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How to lower HBA1C before pregnancy? Help!!!

A

agold

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I've been trying (very hard!) to tighten my control in preparation for starting a family for about TWO YEARS now and I cant get my HBA1c lower than 7.6. I test on average about 7-8 times a day. I make corrections where needed. I'm on a pump now (about a year). I count carbs. I write down all my results, the food I'm eating, dosages etc. I'm continuously trying to find the right ratios for basal/bolus which, work for a bit, then stop working. I do fasting tests. I try to avoid high GI foods.

Despite all this, my bloods still have a bit of a life of their own and even my previous consultants and nurses couldn't really offer any more advice. I feel there's not really anything more I can do and I'm wondering, after all this time, if perhaps I should just go for it. I have a sneaky suspicion that this is as good as it can get for me. Just wondering if anyone has been in this position or had any advice? Is it a case of just wacking up the basal rate and endure lots of hypos??
Any feedback much appreciated. Very unhappy. :-(
 
Have you done the fasting tests (4 in total ) 3 through the day and the dreaded overnight one. This ensures your basal doses are correct. Only then will you get consistency with bolus doses.

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Yes, I've done that.. more than once. I've even plotted a graph from it! The problem for me is that these rates seem to change before my period, during my period, near the end of my period, a few days after my period, at ovulation!!! By the time I've worked out a good rate (or rates), it's changed again and I can't keep up with it! It even changes month to month- so I find a good rate for period, for example, and the following month it doesn't work. I'm chasing my tail and very very tired.
 
Sorry I can't offer much advice on that, hopefully someone will reply who's been in a similar situation.

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No to sure if this will be a help to u but have read for t 1 the contraceptive pill can help balance hormones and keep your monthly loss to a similar amount making it easier to get ur levels stable and even though u can conceive as soon as u stop taking them there good affects can last for several months after use good luck

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Hello, you sound exactly like I was & still am although I'm now 8 weeks pregnant. I used to get so fed up because there was just no consistency or logic to my sugar levels. I went on a pump like you & managed to get my hbac1 down to 7.2 pre conception. My diabetes team were happy for us to start trying for a baby at this level so we did & two months later I was pregnant! I have managed to get my hba1c down to 6.3 since but I'm literally using temp basal rates all the time. I test a ridiculous number of times a day (I think my nurse spotted 26 in one day!) & I'd rather give too much insulin & be prepared to snack than not give enough. It's tough because we obviously have to try to function at work etc as well but I guess it's not forever. Good luck & hope you get there soon. Pregnancy messes with your levels anyway so if you get used to constant changes now you'll be well prepared lol xx


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Thanks all! And thanks HDM_84; it's soooo reassuring to hear someone else in the same situation and able to make a go of it anyway! It gives me hope! I set a target of about 3 months to really hone down my hba1c but it's 2 years later and I'm still trying! Bring on my pancreas transplant I say!!!
 
You're welcome & you'll do it. My diabetes team say women always get their hba1c down when pregnant. When I asked how they said 'they just do' lol. I guess if that means eating the same thing for 9 months then that's what you do (difficult if you feel unwell though). My best advice would be to test test test & always opt for the higher dose of insulin & eat snacks rather than risk going high. Feel like I need an update when you conceive now ha ha x


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Ha! Ha! Oh I will update, if it ever happens, I will defo update! Good luck with your pregnancy too though! Hope it's all smooth sailing! X
 
Hi agold I'm in totally the same position as you. Just curious have u been warned not to start trying yet with that hba1c? I was really happy as got it down to 7.2 from around 8. What u aiming for? I've totally eliminated all carbs from my diet now so not trying to count carbs anymore just taking minimal shots of rapid acting and have been playing around with my background.


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Well they haven't actually said the words "don't do it!". I've just had a lot of "well you know it really needs to be below XYZ..." And "you have to get it really tight before you try" "It's not terrible, but it could be better", and...my favourite, "It's sub-optimal". So basically, yeah, not really been given the green light!

I recently asked my new consultant (I've just moved) if perhaps I should look at a low-carb diet as haven't really tried that, but he said he couldn't really recommend it to me.(??)
 
agold - lol!

I think the issue is that the first 12 weeks after conception are the critical development weeks for baby so they want you to have the best control you possibly can. Let's face it, we're not going to know we're pregnant until at least 2 weeks if not more and if you've had highs during that 2 weeks you're only going to worry.

I got my hba1c down from 8.1 to 5, yes 5! In 12 months. I got told off for having to many hypos and to "relax" about it. Which I have done. I'm actually hoping my next a1c will be between 5.5 and 6.

So it can be done. Don't ask me how because I think it's a very personal thing, you have to find what works for you.

Good luck xx

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Useful to know. I think what I've gleaned from people is that basically you have to just run on just a bit more insulin than needed to avoid any highs and just deal with all the lows that comes with it. Wowsers, I need one pump with insulin and the other with lucuzade! Then you can just give yourself a little drip feed as needed!!!
 
So my latest Hba1c was 7.1%! Yey! So that's down from 7.7previously. I'm so pleased as have been trying so hard. And the consultant said, although he'd like it to be below 7, he said it's not like it's 10 or anything so we have kind of an amber light at least!
 
Hi,
Have you thought about a cgm over your pregnancy? It might help you to keep a better handle on things and I know consultants prefer to give them to pregnant ladies if they have them available even for the first half of your pregnancy might give you a heads up of what to set your basals at and to review your bolus quantity and timings. You can also set the alarm if there is a big jump up and down in your levels even before they go out of the acceptable limits. Depends which pump your on you might even consider funding it yourself, it's what I'm getting for my combined Christmas/ birthday present this year, £500 for the transmitter and 4 sets which may last up to 4 months for me. Definitely worth trying to ask the consultant first though they rarely suggest them but may have the resources to temporarily provide especially if you are pregnant.
Good Luck
 
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