First, THANKS for all the great info out here. Just seeing all the success stories form people who have been through a pregnancy and dealt with Diabetes successfully too is awesome!!! There is alot of scary info out there, but those of us who have made the leap and with a TON of work had success are out there.
I am T1 since age 11- so 21 years now, and am at 23 weeks pregnant currently. We're expecting a baby girl and thrilled! So far, I have been seeing both a high-risk pregnancy doc for monthly ultrasounds and a high risk OB monthly too. Baby looks good in terms of the anatomy scan, and was a normal size as of the 20 week scan, we also did a fetal EKG which was fine. We've done genetic/perinatal(?) testing which showed no scary risks, so I am feeling good overall.
I've been on a minimed punp for 13 years now, and I have kept my A1C below 7.0 for the past several years. During pregancy so far its been 6.5-7, and aiming for better! I am testing approx 12x/day and trying to keep control v. tight but the ever-0changing need for more insulin is making this tough. I am curious about how much weight others gained...As of 22 weeks I had gained nearly 18 pounds! My doc said not to panic, but to try and slow it down-- easier said than done. I dont feel like I have been over-eating, nbut will admit that I have not been exercising as regularly probably since the holidays... I am getting back to it! I think the true issue may be my underactive thyroid but am seeing my endocrinologist tomorrow so hope to remediate that soon too if its an issue.
Phew- so that's what's on my mind, I am glad to have found this board. Thanks in advance, for your thoughts on this!
Hi Megan! I've only had T1 for about 3 years, but my little brother has had it for 16 years, so I grew up with it a little bit. I had my first child (a daughter) 16 months ago and made it through my pregnancy mostly without incident. My baby was born at 37 weeks and was 7lbs, 3oz - so a good size, but not huge. Sounds like you are doing well and on the right track. I gained 45lbs overall!! But I lost all the baby weight by 6 months postpartum by taking the baby on lots of walks, working out some, and watching what I ate. I gained a ton of weight in my 3rd trimester and I blame it on how much insulin I had to take - 3 times what I normally took!! That third trimester really makes insulin needs really sky-rocket! Try to stay as active as you possibly can, is my best advice. My favorite excercise during pregnancy was swimming. The feeling of being in the water is great when you're pregnant!
Please feel free to ask me any questions you have and I'll do my best to answer them! Being a mommy-to-be with T1 is so hard sometimes. You really feel like you have to do a ton more work than other mommies but it is all worth it when you hold your little angel for the first time! I planning on going down that road again in about 6 months or so! :)
[quote user="meganh"]I am curious about how much weight others gained[/quote]
My doctors were pretty vigilant during both my pregnancies and told me from the start they didn't want me gaining more than 25lbs. I think it's just the added weight puts more stress on the body/organs. Somehow, I was able to keep it under 25 for both. The Perinatology Center I went to had a nutritionist on staff that I met with at every appointment. Most times - it was a "hi, how you doing" quick in and out kind of checkin, but those weeks where they saw more than expected weight gains, they'd stay longer and we'd try to work on the diet and stuff.
I do remember that by the end of the pregnancies, I was taking 1 unit for every 2 grams of carbs which is at least 4x almost 5x was I normally take. Barely made it through a day without refilling pump reservoir. :-) That went back to normal doses within 48 hours after delivery (I didn't need ANY insulin in the first 24 hours after giving birth - be aware that this might happen).
Also - the weight came off in about 6 weeks after giving birth.
Thanks for your email, all great info! Did you have a 'normal' delivery or a C-section? I am just curious as had always assumed my high-risk status would warrant a C-section but my doc said thats not the case which was good to know. Though I am testing my BG a ton I am still struggling to nail the targets my OB (not endocrinologist set, I think they are more used to dealing w/ gestational diabetes that T1. But 120 post meals is proving really tough. I will keep working at it though!
