Diabetes challenges and pregnancy

[emmie]

Good afternoon all,

This is probably going to be a bit of an essay but bare with me!

I have been type 1 since I was 4 yrs old and my diabetes will be 25 yrs old this year. My diabetes as always been a challenge and the last few years especially. In 2009 I had an infection which caused massive yoyoing and resulted in me having a hypoglycaemic fit, which I hadn't had in over 10 years. After a period in hospital I was devastated to find out I had lost my hypo awareness, so no longer felt the signs of a hypo. This altered my life dramatically as I had to give up driving and be redeployed from a community nursing post to an admin post.
I have also just found out that I have nerve damage to my bladder, which I have to learn to self catheterise as my bladder doesn't empty by itself. I have also been on high bp tablets for 10yrs too.

I have never regained my hypo awareness despite being put on an insulin pump and I am extremely fortunate to have a hypo alert dog who lets me know when my levels are changing due to a body odour change! He really has changed my life...

Well background over with. I've now made the decision to give up work and focus on my health. My fiancée and I are getting married in October and want to start a family.

I'm very nervous and excited about this and have already researched into diabetes and pregnancy. Luckily my last HAB1c was 7.2 so got another blood test next week.

I would just like to hear from other T1 diabetes and hear how they managed preconception and during pregnancy. I do worry my pre existing neuropathies may cause problems in trying to conceive and holding the pregnancy. But trying not to be in 'steel magnolias' frame of mind as diabetes care is much more advanced nowadays

I'm probably worrying way to much and I am awaiting a consultant appointment but I so want to do everything right.

Many thanks in advance

Emmie



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[vans]

Wow Emmie, sounds like you've had lots to deal with!
Don't really have any advice to offer, I'm 12 weeks and although my control wasn't brilliant preconception I did manage to get my hba1c into the 6s which I was happy with. I am on a pump too...

Try to stay positive, do all you can to gain good control in these months and enjoy the build up to your wedding!

 

[kt78]

Hi Emmie

Congratulations! If you are looking for inspiring (though hard-core!) advice, Dr Lois Jovanovic is credited with many of the improvements seen in diabetic pregnancy outcomes.

She is tough, but if you want to see if you like her approach before buying any books or anything - here is a video of her giving her 'top tips'.

http://www.youtube.com/watch?v=XaapntWJGDc

All the best

Katie

 

[lexilox]

I've had type 1 for about 21 years and have two kids age 11 and 7. First two pregnancies went great but I've lost two babies since then which is heart breaking. I believe that was down to poor control as although my HbA1c were in the 6s my control was more erratic in the past few years with many more highs and lows than when i had my two successful pregnancies. My advice based on my experience is that keeping BGs stable as possible is a must before conception and during pregnancy. Wishing you all the best as they are worth it don't let the diabetes stop you from doing what you want. X

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[emmie]

Thank you all for your posts! I've made some big decisions over the last few weeks and decided to give up my full time job and focus on my diabetes. I've also just found out I have moderate diabetes disease - retinopathy so just waiting for an appointment with eye unit. With all this I have become extremely focused on my blood sugars and I have gone onto a low carb diet and after 2 weeks it is already making a big difference. It is such an elating feeling doing a blood test and seeing it in single figures and certainly the last week that is happening all the time.

I'm seeing my GP next week so will speak to him about starting me on the folic acid and hopefully will be in a much better place by the end of the year to start trying. I had a hb1c taken on Wednesday so fingers crosses its not too bad.

Thank you again and I will look into Dr Lois too

Cx


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[emmie]

Hi Katie,

Thank you for my private message but I'm not authorised to read it yet apparently but I will respond to you as soon as I've used the forum more x


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[saz1902]

I cannot give any advice im afraid. Only had t1 for 7 months. I would love to give you my best wishes and Congrats on every thing! I really hope all goes well for and hope the future bring lots of happiness for you! X keep us updated on any wonderful news x

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[Lucyturner]

In regards to being type 1 and pregnant I can't advise but if there's one thing I do know it's the want for a baby. I was diagnosed at aged 19 with premature menopause so I went many years thinking I would never have children. I have been very lucky in this respect though as I met my husband who was very understanding and I have an amazing sister who donated eggs and after going through IVF I have been blessed with a beautiful daughter. So my message is simply this. Never give up hope stay calm and look after yourself.

