocrinologist) and he told me I need to have some tests runned before I get pregnant. My blood sugar has been a mess recently so I started today to take care of myself, eating what I have to eat, etc.

14

Hi
I just saw your post. I’m wondering what you ended up deciding to do ?
I’m type 1 for 31 years and I’m 41. I am not pregnant but I have wanted to have a second child . I had my daughter at 27 , she was born very heathy and a normal birth . However I gained 90lbs during my pregnancy and now she is 14 and I’ve never lost all of that weight. I have never had another child because of the fear of gaining all that weight again . During my pregnancy I was up to 7 units every hour just for my basil . Before being pregnant I was only using a 1.0 basil every hour . I know that all that insulin made me gain all that weight .