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Unplanned pregnancy risks of high blood sugars

Discussion in 'Pregnancy' started by Jd040767, Jun 15, 2016.

  1. Jd040767

    Jd040767 Type 1 · Member

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    Hi,
    I am 29 and have been type 1 for 23 years. I'm ashamed to say I've missed my past two annual checks at the diabetic clinic. I'm pretty sure my Hb1 will be over 100.

    I had made the choice to get back in control of things (a hectic work life just seemed to take over) and had an appointment with my local GP diabetic nurse arranged for next week plus an appointment with the diabetic consultant in July.

    Unfortunately before any of that could happen I've just found out I'm 3weeks pregnant.

    This is unplanned and will place great stress on my relationship with the father (partner of six years, doesn't want kids but will support me if I go ahead).

    I'm incredibly worried about my Hb1 being over 100 and the impact this will have on the pregnancy or if the pregnancy is viable. I've had bloods taken and get the results on Friday.

    Has anyone any advice?


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  2. catapillar

    catapillar Type 1 · Well-Known Member

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    Morning @Jd040767 I am not the right person to be giving advice on pregnancy, so I'm tagging @azure for her knowledgable assistance.

    However, if I were you I would be getting in touch with your hospital DSN for support & advice - I think most hospital diabetic clinics will have a pregnancy DSN and they can help you with early pregnancy advice, sort all the checks and get you on the high folic acid etc. Maybe try getting in touch with them this morning, if you haven't already.
     
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  3. azure

    azure Type 1 · Expert

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    Hi @Jd040767 :)

    Definitely phone your DSN or local Diabetes Centre. Most have a special 'pregnancy DSN'. I phoned mine as soon as I got a positive test.

    It's also important that women with diabetes take a high dose folic acid tablet. It's 5mg and will need to be prescribed.

    There have been ladies here with high HbA1Cs at conception, and they went on to have healthy babies. You can't alter the past, but it sounds like you're working hard to get control now, and that's excellent. There was a lady here who got her HbA1C down dramatically after getting pregnant, so it is possible :)

    Give your DSN a call and get an appointment as soon as possible, is my advice.

    As for the pregnancy not being planned, just make sure you do what's best for YOU not anyone else or what you think is the right thing to do. Hopefully, speaking with the DSN will help you.

    Take care - wishing you all the best XX
     
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  4. claire1991

    claire1991 Type 1 · Well-Known Member

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    Morning!
    I second what @azure said.

    Make sure you get an appointment as soon as possible. They will put you in touch with a specialist diabetes pregnancy team and you will more than likely have weekly appointments after that, I did.

    My hba1c was high when I conceived, not majorly bit definitely not perfect.
    Through a lot, and I mean A LOT, of hard work I got it down and now have a healthy 10 week old baby so it is possible. These babies are stronger than we give them credit for sometimes!

    It's going to be a long journey to get there and it's not going to be easy but it is definitely worth it!

    There's lots of support on this forum too. I didn't join until near the end of my pregnancy and wish I'd joined earlier.

    All the best!
    Claire x


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  5. 1Sarah1

    1Sarah1 Type 1 · Well-Known Member

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    Hi @Jd040767 as the lovely ladies above have already said it's possible to get your hba1c down. Ring your dsn asap for ante natal care though.

    The key for me through both my pregnancies (2yr old and twins) was lots of testing. I take it you are not pumping? I personally couldn't have done it without the pump as suffered badly with dawn phenomenon. I have been diabetic since I was 2 and my hba1cs never great but once I was pregnant that's it-there is a baby relying on you.

    Do you know what your carb ratios are and is your long acting right? (Take some carb free meals to check it). I also tested twice a night religiously -second time round my daughter used to wake me up (who has recently also been diagnosed type1) so didn't need to set my alarm but did the first time. Targets normally about 5.5 before meals and 7.5 an hour after xx
     
  6. Jd040767

    Jd040767 Type 1 · Member

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    Thank you for your speedy and incredibly helpful replies. I have an appointment with my DSN today, and should get HbA1c back on Friday.

