7 Weeks pregnant and a type 1 for less than a year... nervous!

Pregnancy
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Hi Everyone.  My husband and I started trying in December...and by early Feb I found out I was pregnant!  I really thought it would take a few months (especially since I had been on the pill for four+ years) but I feel so blessed right now.  Unfortunately, I am a very new Type 1 (was diagnosed in June 2012 at the age of 29).  My A1C in June of 2012 was a 13, but with a lot of work, by December of 2012 I had gotten it down to a 6.3, and when I went to my endo two weeks ago, she said it was a 6.  My first question is, however, I know that you should have a steady A1C between 5.5-6.5 before getting pregnant for at least 6 months - do you think my high numbers will have affected the fetus?  Or has anyone else been in a similar situation? 

Also, my current endo doesn't deal with pregnancies, and instead only referred me to a diabetic nurse to work on my diet.  I go to see a perinatologist in 10 days.  Should I be looking for a new endo?  I'm not quite sure who is supposed to be helping me with my insulin intake/adjustments.  Right now I am only injecting, using Novolog and Levemir at night.  The nurse suggested I may want to switch to the pump eventually, but I find it so cumbersome.  Are there any Type 1's out there who DON'T use the pump and able to keep there sugars regulated? 

I get really scared whenever I see numbers in the 200, which I'm not proud to admit I had quite a few before I knew I was pregnant.  I've been reassured a bit knowing that my A1C was a 6, but right now I guess I am just looking for some advice on what to do to have the healthiest baby/pregnancy possible, and if anyone out there could share any similar stories with me.  Thanks everyone for any feedback! 

 

Jessica

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You're going to have highs and lows when pregnant.  Just try to catch them quickly and avoid as much as possible.  Lows are especially dangerous for your baby's development.  Highs will cause a fatter baby who may have a big blood sugar drop after being born.

Lots of moms with diabetes have had healthy babies doing shots, but pumps make it WAY easier.  If you have a 6.3 and few lows (none below 60) with shots then you might be okay to keep the shots.  

Can you find an OBGYN who's worked with diabetic moms?  When expecting I actually stopped seeing my endo and my OBGYN communicated any pertinent info to my endocrinologist.  But I had diabetes for a long time and was adept and changing my own doses.  In your case, make sure you have some doctor who is monitoring your results weekly and helping you to make insulin changes.  In your 3rd trimester doses increase almost daily.

An acquaintance of mine has terrible control of her type 1 (A1cs of 10+) and still delivered 2 healthy babies who are now healthy kids.  Your baby will be healthiest if you manage your diabetes, but try not to stress too much about what happened before you knew you were pregnant.  

To give my baby the best chance are being healthy I aimed for a non-diabetic blood sugar of 80 and tested a lot to make sure I didn't have lows.  

Congrats and good luck!

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   I have been a diabetic for 33 years, since the age of 8. I have never been on a pump and though my blood sugars were not absolutely perfect during my pregnancy was A1Cs were between 6.5.-7 My son was born in April of 2012 and I was 40. He was my first child. The reason why I have opted not to have a pump is because I believe the pharmaceutical companies have pushed the pump issue because of the cost.

   Every doctor on the planet will also try and push the issue because they get a cut of the brand that they write the prescription for. My sister in law is a sales rep. The reps make about $150k a year.

  When I was 8 and sitting in the doctor's office newly diagnosed I was told there would be a cure by the time I was in high school. The same mystery goes along with cancer. Those big companies take the licenses of doctors away if they use other methods of treatment that cure the cancer. There is probably a cure for diabetes out there but because the glucose monitors, insulin, and pumps are so expensive the drug companies are not going to let us all know about it.

  Diabetes is a big money maker. When you don't have insurance it is impossible to pay for the cost of a pump or the insulin it requires. I was a teacher and when the huge school district I worked for found out I was written up left and right until I quit. It is something to consider. Some people love pumps but the syringes now a days are so small you do not feel it. I take 5 shots a day and manage. I had some pretty low blood sugars while pregnant but my son was born with very few problems. He was a normal weight and is very intelligent.  As far as I know, I am one of the few diabetics on this blog who has diabetes this long and is still taking shots. The best support I ever had was from a nurse educator who is also a diabetic. She sat down and explained everything to me, how insulin works. What can cause it not to work as well etc. It really helped to have someone who was going through the same thing. Someone without diabetes cannot possibly begin to understand how tough it can be. She was an athlete and wore a pump. When I asked her about it she said, "If you don't have to do this to yourself don't."  

