New and confused! Advice and opinions please!

[Lelliee]

Hi everyone,

My name's Ellie and I'm completely new to having an account on this website although I've been reading the forums for a while now
I'm pretty nervous about posting as I get afraid I'll sound silly.

I am currently 24+6 pregnant.
At the end of January, I received a phone call from the midwife saying I urgently needed to attent the hospital as the biochemists had noticed a discrepancy and ran an extra test and my HBA1C was 78.
In complete shock (very upset, anxious and confused, plus needle, blood and hospital phobia) I went to the hospital to be told I had diabetes, suspected and to be treated as type 1.

Over the next 8 weeks I was testing 4 times a day, targets of 5.6 or less fasting or 7.6 or less 1hr after food, eventually I was given a freestyle Libre. In this time I was injecting bolus and basal- levemir and novorapid everyday.
I would constantly ask the clinic what my diagnosis was and they would always say 'it doesn't matter which type you are you'd receive the same treatment during pregnancy'. But to me it really did and does matter. Getting the libre helped me alot, it took me 2 hours to do my first fingerprick due to being so phobic.

My blood glucose levels got lower and lower and I was in hypo daily. My insulin requirements were reduced and eventually stopped completely. I also had negative cpeptide, isolet cell and GADA tests.

I still have the freestyle libre and was put on 500mg sustained release metformin in a morning, which has since been increased to 2x500mg sustained release metformin each morning as I have a post breakfast spike (bacon and egg sandwich on medium sliced hovis best of both) which tends to go to 7-8 and drops to around 7 within the hour after eating.

A few weeks ago I had my HBA1C redone which was 45 and my fructosamine level done which was 226. The medical secretary for the doctor said notes said type 2 or probably gestational.

The clinic were so positive about my levels and graphs and jokingly said they wanted to use me in a textbook! Which really helped raise my morale. This doctor said definitely not type 1.

I attended my latest appointment this week and the Doctor claimed that it was probably type 2 but could be type 1 and ticked I'd need a sliding insulin scale, when I'm not currently on insulin.

I know I can't get a straight forward answer during pregnancy and I appreciate it's a long winded post, but I just wondered what people thought and how I'm doing basically
Thank you

 

[ArtemisBow]

Well firstly congratulations on getting your levels down so quickly and during pregnancy too. Getting a diagnosis is a lot to take in at the best of times, but being pregnant means it’s even more important to get it under control quickly, and you have.

One thing about pregnancy for diabetics (regardless of type) is that everything changes all the time. The mix of hormones and a growing baby mean that insulin requirements (either made by you or injected) change constantly. That might mean you end up on insulin, it might not. Keep testing, and make sure you stay close to your health team so that the necessary changes can be made swiftly. It sounds like you’ve been doing a great job so far, so just keep going!

 

[NicoleC1971]

Hello and I am sorry you got a bit of a shock of a diagnosis and understandably want to know where you stand and if you will need to continue taking insulin post pregnancy?
As your antibody and c peptide tests were negative then it is likely you are a gestational diabetic meaning your baby is growing fast and your body is making you extremely insulin resistant in order to fuel your baby's growth. The issue as you've doubtless been told is that this might make the baby very big and cause problems for delivery.
I am so glad you have an fsl becaue it makes checking so much easier and you can work out which meals will make you higher.
Once the pregnancy hormones dissapate it is likely your bgs will go back to normal but there's no guarantee so that is probaly why they are being cagey. If it is type 2 gestational diabetes then you should be aware that this shows that you are at raisk for developing t2 later on so it might be a good time to change your diet and you will get some good ideas here. If it turns out those earlier tests were wrong and you need to take insulin then your blood sugars will let you know and again then it isnt the end of the world but as this seems unlikely I would cross that bridge when you need to.
I really hope you are enjoying this pregnancy as much as possible and am glad that they caught the blood sugar problem and that you can give you and your baby the best possible pregnancy and delivery just by testing and eating things that don't make you go high for too long.
I've had 3 with full blown type 1 so I get how anxiety provoking a medicalised pregnancy can be but its better that you know.