I am really encouraged that you are considering a second pregnancy- that's terrific!! Also good to know you didnt keep the weight on, I must admit that I am finding the weight gain tough although its natural and essential for baby of course. What was your BG testing regimen while pregnant? In addition to testing prior to each meal, I am doing this 1 hour and 2 hours post meal. Plus alot of other ad hoc testing and usually at least once/night when I am up anyway. Does that sound about right?
Thanks for the info-- appreciate it! I am seeing my endocrinologist today so this is good timing...One thing I am now becoming more aware of is that other Diabetics seem to have much closer contact with their Endos during pregnancy than I have had for the past 5 1/2 months. I am seeing other posts elsehwre with people sending weekly logs etc to their docs, mine has been pretty hands off. Perhaps this is b/c I have been doing this a long time and have good A1C control, or perhaps he thinks my OB is handling that. But I am thinking I may need to be more assertive and force him to be more involved. My OB doesnt get into that level of detail either, and I am at one of the best hospitals in the country- HUP in Philadelphia. So, I guess I need to take the ball into my own hands more. I am testing a ton and my A1Cs have been 6.5-6.8 so far during pregnanvy, am hoping for a lower # after today's labs too. Some nutirtional help would be a huge help I think!
Thanks for reaching out, every time I hear form another diabetic mom I get even more excited about our baby!
I did end up having a c-section, but I was really happy with that outcome, to tell you the truth. I delivered a little early at 37 weeks. It's a bit of a long story, but I'll try to condense it as much as possible: My insulin needs kept going higher and higher and finally, at 36 weeks, they took a massive drop. All of a sudden I was having lows all the time (40's and 50's, even a couple in the 30's). My doc and I kept dropping my insulin, but it kept not being enough, I was still going low. I think we finally stabilized it after some pretty drastic cuts, but my endo was VERY concerned that this is a sign that the placenta can be breaking down prematurely. If the placenta separates unexpectedly, then you may have a still born baby (yeah, this scared the you-know-what outta me). I went into my perinatalogist the next day for an ultrasound but they didn't see any evidence, the placenta looked fine. No one wanted to take any chances, and 37 weeks isn't really all that early (it's considered full term), so we did an amnio to make sure the baby's lungs were fully developed (they were) and scheduled the birth for 2 days later.
My OB gave me the choice of trying an induction or just going straight for the c-section. She told me that I wasn't effaced or dilated at all and so the chances of the induction drugs getting me all the way to a vaginal birth were not very high, still she said she's had some patients try with success. But she warned me that labor pains from pitocin are much, much more intense than natural labor pains. She seemed to think the chances were high that I'd go through the induction and end up with a c-section anyway. My perinatalogist was 100% in favor of a c-section. My baby's stomach was measuring on the large side and he was afraid of the possibility of the baby getting stuck at the stomach. My endocrinologist favored a surgical birth because it's easier to control blood sugars and insulin during surgery. But told me he'd support what ever decision I made. After all that, there was NO WAY I'd do anything but a c-section, but that was just my opinion.
I LOVED my c-section. Again, this is just my opinion and I know it's not for everyone. I had a fantastic anesthesiologist who walked me through the whole procedure before we started so I really felt prepared for what was happening. I got to touch my baby right after she was born and my husband held her against my chest while they cleaned me up. My scar is so low and it never bothers me at all. My recovery was not bad. I was off the hard-core pain meds 4 days after delivery and just alternating tylenol and ib profen for the next couple of weeks. For my next kid, I'll just be scheduling the c-section right from the beginning. I know that not everyone feels that way about surgical births, and I totally respect that. It just ended up being the right choice for me and my baby. I hope you end up with a situation that you feel good about and that goes well for you.
The targets you said were the same for me. 120 an hour post meal. It was TOUGH. I was checking about 10-12 times a day. When I woke up and before bed, sometimes middle of the night, before and after every meal, before and after excercise, sometimes during excercise. I'm definitely getting a CGM for the next pregnancy! :)
Sorry for the novel! I hope it's at least a little helpful. I'm so excited for you! It's true that diabetic mommies have to start doing a lot more work for the baby long before they arrive!
