Type 1's and Pregnancy

[clared]

I've been a type 1 diabetic since I was 11 yrs old. I am now in my late 30's and now have 2 beautiful children aged 6 and 3. My first pregnancy was difficult with 2 coma's in the 1st trimester due to no hypo warnings. I think I was trying so hard to have good sugar control I was not allowing for pre meal dips in sugar levels. The best thing to do it test, test and test your sugar many times a day (without being too obsessive about it).
Unfortunately my first child was diagnosed with a congenital heart defect at the 20 week scan. These conditions are more common with diabetics which is why they do a special heart scan of the baby at 20 weeks. He is now 6 years old and has had his corrective heart surgery and is healthy and strong, but the reason he developed this condition is my poor sugar control in the first few weeks of pregnancy (before I was aware I was pregnant). My advise to any type 1 diabetic who is planning to get pregnant is to try to get good sugar control before you are pregnant and continue with this for the whole pregnancy.
My second pregnancy was so much easier as my sugar control was better in the early stages of pregnancy and my daughter is healthy. We can have beautifully healthy children, we just need to look after our diabetes during the whole pregnancy

 

[pinkemz]

hi clared,
thanx for sharing that with us. glad toi hear your son is doing well. What was your hba1c before you fell pregnant. Thanx again for sharing that with us

 

[clared]

My hba1c was approx 6.8 (cant remember exactly as over 7 yrs ago now). I remember my consultant gave the green light for trying for a baby. In my story, I remember doing a pregnancy test a few days before Christmas that was negative, so I kind of slipped in my sugar control over the Christmas period believing I was not pregnant. I then did another pregnancy test on New Years eve and it was positive. In short, although my hba1c was fine, I had bad control when my foetus was a maybe 3 weeks old. I remember the heart consultant telling me that all the babies major organs develop in the first 6 weeks, so for a diabetic, tight control is so important duiring this first 6 weeks to ensure the heart is formed correctly. It also important to remember that 2 diabetic women could have equally good or equally bad control, one may have a heart baby and the other may not. Just because you have bad control in the first 6 weeks DOES NOT MEAN YOU WILL HAVE A BABY WITH A CONGENITAL HEART DEFECT. Loads of other factors come into play as well. But hey, why take the risk.

 

[jannie_k]

Hello all, I'm glad to have found this thread and wish u all well wish pregnancies and preparations. I'm type 1 and hubby and I are trying too. has anyone found their BS went crazy as soon as you conceive, ie the first two weeks? Mine went madly high mid way through my cycle, I didn't do a pregnancy test as I thought it would be too early, so I'm wondering if the hormones kick in straight away? Look forward to hearing from you all

 

[jessie]

Hi Jannie,

Last time I was pregnant (not a successful pregnancy unfortunately) I started getting high BS at about 5 weeks but I guess this could happen at any point depending on your individual hormone levels... I don't know? I read on a pregnancy site that unless you're very 'aware' of your body you won't get any symptoms until at least week 4. I think as diabetics we are very aware of how we're feeling so I noticed changes at about week 2. Try and wait until day 2 of your expected period to test though, if you can!!

Best of luck,

Jessie. x

 

[tigger]

Hi
Can I join? I'm 30 have had type 1 for 27 years and have a ds who is 4. 2 years ago I conceived again and then miscarried. Yes I beat myself up about my sugars but at the end of the day I knew and the hospital insisted that it was just one of those things. I then had a lot of trouble conceiving again but have recently had success and it turns out I'm expecting twins! Very exciting but I'm rather nervous as a result as this makes me extra high risk.

I had also let my sugars slide as I didn't believe I could conceive naturally but the result was 6.9 which is within the hospital's ideal range. I imagine my next one will be much better. Happy to chat to anyone else going through this. My bs have been going all over the place but not as badly as the last 2 times as I'm not quite as sick so eating is not as much of a problem. I'm on pork insulin which I inject 3-4 times a day on mixed doses. My consultant's view is that I know what I'm doing so there's no reason to change. They've also offered me continuous glucose monitoring. Has anyone else had this? It sounds quite useful as you get a full record of what's going on with your sugar 24/7 for 3 days and can adjust accordingly.

 

[Happyyo]

Yes, hello everyone; two miscarridges in a row (after listening to the nurses advice) means that I will never listen to her /see her again. Still, I think that many nurses should remember that they are just that and not doctors.

My lovely daughter is doing great and I'm still pregnant (with the last two pregnancies where I kept tight contol over my blood sugers, my babies would have been dead by now).

If you test your sugers every 1-2 hours doesn't that make your fingertips really sore? Maybe even making you liable to infections since you are constantly breaking your skin when your hands go everywhere!

All I can say is; my vision is still 20/20, my baby is still perfect and kicking me loads, I'm as fit as a butcher's dog and its my body and I can do with it what I like - I and I should of died years ago!

If thats not good enough for particular members of staff then perhaps they need medical teention themselves!

God Bless!

 

[jessie]

Hey ladies,

I hope you are all doing well with your pregnancies / pre-conception etc! Tigger, great news that you're expecting twins - WOW!

OK, so I've done a pregnancy test and it was positive... VERY early days so I don't want to get too excited yet.

