Type 1 and pregnant

[Louise1981]

Hi,

I was diagnosed with type 2 when I was 27, a year later after being on the wrong meds and ending up in hospital they finally realised I was type 1.

two years later I have gone from an average sugar level of 14.2 to 8.4.

I am now 9 weeks pregnant and got my level down to 7.1 in 4 weeks. I have read so much about gestational diabetes, but want to ask those with type 1 for advice!

I have has some serious mood swings, depression etc as my sugar came down. I am hungry all the time and seem to lack any willpower to make the healthy choices. I am fully aware that my sugar needs to be controlled, which I am actually not doing too bad at, but I am struggling to lose any weight and keep my crying/mood swings under control.

Im hoping that someone out there can give me some pearls of wisdom!

Thanks x

 

[squeeze321]

Hi Louise1981,

Congratulations with your pregnancy.

I was advised by the DSN at the hospital if I ever became pregnant to get my blood sugars down to between 5 and 6 mmol but not to let them go higher than 7 and that blood sugar levels can sometimes become challenging during pregnancy because pregnancy hormones can play havoc with blood sugars. Other diabetics I have known and worked with whilst they were pregnant said that one of the biggest issues they had was going hypo all the time.

Your hospital should be doing a lot of checks, growth scans etc and your GP may refer you to an Obstitrition who specialises in diabetes in pregnancy. Just make sure that you have the support that you need from your healthcare team and that should take some of the worry away from you. Then you can stay well and look forward to the arrival of your new baby.

You may want to download the NICE Guidelines just to make sure that your GP/hospital are doing everything to help you and your unborn child. Your mood swings are probably due to hormones but they should settle down eventually.

 

[michaeldavid]

My HbA1c readings are probably better than many who do not have any form of diabetes.

I achieve this with safety by eating rye bread most of the morning and into the late afternoon. (With Biona Pear & Apple Spread, it's delicious.) This makes for effective hypo prevention: my blood-sugar never crashes - I always get time to react.

I test my blood-sugar 15-20 times per day. (That's no big deal; I never use those nasty spring-loaded gadgets - just the bare lancet.) I couldn't do without Betachek Visual for this: they're very inexpensive; each strip can be cut with scissors into 2, 3, 4 or even 5 striplets!

Crucially, I 'feed the insulin' I take. The last thing I would do is to take a DAFNE course. (The acronym stands for 'Dose Adjustment for Normal Eating'.) Eating normally is the last thing a type 1 diabetic should attempt to do.

Nevertheless, I eat very well indeed. (I'm ten stone, incidentally; and I've been that weight since my teenage years.) But I never 'count carbs' - I simply don't need to.

When I go to bed at night, the insulin I take has run its course. (That's apart from a very small amount of long-acting insulin which I take last thing, to stop my blood-sugar rising overnight.) So I know I can sleep safely.

 

[Talia43]

I was diagnosed type 1 diabetic in November 2012, became pregnant in December 2012. Obviously not on purpose, but nonetheless decided to carry baby to the end! My original a1c was 16, it is now 5.9, I am due sept 6. In the beginning I cried all of the time, as sugars were coming down. This is most likely due to horomones and the body just going through the healing process. There is a grief process you go through as well with any big life changes. It will subside. Also we all know that pregnancy causes crazy moods for some women. I am also bi polar and have PTSD. I went off all psych meds when I found out I was pregnant-Doctors wanted me to get to 2nd trimester if I could, before being on any meds. After the initial Emotional roller coasters, my first trimester was wonderful, 2nd trimester hit and bi polar was back in full force-I am now on a low dose of an "off label" medication. There is a list of approved meds during pregnancy for psych problems. Most doctors do not want pregnant women to have any type of stress-it is worse for baby than most things. If I were you, I would try to make it to the 2nd trimester and if symptoms persist, make an apt with a psychiatrist and discuss some options. Also know what meds affect glucose readings. If you are not sleeping well, get some unisom (safe during pregnancy) and make sure to rest and sleep as much as possible-this helps regulate serotonin. exercise (30 min walk daily) and get some sunlight! As for the hunger! I too was DYING of hunger, and scared to spike sugars. I email weekly with my diabetic specialist and I contacted her and told her I need to eat more-period. What do I need to do? And she and a dietician worked together to help me figure out a meal/snack plan. Protein is always good-nature valley makes a protein bar that doesn't affect my sugar at all. I will post links at the end for you. Every diabetic is different but sharing info is good. I have a MAJOR sweet tooth all of a sudden, and I too, lack the willpower to refrain from indulging. Not good-gotta reign it in! I try to eat things like graham crackers or toast with peanut butter, apples and peanut butter, grapes, drink crystal light raspberry lemonade, diet dr pepper, sugar snap peas, yogurt, MINI kit kat or snickers. Sometimes though, that cheesecake would take priority over anybody or anything and it just doesn't matter. I have put on too much weight too. My female OBGYN says "so what? some women JUST DO". My male OBGYNs are not happy. They are men. Let them try managing diabetes AND growing a human life without cheating. At the end of the day, if your A1C is between 3-6, things will most likely be fine. Consistent highs are not ok, and not recognizing lows is not ok. Wear the glucose sensor if needed to help regulate. I can't afford the sensor but I check my sugar probably 8-15 times a day and even set alarms to wake up at 2 or 3 am just to check.
As you will discover, later in pregnancy insulin doses can double, triple, or even quadruple. Therefore, keeping a1c down gets hard. You have a high risk doc I assume? As well as a primary care, endocrinologist/diabetes specialist and regular OBGYN? High risk docs sometimes will make insulin adjustments, but constant close care is the best-if you can be in touch weekly with someone from a team of docs to report sugar readings and questions, tight control is much more manageable.
Reach out for help when you need it, there is always help to be had! You are doing great and everything will be just fine, keeping a1c low is best. Congrats to you and family!! Take care and try not to stress, diabetics have healthy babies all the time
protein bars:
http://www.naturevalley.com/?utm_source=yahoo-bing&utm_medium=cpc&utm_campaign=nature+valley&utm_term=nature%27s%20valley&gclid=CJDCobXom7gCFRO44AoddzoAAA&gclsrc=ds
meds that affect blood sugar:
http://www.dlife.com/diabetes/type-2/diabetes-treatment/drugs-that-raise-blood-glucose