 

[Lelliee]

Well firstly congratulations on getting your levels down so quickly and during pregnancy too. Getting a diagnosis is a lot to take in at the best of times, but being pregnant means it’s even more important to get it under control quickly, and you have.

One thing about pregnancy for diabetics (regardless of type) is that everything changes all the time. The mix of hormones and a growing baby mean that insulin requirements (either made by you or injected) change constantly. That might mean you end up on insulin, it might not. Keep testing, and make sure you stay close to your health team so that the necessary changes can be made swiftly. It sounds like you’ve been doing a great job so far, so just keep going!

Thank you for replying to me and for your kind words
The diabetic clinic and maternity clinic have both been absolutely amazing. The whole diagnosis and following few weeks were very much traumatic! Particularly the hypos following injecting insulin and not being able to hold food down.
I'm nervous about the whole diagnosis post pregnancy, I'm not sure how my numbers fair in comparison to type 1s or type 2s or gestational, it's all such a big spectrum!
I have another fructosamine and hba1c scheduled for 3 weeks time, as the last one of 45 still included some of month pre diagnosis the doctor said. So I'm hoping it's lower

 

[Lelliee]

Hello and I am sorry you got a bit of a shock of a diagnosis and understandably want to know where you stand and if you will need to continue taking insulin post pregnancy?
As your antibody and c peptide tests were negative then it is likely you are a gestational diabetic meaning your baby is growing fast and your body is making you extremely insulin resistant in order to fuel your baby's growth. The issue as you've doubtless been told is that this might make the baby very big and cause problems for delivery.
I am so glad you have an fsl becaue it makes checking so much easier and you can work out which meals will make you higher.
Once the pregnancy hormones dissapate it is likely your bgs will go back to normal but there's no guarantee so that is probaly why they are being cagey. If it is type 2 gestational diabetes then you should be aware that this shows that you are at raisk for developing t2 later on so it might be a good time to change your diet and you will get some good ideas here. If it turns out those earlier tests were wrong and you need to take insulin then your blood sugars will let you know and again then it isnt the end of the world but as this seems unlikely I would cross that bridge when you need to.
I really hope you are enjoying this pregnancy as much as possible and am glad that they caught the blood sugar problem and that you can give you and your baby the best possible pregnancy and delivery just by testing and eating things that don't make you go high for too long.
I've had 3 with full blown type 1 so I get how anxiety provoking a medicalised pregnancy can be but its better that you know.

Thank you for replying to me and for being so kind
I've found having the libre really helpful! Although I'm not sure how good my levels or my graphs are.
Thankfully I'm not currently taking insulin, just metformin. I'm hoping I can keep this up for the rest of my pregnancy, although, that too is uncertain.
I can understand them being cagey, I'm hoping your prediction of gestational is correct, I thought it was rarely diagnosed or present in the first trimester, plus the clinic to begin with were so adament it couldn't be. It just all feels so overwhelming when I don't know what I'm working towards.
Three pregnancies! Wow well done! I'm struggling with just one! It's my first.
At the anomaly scan the nurse was very happy with what she saw and said all looked as it should. The smoking cessation lady who helped me quit reckons I'll be induced between 37-39 weeks probably, but I'm not sure.
I've got another fructosamine and hba1c due at 28 weeks, so I'm hoping to have better readings then than my ones a few weeks ago, as the doctor said the reading of 45 will include some of January pre diagnosis. My 4th blood tests of the year! I'm currently 27, before that my last one was at 16 years old. So I'm somewhat easing my phobia I suppose

 

[Daibell]

Hi. I can only guess that it may well be gestational diabetes as the T1 behaviour has faded and you are off insulin. I would avoid sliding scale insulin if it's suggested and it may well not be needed anyway. It needs a good level of nurse attention and they can get very busy. If you do need insulin at some point, injected insulin is more controllable as long as you control it.