Hi Megan, I'm glad you found us! I don't think Juvenation was around when I was pregnant 2 years ago, so there was one mom w/ T1 I knew, and I literally called her 3-4 times a week!
I gained 33 lbs when pregnant. They didn't seem concerned w/ that at all at my OB office. I lost the weight easily after, w/o exercising at all to be quite honest other than walks w/ the baby, thanks to breast feeding. I'd eat and eat and eat, and my BG would be 40 and I lost tons of weight. I wish I had an outlet for my extra calories to leave now, lol.
From talking to other moms online, I think c-sections are slightly more common in T1 moms, even w/ normal sized babies, b/c drs induce you earlier, so the vaginal birth doesn't always work out. That's not to say it won't or can't. After 2 days of labor at 38 weeks pregnant, I ended up w/ a c-section. But, they said it was b/c the baby wasn't coming out straight. Honestly, I don't even care now -- once the baby was here, I barely have given a thought to it.
I saw my endo every 2 or 3 weeks when preg -- I can't remember which now. I'd had D since age 4, but I found his visits very helpful b/c I'd never dealt w/ the pregnancy / hormone thing before. He said 120 was the post-meal target but he was fine with my 140-180 readings post-meal if it prevented bad lows later. He was pretty relaxed and kept telling me everything would be fine. I used a CMG for part of the pregnancy and tested about 12-15 times a day during the rest.
I have to say that having a healthy pregnancy despite T1 was one of my proudest achievements! As I'm sure you know, it's a full time job. I couldn't believe all the work I put into it day and night, so I tell my son everyday how lucky and happy I am to have him here with me! (:
Please send us updates! Also, you may want to check out www.diabeticmommy.com.
Wow- great info, thanks! You know, the more I think about and hear fomr other people, the less scary a C-section sounds. You're right, its a totally individual choice and frankly at the end of the day, the baby and mom's health is all that counts. I have lots of friends who had 'au natural' births and advocate for those, but that never seemed real feasible for me anyway. I guess we'll just take it one day at a time, and keep an open mind....
Appreciate all the info and glad your little baby is such a treat! I cant wait for ours-- at least we get to see her again on Friday for a 24 week ultrasound. ;*) Thanks
Thanks for your post-- very helpful info! I just stumbled onto the juvenation site the other day and its great!! I was saying to someone else that regardless of delivery method, the ONLY thing I care about is a healthy baby, so I will try to be a flexible momma and see whatever the doc thinks is best when we reach that point. At only 24 weeks, that seems like ages from now anyway!!
I think you and all of us are right to be extremely proud of this accomplishment-- pregnancy is hard enough without this huge extra layer to consider. Thanks too for the other weblink, I will check that out for sure. Go us!
Hi Megan: Congratulations on your pregnancy! I happen to be in the same boat that you are - as my husband and I are expecting our first child in May - we are also having a girl!! I'm about 26 weeks right now, so it sounds like I am a couple weeks ahead of you. I think the insulin resistance is starting to kick in - slowly but surely. As for all of the extra tests we T1's have to have done, all of mine were fine as well.
Now on to the main question: weight gain. I've only gained like 8 pounds so far and at my last doctor appointment he told me he wanted me to gain some weight...and just to be sure I heard him correctly, I said "Did you say you wanted me to GAIN weight?" and he said "yes, defnitely don't lose any, but don't put on too much". Gee thanks for the tip! Ha! So now I am trying to gain healthy weight <-- if anyone has any advice on gaining healthy weight...I'm all ears. I'm a little afraid that all of a sudden it will catch up to me, but I guess we'll see what happens at my next appointment. I know I surely haven't not been eating...my husband even vouched for me at my last appointment and told the dr. that I am eating ("Oh she eats!"). Honestly I feel like all I do all day is eat small snacks and check my blood sugar. I've been eating a lot of fruit which I can't get enough of...and I was craving pasta and rice (although I've always loved my carbs...so this is nothing new!) You may be right in the fact that your thyroid might be playing a part in your weight gain...hopefully your doctor was able to shed some light and help you out.