Lucy

 

[emmie]

Aww thank u Lucy that's lovely to read! I do feel very focused and we have spoken about alternatives if I'm not able to full pregnant for whatever reason. Ivd also been a strong believer in doing everything I can so I have no regrets. X


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[Mshipmonkey]

Hi Emmie,

I would suggest getting a referral from your doctor to a hospital's pre-conception clinic for diabetics. You would see them on a monthly basis & they would do blood tests, you would have to keep track of your blood glucose levels & they would advise you as the months progress. Also you would need to take Folic Acid 5mg daily which is only available on prescription.

I attended this clinic myself for 3 or 4 months before I fell pregnant. It was the best decision I made - you have to be persistent with trying to get the initial appointment. According to the Diabetic Specialist at that clinic I have given my baby the best start as my blood glucose levels are better controlled now.

Wishing you every success in the future :smile:

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[emmie]

Thank you Mshipmonkey,

Unfortunately we have lost our areas preconception clinic but my diabetes nurse is trying to find an alternative place for me to get advice and she has been a great help with my levels.

I'm hoping to get as much help and support as possible as I want to do everything right.

Did you have a normal birth or did you have c section if you don't mind me asking

X


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[Mshipmonkey]

Hi Emmie,

That is terrible news about the preconception clinic. Where they need to invest money they don't and the diabetics suffer. They must run something in the hospitals right?

I've just gone past the 10 weeks stage & it hasn't sunk in yet that I'm pregnant. I have an appointment this Wednesday with an obstetric doctor and I am going to ask all the questions regarding the birth & delivery. I have heard in some diabetic cases they may deliver the baby early.

Is there anything in particular you are concerned about? I could try & find out for you if you would like.

Take care of yourself Emmie.



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[emmie]

Awwww bless you didn't take it on board your expecting now that's so lovely! Congratulations and I hope everything goes well! How are you finding things so far?

The main thing I am nervous about is how low I need to keep my blood sugars. I don't have hypo awareness but I am extremely fortunate to have a hypo alert dog who alerts me when levels are 4.5mmols and below. So guess its wanting to know what's the highest blood sugar levels can be without causing problems.

My diabetes nurse is going to speak to the hospital I get my pump from as they have a preconception service. I was only discharged from them because it was hard to get to as I no longer drive with no awareness. I'm also going to try and get them to change my pump to the Medtronic veo so if needs be a can use the CGM.

I really hope Wednesday goes well for you and you feel confident in the team!

x


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[GingerBabyMama]

Hi girls

I'm Type 1 (diagnosed 6 years ago) and 22 weeks pregnant. I haven't had any serious issues yet, luckily, but my diabetes was a big concern for my husband and I when we decided we wanted to start trying. I was convinced it would cause major issues with conceiving and remaining pregnant.

I started by going to my GP to get all the facts. They prescribed 5mg folic acid to start taking once I was ready to start trying (which I then took for the first 12 weeks of pregnancy). They also explained that I needed to get my HBA1C as low as possible (it was about 8% at the time). I then had the same conversation with my diabetes consultant. So I spent a few months focusing on stablising my levels, and once my HBA1C had been in the low 7s for a while I had the go-ahead to start trying.

We were so lucky as we conceived the first month. I had a viability scan at 6 weeks, a dating scan at 12 and an anomaly scan at 20. So far so good, although we have had some scares along the way (nothing was actually wrong, but we thought there was). I am seen every 2 weeks at a prenatal diabetics' clinic. All I can say is - we are VERY well looked after. Each time, I am weighed and blood pressure taken by community nurses. I'm then seen by a midwife who listens to baby's heartbeat (how lucky we are that we get to hear it so often) and discusses anything as and when it comes up, I am offered to see the dietician, and I then see the diabetes consultant and obstetrician (at the same time). I feel so supported and encouraged.

FYI, a normal pregnancy is 40 weeks but I will be induced at either 37 or 38 weeks for a few reasons: placenta can fail from 38 weeks in diabetics, increased risk of retinopathy in the mother and they don't want baby to get too chubby.

My insulin requirements are changing this week which I'm finding frustrating - every time I think I've got the perfect balance, it changes again. But my HBA1C is in the 6s now with NO hypos (apart from one last night but shhhhh!) so it's a fair HBA1C result. I'm going to clinic tomorrow so I can discuss this with them and they'll sort me out. See what I mean? I feel like a VIP ;-)

I have ready some horror stories (that's always the case on the Internet!), but I've read more success stories. All I can say is, prepare your body as best you can. So far I've felt blessed. It has had its ups and downs, particularly as the diabetes makes me extremely paranoid that something HAS to go wrong. So far the diabetes hasn't caused any problems. There's still time for things to go wrong for me - touch wood it won't! You can only do your very best, and you'll have to take the risk of being heartbroken at some point, perhaps this is where my paranoia comes from too as I had built myself up for the worst-case-scenario. I understand the dilemma you're facing, as you do have a very specific set of circumstances. But speak to your team and let them help you.

