Type 1 Pregnancy Numbers

Diabetes and Pregnancy
#1

So I am about 9 weeks pregnant and am being seen by Maternal/Fetal Specialists due to being high risk.

I feel like the doctor's blood sugar targets are higher than I would have ever expected them to be during a pregnancy.

I am just curious if others have experienced this type of guidance?

My doctor has decreased my fast acting insulin, increased my long acting (by 2 units and honestly I think it needs to be bumped down by 2 due to morning lows) and has told me to only correct if I am 200 or higher.

I feel like that 200 range is way too high, and I prefer to correct once I am ~150.

I understand her concern for lows, but I feel like allowing myself to run higher is just asking for problems.

My A1C is well on its way to the ~6 range, and I want to keep it there or lower.

Thank you for any & all input!!

Nicole

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#2

Congratulations on your pregnancy!!! Blood sugars and pregnancy are a completely separate and confusing aspect of diabetes. I understand your docs goals...I have had 3 successful pregnancies. So, here's my take on it. First trimester your insulin requirements will drop significantly. In fact, a lot of D women find out they are pregnant because of severe lows. Our bodies just don't require the insulin we needed pre-pregnancy. Second trimester, you will be back to probably the TDD you had pre-pregnancy. Third trimester, LOOK OUT MAMA!!!! You will need more insulin than you ever thought humanly possible. This is due to baby growing at warp speed and taking in all of the food we can give him/her.

Severe low blood sugars while pregnant are quite scary and can cause problems with baby. Averaging a little higher does not have the same impact on your growing baby.

I received the same guidance during my pregnancies. I kept in constant contact with my endo...usually weekly. I also met with my OB/GYN a lot more than a regular pregnant woman. Around 30 weeks, I would see my OB/GYN weekly for non-stress tests to keep an "eye" on baby. And around 35 weeks, it was twice a week. You will become quite close with your team of docs...both for baby and you.

Personally, for me, I would tend to go low in the middle of the night and have no symptoms. So, my husband woke me up at 2am every night. Talk about dedication.

I wish you all the luck in the world. Pregnancy and diabetes is an intense game, but it can be done.

Please feel free to contact me with questions, concerns or just notes about how you're doing.

Sarah

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#3

Sarah,

Thanks so much for the reply!!

That makes more sense to me. I am sure she probably explained it, but she gave me so much info that I probably forgot that explanation. So running a bit higher doesn't have the same negative impact as lows on the baby?

Are on pumping? I have been on MDI since I was diagnosed in 2005.

Well I am creeping out of the 1st trimester, and needs have decreased! It has been a nice change. I do anticipate to be doubling up on my intake come the 3rd trimester.

My team of doctors are amazing and we talk twice a week so for via email/phone. They did tell me to expect to come in about once/twice a month and then twice a week once the due date gets closer and that baby will probably be delivered early.

If you don't mind me asking, did you have to have a c-section? They told me that is the 2nd option and to plan on a normal birth.

I will have to ask my fiance about waking me up! lol that is some sweet dedication!! I have been going low in the night, but luckily I have had symptoms. I need to probably set an alarm for a set hour each night.

I really appreciate the info & the well wishes.

I will take you up on contacting you and would love to keep you updated. I am sure I will have a million questions.

Thank you,
Nicole

#4

I started pumping 18 years ago....been D for 31 years this month. I had all 3 babies naturally....with pain meds though. All 3 times I was induced at roughly 37 weeks.

This is such an exciting time for you. I'm actually a bit jealous....I LOVED being pregnant.

Enjoy and embrace every moment.

Sarah

#5

How exciting! Conradulations! I agree with everything that Sarah related to you. It is very silimar to my experience of two pregency. Just remember to enjoy the experience and while you have to be viligent about your numbers more than ever right now, you can do this. Blessings my friend.

#6

Hi,

During my 2 pregnancies my endo required me to keep my blood sugars as follows:

< 95 fasting and before eating
< 120 1.5 - 2 hours after eating
Never above 140

To do this I monitored frequently and adjusted as required. I mostly was about to keep under 140 (though I think I got up to about 160 with my second pregnancy occasionally - but always promptly adjusted). I also ate very low carb during my second pregnancy - and no carbs for breakfast, when my blood sugar was most reactive.

It was very hard work and I was still pretty early in my diabetes management. But my a1c was at 4.9 at the end of my first pregnancy (about 80 units of insulin/day by end of the pregnancy), and 5.6 for my second pregnancy (about 120 units of insulin / day compared to my typical < 30 when not pregnant). Both my babies were normal weight at about 7 1/2 lbs. My first was a vaginal delivery (with Pitocin), and my second was a cesarian due to failure to proceed (after 3 days in labor), the cause of which turned out to be completely unrelated to my being diabetic).

My take is if you can manage to keep your blood sugars at these lower levels without lows (and this does require lots of monitoring), then you certainly should. Basically you are the one managing your blood sugars not your doctor and you need to be able to adjust as necessary.

You can also look up works by Lois Jovanovich. She is a specialist in diabetic pregnancy. She advocates both lower carb and very tight blood sugar control during pregnancy.

Hope the following links may help.

http://diabeticmommy.com/sp-pregnancy-diabetes-bd-faq.html
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=8&cad=rja&uact=8&ved=0CFcQFjAH&url=http%3A%2F%2Fwww.diabetesmine.com%2F2011%2F07%2Fdiabetes-and-pregnancy-a-video-chat-with-dr-lois-jovanovic.html&ei=pxKJVOkMht6YBa6agfgG&usg=AFQjCNG0TUQyM43d6LxAt7MVN69E_X4eBw&bvm=bv.81456516,d.dGY

http://press.endocrine.org/doi/pdf/10.1210/jc.2010-0383 (this is a case study on a type 2 diabetic pregnancy, but the principles are the same).
http://care.diabetesjournals.org/content/30/Supplement_2/S220.full (discusses types of insulin to be used in pregnancy and why)

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#7

Thank you for the replies and the info! I will read up on as much as I can.

I really appreciate all of the support!

#8

You will be fine! Just follow the close and keen instructions of your doctor. If you feel a bit off then seek a second opinion.