Shoot me a message and keep me updated on how things are going for you. It's so nice to have this website to talk with other people who know exactly what you are going through. :o)
Congratulations on your pregnancy! I have had T1DM for 21 years too. Had my first baby almost 6 years ago and the second 2 years ago. Both were c-sections. I had an idealized birth plan that went out the window when the induction didn't do anything. I am SOOO glad we made that choice! Having delivered a handful of babies and watched a host of other births, I have not for one moment regretted the decision. Labor looks painful and the c-section avoided all of that!
Blood sugars are very frustrating in pregnancy. It takes a very skilled clinician to help you with this management. We are more resistant in the morning and in the 3rd trimester, the hormones produced by the placenta cause worsening insulin resistance. There are a couple of things that can be very helpful.
One of the most important is frequent testing. Though OB/GYNs recommend before and after each meal, I don't think this is enough. Have you considered getting a CGM? My Dexcom was even more accurate and reliable in pregnancy than it is now (and I live by it) and provides you with a constant monitor for blood glucose levels. Tight control in pregnancy is key but it also is associated with risk of hypoglycemia - which can be just as dangerous in certain circumstances. I think the CGM is a good protection for this. It also alerts you when you are on your way up or down so you can catch it early.
The other thing that is important in pregnancy, particularly as insulin resistance increases, is using a lag time between meal bolus and actually eating. This is a sophisticated concept encouraged by the diabetologists among the endocrine community but is vastly overlooked by most general endocrinologists. Its very difficult to wait 30 minutes to an hour to eat after giving insulin, especially when you are pregnant, but this can help to minimize the post-prandial glucose spike that occurs when insulin resistance increases.
The other question regarding weight gain? I think that as a person with diabetes with a goal of very tight control, it is difficult to not gain more weight than the people without diabetes. I gained 80 lbs in my first pregnancy (secondary mainly to an insatiable appetite) and 60 with my second. With both, I gained a lot of weight in the first trimester with the constant eating associated with intermittent low blood sugar levels. Not ideal but the weight came off very quickly and my babies were both healthy healthy healthy. No regrets. Gave me a different perspective and a LOT of big clothes!
Thanks for your post- its interesting to see what all us pregnant ladies are dealing with and hear how others are tackling the shared issues. I am jealous that yor doc wants you to gain! ;*) I have my monthly OB appt for 26 weeks today in fact, so we shall see if I've managed to slow the gain down enough.
When I saw my endocrinologist right after the last OB appt (which had me all upset as I felt worried about teh weight, mostly as I feel good and people kept telling me I look good so it was a shock! and an ego blow if I am honest). My Endo kind of pooh-poohed the weight concern and said the most important thing is what i am doing-- keeping my BGs tight and getting my thyroid function back to normal, keeping a healthy blood pressure etc. So, I am feeling less stressed after that. BUT, we shall see what my OB says today- fingers crossed and a light lunch ahead for moi!
Congrats on your baby girl! Thats great! Where are you guys located? We're in Philly area so looking forward to this cold snowy weather going away soon. Hubby and I are doing a trip in late March to the Caribbean as a pre-baby splurge and I am couting down the days...
Keep me posted on how its going with you and your baby, thanks.
Thanks much for the great info-- appreciate it! Congrats on your 2 healthy, happy babies- that is awesome and very enocuraging as a first-timer. Its pretty wild to think that even a generation agao we long-time diabetics would prob have been discouraged from getting pregnant at all despite working hard for tight control...The more I hear about it (and the closer I get to delivery though still 14 weeks off!), the more I am realizing that we need to be prepared to go with the flow-- as you say, the best planning in the world can be derailed, and the only important things is safety of baby and mom.
I also appreciate the weight feedback, I was telling someone else on this board that while my OB lectured me, my Endocrinologiust wa snot concerned. He reiterated that the health aspects of blood sugar control, my existing underactive thyroid, and B/P were alot more important to him than whether I gain 5 or 10 pounds more than the norm. So, we shall see how I do on the scale at my OB appt today. I have decided that feeling good and knowing bbay and I are healthy is more important than the # on the scale. Part of the weight stuff is purely vanity on my part anyway!