Http://www.diabetesincontrol.com/DrugListAffectingBloodGlucose.html
safe meds during pregnancy:
http://www.guideline.gov/content.aspx?id=12490

online isn't great for safe meds-ask dr for a list, mine gave me a list.

 

[Louise1981]

Thank you! This really put my mind at ease, just knowing im not the only one going through this

 

[SC1977]

I had gestational diabetes on my first pregancy and then was got type 1 two years later. I was also diagnoised incorrectly as type 2 and ended up getting very sick. I was advised to get my A1C under 7 before trying for another baby. Once pregnant I attending the diabetic clinic who helped me keep my A1C under 6.5 for the full pregnancy. They changed my insulin intake twice per week and I had to go the clinic every 2 weeks and had lots of scans to monitor the babies growth. It was tough going but 9 months later I gave birth to a beautiful baby boy. My advise is work with your hospital as best you can, try stick to the same foods and they will increase your insulin as your body needs it due to the changes in your hormones. Best of luck!

 

[Louise1981]

Thank you for your post, I am doing much better now and keeping a good control on my sugar levels. The only thing I have problems with is the lack of hypo warning. I drop to 2 without realising and then panic and over eat to bring myself up. That then causes a high, which I then have to deal with.

 

[Glitzy_girl_gem]

Hi Louise. Congrats on the pregnancy I was reading through your post and I noticed how your sugars are dropping down to 2s and your not feeling it I am the same tho Im not pregnant but somebody told me who are a type 1 them selfs like me to get some glucose tabs can buy from boots or super drug and if you drop down to say 3 have 3 of them which would take you to 6. I learnt to do this as before meeting her i would have a low, binge eat then then would be through the roof or if I do have a little binge have abit of insulin to cover yourself !It might take abit of time to feel like your sugers won't come up from the glucose tabs but they do my hba1c use to in 9-10 and above now I've learnt to do that and get it under control my big bloods are down to 7.9! Good luck with things


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[Louise1981]

Thank you!! This describes me exactly, panic, eat too much then have some insulin. I will go and get some glucose tablets tonight!

 

[Glitzy_girl_gem]

Welcome it's not i panic when I have a low I just crave sweet things and thing that will give me suger quick! I never use to cover myself with insulin but now I learnt to do it loads better. I prefer the lucozade orange tabs.


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[Robinredbreast]

Thank you! This really put my mind at ease, just knowing im not the only one going through this

Congratulations on your pregnancy, that's wonderful news I had my daughter 12 years ago, an older mum and Type 1, 42 at the time. My pregnancy blood sugars weren't too bad at all, I just found that I had to take a lot less Insulin, maybe just one unit with meals (sorry I can't remember all the details).

Any questions or problems you may have, always ask your specialist in charge for help and advice and I look forward to hearing the good news in a few months times.

Take care with best wishes RRB

 

[Sabina81]

Hi Louise,

I firstly wish to say congratulations on your pregnancy but also you managing to get your Hba1c levels down. I myself is a type 1 and I had asked my consultant to be put on an insulin pump,he refused saying it was too costly but after showing some NICE guideline's and journal articles he agreed. Firstly I had to attend a DAFNE course and then January last year I started the pump. Two weeks later I found out I was pregnant!The hospital I was referred to was brilliant and I truly believed they cared for both me and the baby's health any questions I asked they found the answer.I went for a checkup every fortnight and tested my BG regularly and also at 2am,4am,6am and 8am! After a couple of months a consultant nurse suggested a continuous blood glucose sensor.It measures the interstitial fluid glucose and not the blood glucose . There is a lag time of about 10minutes and it needed calibration a couple of times a day but it made my pregnancy so much easier. It did not require measuring glucose levels by the use of strips as there was a needle sensor. It would automatically record a BG reading every 10 mins and show if your BG levels were stable going up or down.It would beep if the BG level went above 6.5 or below 4.5 and it meant most important that I could snack if necessary and know whether to take insulin or not.If levels went too low it would automatically cut off my insulin.The only trouble was that it was self funded as the NHS don't provide it. It is seriously worth considering, and I happily gave birth last October and he is now 9 months. Ant questions I would be pleased to help. Take care

 

[nestegg]

Hi
I have been diabetic since the age of 4.
I didn't not find out I was pregnant until I was 6 months so I can say my diabetes control was probably not its best as I did very few blood tests. My son was born 6 weeks early and was 5lb 15 he is now a healthy 21 year old.
Yes control is very important but don't stress too much about it as that will just make you worse.