 There are tons of people on this site who love their pumps. If it works for them that is good. Don't worry too much about what you did before becoming pregnant. I was drinking alcohol before becoming pregnant and will readily admit I had a glass of wine or beer while pregnant. Yeah, I got dirty looks but my son is just fine.

   I wish you luck and hope that all goes well! You will do great!

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Thank you so much to both of you for taking the time to reassure me!  Finding this site has been a godsend to me, knowing that I can communicate with other women who have experienced my situation already, or who are going through the same experiences too.  For now, I'm going to stick with my injections (I feel so relieved to know that there are others out there who  inject and are able to manage just fine!).  And for now, I'm also going to try to stop stressing every little thing - it's the one thing I should know for sure that is not good for me or baby!  

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Hi Jessica, I was also diagnosed at age 29 with T1. I am almost 36 weeks pregnant with my first child, a baby boy. My a1C when I first got pregnant was like 7.0, three months later it was 5.4, and my last one was 6.1. I do not use the pump either. I use Humalog and Lantus. I have a great endocrinologist who is very well know in our area and my OB is familiar with high risk pregnancies as well. I had to start having an ultrasound with biophysical profile and non-stress test every week starting at week 32. They measure the baby every other week. At 34 weeks, he was 7 pounds already. His belly is measuring larger than his head (the 95th percentile). I am having an amniocentesis on March 18th to check his lung maturity. If they are mature, I'll be induced later that week. If he is 9 1/2 pounds or more, I'll be having a c-section. Thankfully, my blood sugar levels have been really good for the past four days. My endo has told me that I have done really well considering I'm not on the pump. The problem is that the BS levels can fluctuate because your hormones affect your insulin so much. I'm currently taking 1 unit of insulin for every 4 carbs I eat and 14 units of Lantus at night.

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Hi, Jessica!

Your post caught my eye because I also was diagnosed later (at age 22) and got pregnant only about 3 months after they found it. (They thought I was Type 2 at first, since "adults don't get Type 1" but it has since been confirmed that I "turned into a Type 1" lol).

My A1C was 11 something when they diagnosed me. It was probably around 7.6 when I got pregnant because that was the next reading and the last before I found out I was pregnant. It continued to come down to 5.9 and then up to 6.2 during the rest of my pregnancy.

I was induced at 39 weeks, 5 days, the induction did not work (thanks to a mismanaged labor I believe, but that's another story) and I delivered by c-section. My daughter was 7.0 lbs and 20 in. long- not the big baby everyone was expecting from a diabetic and also almost a whole pound smaller than the ultrasound said she'd be. I have also heard from a NICU nurse that diabetic babies are often both big and kind of floppy and weak, but my baby was healthy and strong- held her head up momentarily within hours of being born.

She was in the NICU for one week due to an unrelated infection but other than that was very healthy, and is now a beautiful, happy, healthy 13-month-old.

If I were you, I would (1) find an endo who is willing to manage your diabetes during pregnancy and (2) find an OB who is willing to let the endo manage your diabetes. Type 1 diabetes is much more rare than Type 2 and gestational diabetes, and many OB's don't seem to understand the differences. My OB was telling me to do crazy things that would have been very dangerous for the baby (like wanting me to double my insulin intake before lunch due to only a couple of slight highs- like in the 140s even though I was back in the 70's before I ate again- and only wanting me to test 4 times a day when my endo said 7 times a day. He would even make huge changes after only one bad BG reading instead of looking at treads and he didn't care that my A1C was low).  

Also, try to find an OB, or even a midwife, who is willing to follow your birth wishes (c-section/ vaginal/ early induction/ full-term if healthy). I went almost full-term (just 2 days shy of her due date) because I chose an OB who was willing to let me go that long when most others in the area would have induced at 37 or 38 weeks which can be dangerous for the baby.

Oh, and I have never had a pump- so far, I prefer shots, although a lot of diabetics lover their pumps. I can't say I'll never get one, because I might, but for now, I like shots, and I used them all during pregnancy with great results.  

I don't know if this is allowed in pregnancy- you might ask- but since delivering, I have been following a very low-carb diet- trying to stay under 30 carbs a day, although I admit it's usually between 30 and 40. It allows me to take much, much less insulin and only one shot a day instead of 4 (if I exercise like an hour a day I can pretty much eliminate shots completely, but it's hard to exercise that much and get everything else done in a day with a baby!). My diet helps me keep low BG reactions very rare and highs only slight rather than huge.

I hope that helps. Take care, good luck, and God bless you and your little blessing-to-be!!!

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Thanks so much!  Yes, i was initially diagnosed as a type 2 too!  It's nice to hear that other mothers were able to function throughout their pregnancies without using a pump.  i agree, I can't say i'll never get one, but for now, it's not right for me.