Hey all! I have been T1D for about 10 years now. I just found out that I am 4 weeks pregnant for the first time. My last A1C was 6.9. For the last few weeks I have been experiencing some significant highs when I hadn’t been struggling with that for a while. I am terrified I am going to hurt my baby with these swings as I know very early is so important for control and development. My endo told me it is common to need less insulin during the first trimester but I have seemed to need more the last few weeks. Wondering if anyone has had this experience too and how it turned out for them. I have an appointment with my endo on Monday but I am so worried I have already caused harm.
Hi and welcome to the forum. I don’t have children so can’t help with your question, but I developed Type1 when I was 3 years old and as I got older my doctor advised me that I should find an ObGyn who knew how to manage (help manage) diabetic pregnancies if I chose to have a baby. Much has changed since I was of childbearing age but do talk to your Ob to see if they are qualified to see you through.
Congratulations, and I hope you hear from some moms soon.
@ashleynlambert Hi Ashley, and welcome to the JDRF TypeOneNation Forum! My best wishes for you, and I’ll pray for your well-being and and for your baby.
Having never been pregnant [obviously] I can’t speak first-hand on if you will need more or less insulin in your early month, but I’ve hear from different women more insulin is needed and from others that less insulin is required to maintain target blood/body glucose levels. Every one’s body reacts differently to insulin needs, so you will need to monitor and take insulin that works FOR YOU. A CGM during pregnancy is extremely useful for monitoring BGL and determining when/if yu are taking enough insulin for all meals.
A 6.9% HbA1c is kind of high, at least for me, indicating that your average BGL over the past three months has been about 150 mg/dl, although you are correct knowing that the level of your BG is not as important as avoiding fluctuation between lows and highs. In my opinion [seven decades living with diabetes and trying to figure out this insulin thing], is that both you and your baby will be better off if you can avoid hypoglycemia - LOW BG. Here again, a CGM will alert you when your BG is dropping and when your BG hits either a high or low threshold that you set.
Welcome Ashley, to the forum and congratulations on your awesome news and thank you for sharing it with us. Personally I can’t say I’ve experienced being a T1D during pregnancy, but I can give some advice of general care of yourself and baby. As others have already said a Constant Glucose Monitor CGM is extremely important to have during this critical time in yours and your baby’s life. If you don’t have one, get one. It will give you a moment to moment level reading to keep issues from getting out of hand. During this particular time in your life you will discover your situation will be unique and may not be anything like anyone else’s situation so it will be a learning experience as it progresses. Your hormones will be going off the charts as the baby develops. With that battle going on Blood Glucose Levels BGL’s will be difficult to keep steady and highs can become dominant and that is something that you have to get under control. You need to make sure your endo and obgyn are experienced in handling pregnant T1D’s by all means. You need to discuss with your endo about bolus doses and what levels you need to focus on maintaining. Remember that low BGL’s are the ones you need to avoid to protect the two of you, but highs also need to be kept to minimums. As things go along you need to have things on hand for hydration due to morning sickness and other issues. Pedia Lyte, regular and Gatorade Zero, saltine crackers, melba toast so if vomiting happens you will be prepared to get a handle on the situation the best you can. Cravings are a whole other issue in themselves so you may have issues with that, we hope not though. You’ve got this little lady, please let us know any updates as your journey goes along and we’re hoping you and your little one all the best.
Welcome!
Talking to your doctor is a good idea. Maintaining blood sugar levels while pregnant is a difficult balancing act, but it can be done, and an experienced endo can help you navigate that.
The thing to remember here is gestational diabetes. A small but significant percentage of non-diabetic women temporarily become diabetic while pregnant. It’s dangerous, but I’ve always found it fascinating. As my sister informed me the first time she got pregnant and started reading everything about it, being pregnant affects literally every part of your body.
The cause of gestational diabetes is the developing baby affecting the mother’s body chemistry. The umbilical cord isn’t a one-way connection delivering nutrients. The baby releases chemicals that get absorbed back into the mother’s body and have a number of effects. One of the major ones is causing the mother’s blood sugar levels to rise.
Running high while pregnant is normal. The baby wants you to run high. Gestational diabetes exists because the growing baby is actively working to squeeze as much nutrition out of your body as possible in order to fuel its growth. The higher your BG, the more sugar is flowing through the umbilical cord, and thus the better the baby is able to grow. Babies want that extra sugar so much that they push the mother’s body to the point of risking making her diabetic (which, without modern medicine, could be fatal for them both).
You’re not hurting the baby by running high. And your body will be okay running high for a while, too. What’s dangerous is going low.
So… relax for now. And talk it over with your endo. See how high it’s okay to run and how best to manage it.
Hi @WearsHats .
I usually agree with your advice but in this case I definitely recommend she get it from her physician. I don’t know if things are different with gestational diabetes; but even if so, @ashleynlambert has had diabetes for several years already so hers is not due to pregnancy. There are glucose guidelines for pregnancy - I googled some to see what they are but of course they’re no replacement for guidance from a physician, especially during a joyful time such as this.
Joyful mom, try to stay calm as you wait for your visit (I’m sure it’s hard). Your doctor may give you some guidance over the phone until you get there. It may be tempting to stack insulin or to bring down the high numbers but you don’t want to go low either.
When you see your doctor ask them if they could put you in touch with other Type1 moms who have had babies or are now pregnant. As others have said, managing blood sugar during pregnancy (like most things) is a very individual matter, but they may have some tips and sharing experiences can be helpful to both.
Good point, Dorie. I agree. It’s important to go over all this with your doctor and see what’s allowable. Just wanted to reassure Ashley until then.