I hope this helps. If you have any specific questions please let me know!

x

PS - hypo alert dog?! Amazing! I'm fascinated by service dogs, you must love him so much x

 

[emmie]

Thank you'd gingerbabymama,

It is so lovely to read that you are being looked after so well! I know what you mean about worrying about Diabetes preventing pregnancy, which is one my worries, so kinda nice to know others have had similar thoughts. I've got an appointment booked with my GP in a couple of weeks when he returns from leave so going to discuss things then with him. My previous diabetes team put the fear of god in me when they talked about pregnancy and what could go wrong and it scared me off for a long time but I guess they do that to make sure your prepared and make sure you know the risks.

Yes toby is amazing, I hadn't realised just how anxious I was about my blood sugars until he started alerting and now im not scared to go out on my own now I have him. It's strange when I explain to people what a hypo is like, they say aren't you glad you don't suffer from them now! I say at least even when I felt panicky and legs like lead weights and feeling sick, at least I know why and know what to do as without those warning alarms it's more scary! Now I have Toby who goes "oi do a blood test because you smell weird and I want a babybel"!! Bless him ill see if I can attach a pic of him

I hope the rest of your pregnancy continues to run smoothly. If you don't mind if would be nice o hear how you get on?

X


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[jdizzy74]

Hi Emmie. I have been type 1 for 34 years, my sugar levels have never been perfect but I manage. I have had 3 children, all boys and I must say the best thing I ever did. With my first I obviously didnt kno what to expect from my diabetes, so my sugar levels were probably slightly higher then they should have been, your insulin dose will increase considerably as the pregnancy goes on but as soon as baby is born u will go back to pre-pregnancy dose. My oldest two both weighed 6lbs 8oz and my youngest, who I guess I had more control of as I knew what to expect weighed 4lbs 12oz and I did actually have a diabetes specialist come visit me just after the birth asking how I managed to have such a small baby while being type 1, lol. The only trouble I really had was high blood pressure and six weeks after giving birth to each I had a real bad hypo of which needed hospital treatment. But after all this I have loved every second of being a mum and have just recently became a nan so its all worth it. Good luck.x

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[GingerBabyMama]

My diabetes team had always said to me "don't get pregnant without checking with us first" which put the fear of God in me. They always lay it on thick, though, and it is worrying. Your hba1c is pretty good I was about that when they said I could start trying. Try to stay positive and roll with the punches. I thought this would all be a lot harder than it has been. Having said that I think things are changing this week. I will definitely keep you posted - and you let me know how you get on. I'll also be 25 this year and am called Emma

Toby is beautiful! It must have been life changing to have your hypo awareness given back to you in the form of a super cool pooch! Does he alert when you're high, too, or do they just train for hypos? How does he alert you?

x

 

[emmie]

Hi jdizzy74,

Congratulations on becoming a Nan ! Thank you for sharing your experiences and it is so reassuring to know that all 3 of your boys were and are so healthy. Do you mind me asking how giving birth was? Did you have to have a c' section? I'm so looking forward to getting married in October and then hopefully be able to start trying and ill do everything I can.

X

Thank you gingerbabymama,

A lot of what your saying is how I feel so fingers crossed you'll continue well through your pregnancy and ill hopefully be in your shoes next year! I am slightly determined to be a mum or an expecting mum by the time I turn 30 years old next June! Lol will have to see about that one!

Yes Toby learnt by himself to alert to my highs too. We have now harnessed him to alert to 13mmols and over but due to recent complications and hopefully pregnancy the charity and I want to work with him so he can alert to 10mmols and over so I can get tighter control. Originally he was trained to lick and nudge my hand but once he started alerting properly he started pawing me or making this funny noise, which seems to be his natural instinct to my changes.

X


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[emmie]

Hope today goes well Mshipmonkey x


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[jdizzy74]

Hi emmie. I had a natural birth with all three boys, they were all early, oldest two I had at 37weeks and youngest at 36 weeks. If I remember correctly I was on a drip with oldest two during the birth cant remember what drips were for n for the most part its the only time in my 34yrs that I forgot bout bein diabetic lol. I had no drip, no medication for the youngest as they all seemed to think I wasnt in labour untill they caught him!!

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