    My GP has been great and already got me on folic acid prescription.

    I've been on top of my bloods for past day or so, slowly getting nearer where they should be (apart from spikes in the morning). Hopefully I can be similar to the stories you have of the women who get them in check quickly.

    I'm still hesitant of the risks even at this early stage but am hopeful to progress with this pregnancy.

    Xx
     
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  7. 1Sarah1

    1Sarah1 Type 1 · Well-Known Member

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    Good luck let us know how you get on xx
     
  8. Jd040767

    Jd040767 Type 1 · Member

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    Hi @azure @1Sarah1
    I got my Hba1c back today. It's 97. Very high. My GP consulted with a DSN at my local hospital. I've been told to progress with this would be incredibly high risk for me and the baby. There would be 20% chance of abnormalities, strong possibility I would miscarry and I'm at risk of DKT.
    Not an ideal picture at all.
    Will be seeing the DSN tomorrow morning. Doctor said he would never offer an opinion on it but that he suspected the DSN would tomorrow.

    Annoyingly I've managed to get my bloods running at 4-8 the last few days.

    Thanks xx


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  9. Postitnote

    Postitnote Type 1 · Well-Known Member

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    @Jd040767, I did not plan my pregnancy and conceived with an Hba1c of 9. After 12 weeks I'd got it down to 5. I couldn't correct what I'd done but I wanted make **** sure The Bean had as much of a chance as I could give him. I am hypo a lot. I'm lucky that my eye exam came back normal (rapid decrease in blood sugar levels can trigger retinopathy). I have just had my 20 week scan and all is well. That does not mean that I (and The Bean) have escaped the consequences. But things are hopeful.

    At no point did any HCP mention that I ought to consider termination. Yes, there is a high risk but there are plenty of women in our situation who have had successful pregnancies. Weigh up the information your healthcare team is giving you. Ask questions. But don't act out of fear.
     
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  10. 1Sarah1

    1Sarah1 Type 1 · Well-Known Member

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    Hi is this 20% based on you not getting it down further or based on if you get it down from now? How are your sugars through the night going?
    There are risks in every pregnancy and lots of women get their hba1cs down.
    Don't rush into any decisions just focus a day at a time and keep those sugars down xx
     
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  11. claire1991

    claire1991 Type 1 · Well-Known Member

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    I agree with Sarah.
    There is always going to be a risk in any pregnancy and an even higher risk in a diabetic pregnancy.
    We all knew this before we started this journey into motherhood.

    Don't make any rash decisions, you've a lot of time to consider this and get your hba1c down before you're past the point of termination stage.

    Don't forget that as good as gps are they are not diabetes specialists. If it were me I would brush what he has said under the carpet now and see what the diabetes nurse has to say.
    20% is not that higher a percentage really.

    I hope you're alright xxx


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  12. azure

    azure Type 1 · Expert

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    @Jd040767 Ive found this study for you:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681038/#!po=50.0000

    There's a chart attached to it, called Table 1. I can't link to that by itself but if you find mention of "Table 1" in the text, then you can click on it and it opens in a new window. Note that this study gives HbA1Cs in percentages. I believe your 97 is 11%. One thing I did notice is that these women appear to have only taken a normal non-diabetic amount of folic acid, not the recommended high dose. The high dose folic acid that we all take reduces the risk of neural tube defects. Possibly a higher dose folic acid, as we have now, would have made a difference to these results.

    If you look at Table 1, you can see that women with HbA1Cs higher than 6.5/7% do have an increasing risk of problems. However, looking at those figures, you can see that 'bad things happening' are not inevitable. Lots of women with higher than advised HbA1Cs went on to have babies that were ok.