I have an appointment with my endo on Monday but I am so worried I have already caused harm.
But I did not mean for that to be more broadly applied than “Don’t worry too much this week. Talk to your doctor next week.”
I know how much everything can be really stressful and anxiety-producing for a first time parent. It’s one of the signs you’re doing parenting right. You’re seeing it for the life-changing deal it is, you’re seeing how much you don’t know and how new this ground is, and you’re worrying over every sign that you’re doing something wrong or there’s something you should be doing right that you’re not or that there’s something that is going wrong that needs to be addressed… Because you care deeply about getting it right.
So: What you’re experiencing is normal. It’s good you caught it. You’ll see your doctor soon, and you can work out what’s okay and how to approach things. And talk about when you should call the office about stuff like this, because you’re going to have a ton of questions this year.
But, yeah. I overstepped. I’m not a doctor and I’ve never been pregnant.
I did a quick search of the site for recent posts about pregnancy, and found these two, which might be useful:
Also tagging the folks who have posted recently about their own pregnancies:
@Metalmommabestla92, @Amcquarry, @EL8765, @Illumanoti, @AlexisJ1208, @whit41587, @linsey.
Hopefully one of them will see this thread and chime in for you!
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Always a pleasure comparing thoughts with you - thank you for your habits reply and explanation. I do appreciate your trying to ease her fears, and apologize if I misinterpreted.
On a side note - have you noticed how the first forum members to respond to questions on pregnancy are guys, or women without kids? The moms have their hands full no doubt!
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You were right, Dorie. Thanks. I’m critically short on sleep and needed the check.
I think this is the first time I’ve responded to a pregnancy question? Usually I leave it to the experts to answer first. But if the thread has gone on for a bit and I feel like I’ve got something relevant to add, I’ll jump in.
Always good to see different perspectives. I hope you get some rest soon - I remember you said you had sleep problems.
I had three children, one after being diabetic for 5 years, one after 8 years and one after 18 years. In all cases, my sugars dropped a lot in the first trimester. During my second pregnancy I even passed out at the wheel of my car right after lunch one day. But the duration of my insulin injection declined, so I needed to have more frequent shots. I was on medium acting insulin at the time. There were no pumps then. Also, blood sugar of the mother should be kept lower while pregnant. So your concern about high sugars is important. But by the end of the first two pregnancies, I was using triple the starting amount of insulin. And for the third pregnancy, double the starting amount. This was all normal. As soon as you see a pattern of high sugars, I think you need to phone your endo for help. Waiting a week or a few days is not good enough. She needs to give you immediate help of some sort.
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Many years ago I was pregnant with type 1 The best advice I got was to have an OB who specialized in high risk pregnancies. I went through my pregnancy with no problems and had a healthy baby girl.
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Hi Ashley!
I wanted to reach out to say first off congratulations and secondly, welcome to the forum! I am a T1 Diabetic and had my daughter 8+ years ago, after having Diabetes for over 20 years. It definitely sounds like you’re on the right track keeping your A1C in line while being pregnant! The occasional highs will happen. I went on an insulin pump so my doctor team was able to better fine tune my basal rates throughout my trimesters. As long as you’re able to catch the highs and correct them, you should be good. I think my A1C was around a 6.5 throughout my pregnancy and I was closely monitored as I was considered high risk, but everything turned out okay and my daughter was born completely healthy! As a Type 1, there’s definitely a bit more work involved, keeping track of everything diabetes related, but try not to stress too much! (I know - it’s easier said than done). You got this!!
Best,
Rachael
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Good luck with the appointment tomorrow! I hope you get good answers.
I wanted to offer support as well. I had my son 11 years ago, with having T1D for over 20 years at that point, and not that great of control as I got pregnant (A1Cs in the high 7s low 8s just prior). After a lot of work right after finding out I was pregnant, my A1C was high 6. I know for sure that my sugars weren’t super well controlled right away. I also know I struggled with lows as I worked to get things down and stable. By my 2nd trimester, my insulin needs went up and up. This was before CGMs and pumps for me, so that was a challenge to track. My OB had me see a high risk OB/GYN around 20 weeks to check on me and my baby. Since, everything was going fine, my endo stayed in weekly contact to review sugars and dosing and I cont seeing my regular OB.
The biggest issue, for me, was that my son was getting pretty big in the last weeks. He decided to come 5 weeks early, and was 8.8 lbs, 21". His sugar was low as the cord was cut, which I wasn’t expecting - but they were, and had him stable very fast.
I don’t say any of this to scare you, but the larger baby and low sugars are more common. He was perfectly healthy and all went well!
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All the best to you at your visit today. I’ll be praying for you and your precious little one.
I was diagnosed with T1D over 60 years ago and was pregnant with my daughter (now age 31). That was before the introduction of CGMs. I saw an endocrinologist specializing in Type 1 pregnancies. She told me at the outset that increasing insulin gradually over the entire pregnancy would be entirely necessary, and that it was essential that I keep my blood sugars in range as much as possible - which I did even without a CGM, not sure how that happened at this point! Would advise you see someone with a reasonable amount of specialized expertise in Type1 pregnancies, be aware your need for more insulin will increase continually and that, if anything, lows are less harmful to the baby than highs, I know it’s a challenging and frustrating balancing act, even more so over the 40 weeks.
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Hi. I wanted to check in and see how your visit went. All the best!
Hey all! Thank you for all of the support! I was able to see my doctor yesterday who assured me we will get everything under control and that I am doing well. My newest A1C was 6.1 and have set up weekly telephone calls with the office through my pregnancy to ensure I am getting the support I need and that my blood sugars are well managed.
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