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Starting on a pump while pregnant

ArtemisBow

Well-Known Member
Messages
312
Type of diabetes
Type 1
Treatment type
Insulin
Back in the summer I had an appointment with my consultant. My husband and I wanted to start a family, and while I have been able to get my HbA1c down to 6.2, this was with spot issues on fasting levels, hypos and exercise. On that basis I was referred for a pump, but told to start trying to conceive straight away.

Now waiting for CCG approval, hopefully will be starting on it end this month or early Dec. I had planned that if I was starting on a pump, we would put the pregnancy attempts on hold temporarily for a month or so while I adapted. But now my period is late. So it's possible that I may be starting on a pump in the early stages of pregnancy.

Has anyone else been in this situation? Obviously I know that control is very important during pregnancy, and starting periods on pumps can be bumpy - any tips for getting it in control quickly?
 
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Hi @ArtemisBow and fingers crossed all goes well :)

I'm going to tag @azure as she is always helpful and extremely knowledgeable on pregnancy and insulin pump matters. Good luck.
 
Hi @ArtemisBow :)

I had my pump before I became pregnant so I was familiar with it. But pregnancy is a time of change - hypos early on, increasing insulin resistance later - so I still had to work on my control during pregnancy. My top tips for pregnancy are test and react if necessary, and be prepared for sudden hypos when you normally wouldn't have one.

It's not uncommon for pregnant women to be started on a pump in pregnancy as it can help get control tight. I know I've noticed a number of ladies here who've began pump therapy then. I think @tigger is one?

Regarding the pump, testing is crucial to make sure you get your basal rate right, and that your insulin to carb ratios are working well. I was lucky in that my basal was pretty much spot on witjin a couple of days, but it can take a while to fine tune it. I know you're worried about highs in early pregnancy, but, because of the hormones most women have some of those. I had highs and got freaked out, but all was well. The important thing is to correct them carefully and move on. Pregnancy is a period of frequent adjustment.

If you're at a reasonably sized hospital, I'm sure your team will have experience of starting women on pumps during pregnancy :)

Good luck - and sending you my best wishes :)
 
I am in a similar position, we would like to start a family and I've only just been put on a pump but my diabetic team have told me not to get pregnant until I've been on pump for 6 months so I can get used to it and they can get my levels adjusted (I am running higher than normal at the moment as they are slowly adjusting my levels to get them correct). Best of luck to you, your levels sound really good so whatever happens I'm sure all will be fine! :-)
 
Sort of @azure .

I had 2 pregnancies on injections (not MDI) and strict low carbing. This time I got pregnant unexpectedly and was having a general freak about not having taken any of the precautions (hba1c was 7.5, no folic acid, happily taking hayfever tablets etc) and remembering just how much work the pregnancies were plus the really bad hypos and loss of hypo awareness of certain points (1st trimester and post birth). I requested a pump, preferably one that would do everything for me (not funded by the nhs according to my consultant) and got one at 10 weeks. It's been a lot of work and I'm still mixed over whether I prefer it to injecting but it has meant that I've got through this pregnancy (32+2 now) with no comas, good hypo awareness and exemplary hba1cs plus not much low carbing. My last hba1c at 28 weeks was 5.6 which given I'd had a day the week before where the canula hadn't gone in properly and I was horrible levels all day was pretty impressive. The one at 20 weeks was 5.8%. The one at 10 weeks just before I got the pump was 6.5%.

I think it took me about 3 weeks to sort out my initial rates, complicated by canula issues but I had the advantage that I am quite familiar with the profile of my insulin, my usual high and low points etc. I also had a huge amount of help from people on these boards particularly the pumping forum and a few of the posters who use the same insulin as me. My hospital is a large teaching hospital but I didn't find them particularly helpful. I'm not sure if that was because the DSN assigned to me was thrown by the fact that I insisted on keeping my usual insulin (porcine) or because she's not so familiar with pumps.

I'd really recommend that you buy the Pumping with Insulin book. It helped me enormously with the testing and working out rates.

It is daunting, it's not easy if you're used to other methods (I use a particularly old fashioned one that worked well for me) but providing you can carb count and use the Pumping Insulin book or training from your hospital it is manageable. The wonderful thing about the pump is that it is easy to vary rates to manage different needs at different times of day, to take additional insulin if you're going high. The danger is the temptation to over correct which leads to hypos. The most frustrating thing for me is never being sure if I'm going high because of a usual factor (pregnancy, weather, stress, miscalculation on food etc) or because of a technical malfunction (is the canula/pump working, air bubbles in the reservoir caused by hotter body temp in pregnancy).

So top tips are:

1. If you're unsure on carb counting get the carbs and cals app
2. do lots of basal testing (however much of a pain it is)
3. If you can get funding for a CGM at the same time use it to try and help work out your patterns (I got it eventually but it hardly ever seems to work for me)
4. Buy Pumping Insulin by John Walsh
5. Try a selection of different canulas and different sites to work out what works for you. Everyone is different.45degree sets can be inserted by hand - you don't need the gun like device minimed tries to get you to use.
6. Look at the threads on here and ask people for help. Everyone is very willing to share their experiences.

Good luck!
 
Thankyou so much to all of you for your kind words and advice. I have already purchased and am reading the pumping insulin book so will continue. I also have a meeting with my DSN next week anyway so will talk through the best strategy if I am pregnant - hopefully by then I'll know one way or the other.

I expect I will be back with more questions soon!
 
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