    You say you were told a risk of 20% (that seems slightly higher than the risk shown here, but maybe the doctor was simplifying the figure). So that means the majority of women didn't have problems then?

    I can understand why you're anxious, but you're not somehow destined to have 'something go wrong'. You've managed to get your blood sugar under control at this early stage.

    If it was me, I'd wait and see how things were. It's easy to feel guilty and imagine all bad things happening, but positive outcomes are possible too.

    Do what's right for YOU. Don't be rushed and don't be pushed into doing anything you don't want to. Speak to your DSN, but also as many other specialists as you can eg obstetricians, midwives, etc. Ask for whatever blood tests and scans that would help.

    I've said it before, but examine your heart, think and think, and you'll make the right decision for YOU not for anybody else.

    {{hug}} Best wishes and love xx
     
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  13. ArtemisBow

    ArtemisBow Type 1 · Well-Known Member

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    I can only echo what everyone else has said, but if you are going ahead focus on getting good control in the future - you can't affect the past. I don't think there is a single woman on here who has maintained great control in EVERY week of their pregnancy, even those of us who planned it and started with good Hba1c levels have had spikes to contend with at one time or another - I've definitely had bad weeks at certain times as my needs changed. Your baby has only been in there 3 weeks, if you get good control now (and it sounds like you have) then you will greatly limit any damage.
     
  14. Jd040767

    Jd040767 Type 1 · Member

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    Hi, sorry for no replies in a while, had a lot to get my head around.
    You were all right, DSN explained there were risks and I am high risk but that it wasn't as doom and gloom as I had first thought. She has no doubt I'll be able to get my Hba1c down sensibly as my bloods since I found out have been acceptable.
    It is now looking like my relationship with my partner will not survive this. He will support me either way (offering to go to counselling if we terminate/ stay over to help out with baby first few months if we go ahead) , however after many discussions we are failing to see a compromise or happy outcome for everyone. If we terminate I may resent him, if we keep it he says he will support me but cannot be with me.
    Not ideal in any way, added to which this will be a hard pregnancy xx


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  15. azure

    azure Type 1 · Expert

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    I'm not sure if you want feedback on that situation with your partner.....so I'll stick to a hug...

    I'm glad your DSN was more positive, and I think she was right. There are no guarantees, of course, but that's the case for every woman, diabetic or not.

    A diabetic pregnancy is hard work, but all the more wonderful for that, in my opinion.

    Keep strong and be confident in your own instincts and your ability to do this. XX
     
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  16. claire1991

    claire1991 Type 1 · Well-Known Member

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    Glad your DSN was more clear than your GP hun. I never trust my GP when it comes to my diabetes.

    With regards to the decision you're having to make, do what it right for you and nobody else.
    This is your decision, boyfriends come and go.

    Best wishes xxx


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  17. Jd040767

    Jd040767 Type 1 · Member

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    Thank you for all your support! Have an appointment with the DSN and consultant to go over how we progress/ risks with me and my partner. X


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  18. Erin85

    Erin85 Type 1 · Well-Known Member

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  19. Jd040767

    Jd040767 Type 1 · Member

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    Hi, the DSN and consultant were great. They helped with a lot of the anxiety I'd had about the fact that my blood sugars were very high at conception. They explained there is still a chance the blood sugars may have impacted on abnormalities etc but that I would be screened rigorously to check for this.
    Basically said they have no crystal ball in any pregnancy but that diabetes should not influence my decision to go ahead or not.

    My partner does not want to go ahead, he's never wanted children and thinks the whole thing is too risky for me and any baby. He's been very honest that he will support me but not as a couple if I go ahead.

    Tricky as I'm very very early along (4 weeks max) and I'm aware I may miscarry. Xx


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  20. azure

    azure Type 1 · Expert

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    If you go ahead, you'll find the care amazing. I felt so well looked after, and the extra scans and appointments were a big reassurance :)

    Its good your partner is being honest about his feelings, but this is your decision :)
     
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