Managing Type 1 in pregnancy - Are guidelines realistic?

[eshaw]

Hi,

I'm currently pregnant, my first child, and seeing the specialists about my diabetes (type 1) on a regular basis as part of the treatment programme. I've been a diabetic for about 17 years now, and went on the DAFNE programme a couple of years ago, so very used to self managing it and adjusting insulin when needed, and maintain what I think is a good level of control, around 6-6.5 on average.

Their current advice for Type 1 diabetics when pregnant is to maintain a blood sugar of a 'normal person', e.g it should be 3.5 - 5.5 before meals, and should be no more than 7.8 1 hour after a meal! I was wondering whether anyone else has been able to achieve this for any period of time during their pregnancy?

So far I've been able to maintain it at the same level as before I was pregnant which I think has been quite good. Being pregnant, having a full time job, constantly on the go between locations, in meetings and well having a life as well, I wonder how realistic it is to expect someone to do this. The regime requires me to eat inbetween meals to stop hypo's (not always possible when in meetings), check it 1 hour after meals, again not always possible. I've also had 5 different healthcare profs giving me different (sometimes contradictive) advice about how to achieve it! Plus the blood diary they give me is completely different to DAFNE, and well is rubbish for recording any meaningful data!

Anyone else dealing with this, being given the same regime and finding it difficult?

 

[Dragonflye]

Hi,

I know they would like you to have as close to "normal" person as possible, but according to my team 3.9 or below is hypo therefore bad. Both my previous pregnancies I did really well with control. I work full time also, but probably just because of my attitude I have no issues testing sugars in meetings nor do I have problems with eating, at the end of the day I function better when Im not hypo, if they want my attention I need to ensure I'm not hypo and they are OK with that (in other words I can just sometimes be plain cheeky :lol: )

This time round (still only in 1st trimester) things arent so good, hypos and ketones galore, but my team are just keeping an eye on me and the baby but they dont seem overly worried, I do have a great team though (for the most part, i do every now and again see a different doc but its usually my consultant or dsn) My issues is my GP, I had major issues with test strips (they refused me a prescription once) and had many arguments to get them to increase to 300pm... now im having issues as I now need 400 :?

A lot of hassle and hard work, but the end results are definately worth it

 

[eshaw]

Thanks for your reply, really useful to hear someone elses experience, and interesting to hear about what they think in terms of a hypo. I have felt uneasy about the range, and wished they could be a bit more specific about ranges at different times of the day e.g. when I go to bed, I would be very uneasy about going to sleep with anything below 6. Was told when having morning sugars when I wake up of 5.6 that this was little too high??? For me that is excellent!

Yes, I think you're right, it's a case of changing my attitude and try and get used to the new regime of eating to prevent hypos, and I'm starting to do this now during meetings. When carrying out training sessions is the difficult part, but fellow staff have been very helpful, filling in if I need a break to eat so it's getting better.

You're very lucky to be able to see the same people most of the time. I think that is the main problem for me. The hospital antenatal department don't link up very well with the diabetes team, mainly because they are understaffed I get the feeling, so I don't really get any real consistent help. I'm nearly 23 weeks now and I've only seen the nurse twice, once on request and she seemed to have a different approach to the consultant! It's all fun and games!

Yes GPs can be a real problem when it comes to blood strips. I'm very lucky in that mine seem to be ok. The only issue I have is that they disagree on certain protocols that the hospital have, e.g. the hospital say that I need eye screening every trimester, but the GP who has to refer me, say that they will only do it once!

Thanks again,

Emma