I was prepared for my body to start screaming out for more insulin, which it has. I have upped my Lantus from 9 units to 10 units a day, and have had to almost double my NovoRapid. I am over injecting a little with my meals, but snacking a bit more to make up for this. Carb counting has gone out of the window, I just seem to inject loads and then test test test. Also, I have had a few spikes in the 9's which I'm not happy about. How do I know when to increase my Lantus further? My morning readings are good at the moment - 4.5 to 5.5 ish so I'm guessing it's OK for now? Is this purely guess work or is there any method? Any tips greatly appreciated!

Jessie. x

 

[tigger]

Congratulations Jessie! Sounds like you're doing well. I'm 11 weeks today so just hoping I'll get to the 12 week point at the moment. They've just given me a continuous glucose monitor and it's rather uncomfy.

 

[sugar2]

Wow...congratulations jessie...that is fabulous news!

Sounds like you are doing everything you can at the moment...better go and get that repeat prescription filled for all the test strips. I know that none diabetics "spike" as well...probably not to 9, but certainly into the 7s, so all things considered you are doing fab. I took a similar approach to yourself, and also did a few correction doses as well.

Here to an uneventful 9 months!

 

[jessie]

Thank you both!

I'm lucky that my Dr / pharmacy are very generous with strips so I always have a good supply. I just feel sorry for my battered little fingers!

I have booked an appointment with my Dr for Friday, I'm hoping that he'll refer me to a specialist pretty quickly. Last time I waited and waited for just a regular midwife appointment and by the time I got it I had miscarried.

Are you finding the glucose monitor helpful Tigger? I guess it makes it much easier to judge how much insulin to take... how long will you have it for?

All the best. xxx

 

[tigger]

Not at all sadly as it doesn't show me any readings. They'll be able to show me what's happened when they download the data on friday.

 

[tigger]

hba1c now 6.1 so quite pleased with that. 2 bad hypos recently though (after blood taken).

 

[jessie]

Hi Tigger,

6.1 is great - you're obviously managing your blood sugars OK. Mine have been good too on the whole, a bit hit and miss because I'm eating differently, my routine has gone out of the window as there are things that I can no longer bare to eat. EG cheese for breakfast! And I suddenly want to eat fruit, which I have never been a fan of!

I hope you're well in general. I have just had my first scan date through for a couple of weeks time - scary stuff... when is your due date?

Jessie. x

 

[tigger]

25/9 - I'm now 15 weeks. I hope your scan goes well.

 

[the_anticarb]

Tigger and Jessie hope you're both doing well and everything is ok . I had my little boy on Feb 15th, he was perfectly healthy if a little small (5.5 lbs, which I put down to my tight control) but soon caught up with it he's now on target for his age and doing well. Although being pregnant and diabetic was one of the most difficult things I have ever been through everything turned out ok in the end (except my retinopathy got a bit worse due to the hormones but hey you can't have it all I suppose).

Anyway thinking of you both all the best

 

[tigger]

Congratulations anticarb! I hope you're managing to survive. The first few months were in some respects harder for me than the whole pregnancy both blood sugar wise and generally. My ds's birthday is also 15th Feb

 

[jessie]

Hi anticarb!

I saw your photo of your little one and he's beautiful - big congratulations!

I've had my 12 week scan and so far so good - I have the nuchal scan tomorrow. I think I have been lucky so far as I'm feeling good and (apart from the odd off day) am controlling BS well, although I know that could all change at the drop of a hat.

Hope you and baby are well.

Take care. x

 

[the_anticarb]

Hi Both

one thing I will say to both of you, and not to worry you just to make you aware so you can (hopefully) learn from my experience, is be careful re weight gain/overinjecting insulin during your pregnancy. I am now 2.5 stone heavier than before I got pregnant and apart from the cosmetic angle, it has made my diabetes a lot worse as i am now much more insulin resistant than before. All throughout my pregnancy I was so focused on maintaining low blood sugars that I was constantly erring on the side of over injecting and then gettting into that spiral of eat-overinject-hypo-overtreat hypo and it lead to insulin resistance in my case. I was led to believe that once I'd delivered my (pregnancy related) insulin resistance would go away but it has not, nearly three months later (although its nowhere near as bad as when I was in my third trimester). At the time I just thought sod it, i'll gain weight and lose it after the baby is born, but its proving harder than anticipated, possibly due to the insulin resistance (also when you are looking after a baby everything else is harder!). So if you can manage to avoid that pitfall, (not saying this would happen to everyone btw) it will save a lot of hassle after the baby is born and you are trying to get things under control again.

Good luck sounds like all is going well, can't wait to see the pics of your little ones after they are born!

AC

 

[jessie]

Hi AC, I hope you're well and a belated thanks for the interesting post. I'm sorry to hear of your insulin resistance. It sounds to me though that the way you handled your diabetes during your pregnancy was the best way (only way even) for you to maintain those levels and deliver a healthy baby.

At 16 weeks I am still experiencing lower than normal blood sugar, my Lantus is at 7 units a day (9 before pregnancy) and Novorapid still 1 unit to 10g carbs, although I am having to snack more because of hypos between meals. Not complaining about that! I did have roughly 3 weeks (weeks 5-8) of higher blood sugar which coincided with nausea which of course was due to a hormone 'surge'.

I know my insulin needs will double if not more later on in pregnancy but I am really curious to know why they are so low at the moment. . . there must be a pregnancy related reason but I can't find anything on the good old world wide web. Anyone have any ideas?

Thanks,

Jessie. x

PS: I might also put this in a new thread