Planning for a Diabetic Pregnancy

Hey Gina, it's Windy.   I've had two healthy children and have had T1 since I was 7 years old.  You are totally a step ahead of the game with your planning and pre-conception knowledge!   I didn't plan either one of my pregnancies... with Gabe, my A1c was 7.1 at time of conception and shortly after I had it to a 5.3!!  (This was because I couldn't keep ANYTHING down.  All I ate for my first trimester was fruit cups and cottage cheese to keep my sugars up.  ( I know, weird )   Gabe came a little early due to pre eclampsia, which I have also heard a lot of other T1 diabetic women developing.  But he was HEALTHY.        My second pregnancy wasn't planned either, we weren't sure we wanted to go through all the worrying again!  But Zoe came at almost 38 weeks and healthy as well!  My A1c was right between 6.5-6.9 throughout the pregnancy.   You really can do it!  Sounds like you have an awesome support system and good doctors too.   Best wishes!    

Go Gina! Go Gina!

Like Windy said, it sounds like you have a wonderful support team helping you along.  The positive encouragement and reinforcement will carry you through all the hard work.

Gina...

I know where you are coming from.  I was diagnosed with T1 3 years ago this April...my husband and I had just gotten married and were trying for a baby.  My endo said my A1C needed to get to below 7.0 and stay there for 6 months and then I could get pregnant.  I got it to 6.9 in less than 3 months (from 13.1!!!) and then I came out of the honeymoon phase.  I spent the next 18 months with skyrocketing blood sugars, massive weight loss, and then a hospital stay over easter.  I'd had enough. I made serious plans just like you.  I got my A1C back to 7.8 and got pregnant the first month we tried (which we didn't mean to happen - we figured it would take longer).  Within 3 weeks my A1C was down to 7.0.  I went for my first u/s at 7 and a half weeks and there was no heartbeat.  I was devastated.  My family doc. blamed my diabetes. My endo blamed chance and nature (thank God for him!!!).  I began to work my butt off again, got a CGM and got my A1C to 6.9.  Got pregnant about 4 months later, and lost it within 4 days.  My endo saw me about a month later and said "Are you finally ready for a pump?".  I cried and told him yes.  Our provincial gov't had just put through a plan to pay for a pump for every adult as long as certain criteria was met.  Thank God I met all of it and was one of the first in my province to get a pump.  I've been pumping since Oct. 1 and have had my A1C at 7.0 or 6.8 since then.  I am 7 weeks and 4 days pregnant now with an A1C of 6.6.  It's getting better every day too. It is the hardest thing I have ever done - more challenging than the first few months of being diabetic, but so worth it.  After everything I've been through, I'm nervous for my first ultrasound tomorrow, but I'll deal with whatever comes my way.  I know my diabetes is finally under control, so whatever happens is nothing to do with it.  You'll find that when you get pregnant (and you will!!!) your blood sugars will be so beautiful the first trimester.  Mine have been perfection, but it's a lot of work.  This is such a long post and for that I'm sorry, but I wanted to share my story with you after all of the stories you have shared with all of us.  Your vulnerability amazes me...it's beautiful. 

Gina, 

How would you feel about having a "diabetes coach" - to help you make adjustments - to be accountable on a weekly basis, to have someone objective in your court to guide you safely in bringing down your A1c and keeping it down?  I've heard GREAT things about Gary Scheiner (http://www.integrateddiabetes.com/) - it may be a worthwhile investment to hire Gary and be supported getting to your goal.

Love, Cybermomma

Hi Gina,

I have had type I diabetes since 1979. I was 3 when I was diagnosed. I have had two healthy pregnancy's. I was discouraged for many years by my pedi endocrinologist. But I had to figure out a way. Everyother doctor in my life said a healthy pregnancy was possible. I too spoke to Dr.Jovanavick just to consult and she said that it would be possible with determination. My husband and I got pregnate with our daughter Susan shortly there after trying. My 1st go round with pregnancy was difficult as my husband was diagnosed with nonhodgkins lymphomia and the future was not looking so good. He made me promise no matter what to have one more if all went well so our first child would always have a sibling .( so he froze his sperm in case...) I had an HA1c running about 6.9 my pregnancy with my daughter Susan. The added stress made it difficult to do much better. I lost my husband to cancer when I was 6 months pregnate with our Daughter. I delivered my daughter at 32 weeks. December 2003, She was a huge 10lbs baby but completly healthy! She was in the NICU for a week with some struggles with lo blood sugar but that is normal with a baby delivered to a diabetic mother. with the help of modern medicine  I had my 2nd daughter in 2006. She too was early born at 34 weeks. My HA1c the second pregnancy was in the 6's and the result was still the same she too went to the NICU to battle the lo blood sugar, however she was released with me 3 days after she was born November 2006. I had c-sections with both my girls. The doctor who delivered both my girls, was someone who just believed in me and knew I would be a teriffic mother. So she was very supportive and still asks me reguarlly if I want another one. I think I am content with 2. But a Beautiful and Healthy baby is a more than realistic goal. I say good luck and GO for IT! My girls are the complete reason for my existance in life now. I love them more than anything. They have no effects what so ever from me being a mother who had Type I diabetes for nearly my entire life. GOOD LUCK ---- If you can dream it then it is possible! 

Hey Gina,

I just found this post and wish you luck (and a happy anniversary). My A1cs were OK before conceiving, but it took me a year to do so, and I had to maintain things for that time while waiting to actually get pregnant. As I've said before, I blogged all about it, but my quick advice was to

1. Eat the same breakfast and lunch every day. I did not eat low carb (my breakfast was around 50-60 carb, but with peanut butter and oatmeal, which kept me fuller longer and didn't make my sugars spike after breakfast. I also consistently walked to my train after eating bf at home before getting to work, so the exercise also helped keep things smooth. Lunch was similar--probably a 70 carb sandwich each day, but I just figured out what bolus covered it each day and gave myself whatever I needed. This did NOT keep my weight low, but I was only concerned about my A1cs during the conception phase.

2. I tested about 15 times a day, including 1 and 2 hours after a meal (along with before every meal, before and during exercise, before bed, 1 or 2 times in the middle of the night, and so on). If I was higher than 140 or so after a meal, I would take about half of a typical correction bolus to bring myself down. (I was not on a pump that had the insulin on board feature).

3. I ate high fiber grains whenever I ate carbs, and tried to avoid white rice, flour and such. However, I regularly ate chocolate while pregnant (it was always in my office on a coworker's desk). I would count out exactly what I ate, bolus whatever I needed to bolus, and test and correct an hour later. I also tended to eat things like mini peppermint patties instead of mini Reese's peanut butter cups, strictly because the fat content is minimal in a peppermint patty.

Good luck and feel free to email directly if you want more insight.

--Lyrehca

Managing the Sweetness Within

www.thesweetnesswithin.blogspot.com 

Lyrehca@gmail.com