We're Cleveland, Ohio - and just as sick of the snow as you are...although I think you may have gotten more than we did so far this winter. Anyways...hope you doctor appointment went well today. Your pre-baby trip sounds wonderful! Have a blast and enjoy yourselves! Did you have an ultrasound today? I had one last Friday and baby's head was down, but facing my back, so we didn't really get a good profile picture...but from her measurements, it was determinted that she weighs 2 lbs. 3 oz. and is right on track. And as far as the weight gain goes...my total went up to 13 lbs. as of last Friday and the Dr. told me that I should expect to gain about 1/2 - 1 lb. a week for the balance of my pregnancy. Did your doctor mention anything about doing an amnio at 38 weeks and then inducing labor? Mine told me that I will definitely be induced unless something should happen before that time period. Next Friday I go for a non-stress test where they measure the baby's movements and heart rate.
I sent you a friend request on here - please accept. :o)
Congratulations on your pregnancy! I see that you are from the Philly area...me too! If you don't mind me asking, where near Philly do you live? I am actually hoping to get pregnant for the 1st time in the next few months. Have you seen a High Risk OB at all in our area so far in your pregnancy? I am trying to get a feel for what Docs are around...who's good, etc. I would love to hear your thoughts! Hope to hear from you soon!
We're living in East Falls, Philadelphia (close to Manyunk), how about you? I am seeing both an OB and a high-risk pregnancy specialist asociated with Pennsylvania Hospital in center city. Dr.Harish Sehdev is the high risk doc and Dr.Peter Gearhart the OB-- both have been terrific. I see an endocrinologist also affiliated with HUP for my T1 care of course. I would fully recommend Pennsy's maternity/OB people-- its consistently ranked one of the best in the nation. I work in center city and getting to 6th & Walnut or 8th & Spruce is pretty easy for me. If you're in a more suburban area, I've heard good things about both Lankenau and BrynMawr- both my friends who delivered/ rcd care there were not specifically high risk.
Hope that helps-- I'm happy to share whatever is helpful on our experience, so keep the questions coming & good luck to you guys!
Thanks, my appt with the OB last week went well in fact, I had only gained 1 pound in that month so he said I was back on track. No scolding that time which I appreciated! I did however have elevbated blood pressure and while I suspect its just the fact that my job has been horrendously hectic and sttressful pretty much since January, I need to work on that. He told me to get a home BP monitor, and since I've been tracking this week its been above normal, but more like 132/82-- so, not great but not too alarming. I will be updating the OB next week once I have the full week's data to report...I am terrified of pre-eclampsia so will try to get back to my yoga and not let work drive me so nuts. Thats the plan anyway! I am sure vacation ina week will help.
Good news about your bbaby girl's measurements, etc--that's exciting! We havent gotten into any details in terms of induction etc. All I knnow is that there is no way they will let me exceed my due date, (June 12) which is fine by me. You're getting so close now, thats terrific, hope you;'re still feeling good. We have our 28 week scan next week, so will let you know how that goes.
Take care. Megan
ps- GREAT work on the A1C-- thats terrific. My last as of 2 weeks ago was 6.1 so getting there!
Thanks so much for the info about the docs. I do live more in the suburbs...northern Chester County. I have checked into Lankenau as well as Paoli hospitals and doctors. Lankenau is a little far, so I may go with Paoli depending upon what my OB says when I meet with her next month to have the pre-pregnancy chat/visit. I know the center city docs are good, but I think traveling an hour into the city for appts. would be too much added stress at that already stressful time. We'll see how things go though...I would do whatever I needed to have a healthy baby and pregnancy. Sounds like everything is going really well with your pregnancy! That is great! Can't wait to hear how things go as you progress closer to your due date. Thanks so much for offering to share info...I am sure I will take you up on it! :-)
Take care!
Katie
P.S. It is so cool that I found someone on here from this area dealing with a similar situation!