For the past year I'd say, my diabetes hasn't been in the best control. I was gaining weight, never got above 149 though, and my diet was poor. I have over the last few months started watching what I eat, have lost 20 pounds, and work out about 5 times per week. My next step is better control of my diabetes. I am going back to the old school way; measuring everything that goes in my mouth! I am using the bolus wizard on my pump to give the exact amount of insulin, and have an appt with my endocrinologist on Monday. (New endo. so hopefully I like him! =) ) I do not have any children at this time, but we can not wait to start our family. My main question is once I get my A1C to the proper levels (at least in the 6's or less) and continue to maintain proper diet/exercise/weight, how long should a T1 wait until they start trying to get pregnant? I talked with my OB/GYN the other day, but would like to hear input from other T1s.
I think as long as you can get to the 6.0 range and then keep it there for a few months. Of course, I have no medical training ;-) I'd be interested in what your OB said.
My OB really didnt go into a great detail. I think mainly because I have to still get myself a little bit more under control first before trying. She did say the most important thing was to stabalize my diabetes and get it under control. I asked her about seeing a high risk OB and she said I could do everything in her office, and if needed, they have a great high risk doctor I can go to to get some of the tests done.
I think once you are <6.5 or so is actually fine. Shooting for <6% is actually dangerous as there is a lot of associated hypoglycemia. The biggest life-threatening complication in tightly-controlled T1DM when young is accidental death.
The goal is to aim low safely. The key is to keep your glucose levels stable. Minimize the peaks and troughs. Stay "between the lines" so to speak.
There are a lot of things to help accomplish this. I though CGM was incredible for maintaining control safely. Regular exercise is of great benefit, as is a very regular diet with little variation in carb content or timing. I personally believe that the more boring and ritualized your diet, the better off you will be. HOWEVER, with pregnancy, cravings and hunger make this impossible and so consistency is a good goal.
Your blood glucose needs to be very well controlled in the first trimester during organogenesis, the 2nd trimester for further development and the last trimester for for infant size. Good luck and keep us posted.
(I do have medical training and will tell you that unless your OB/GYN has diabetes or is a specialist, he/she will not know enough about a pregnancy in diabetes to be a good resource. Ask your endocrinologist. Or a perinatologist. Pre-conception counseling is routinely offered by perinatology depts in larger institutions).
During my pre-conception visit my MFM / perinatologist said a T1 could try after 2-3 months of steady "target" numbers. It was less than I had expected. Because I was already in good control, he was like, "Go ahead!" My husband and I sort of panicked b/c we had been expecting to have to wait for 6 - 12 months, lol.
I agree that shooting for <6% can be dangerous. I think I was somewhere around a 6.3 when I started trying to conceive and I hovered around 6 for my entire pregnancy, with the lowest being 5.4 - and my endo was a little worried about me when it was that low, and cautioned me about hypos. Exercise REALLY helped me achieve my BG goals while pregnant and I'm not even talking about hardcore workouts. I aimed to do a little everyday, whether it was just a 40 minute walk for laps in the pool (which were THE BEST while pregnant, and I'm not even much of a swimmer.) I know a lot of people recommend CGMs for pregnancy and while they are a great tool, don't worry or stress out if you can't get one due to cost or insurance issues. I didn't have one with my pregnancy and it was fine (even though I worried incessently the whole time that I didn't have one). You just have to be willing to do a lot of checks - I did probably 10-12 per day to make sure I stayed in the target range and could catch myself before I went too low or too high.
On the whole, it seemed like a lot while I was doing it; but looking back, it was a really short window of time. And it wasn't so bad, I'm getting ready to plan a second pregnancy. Good luck to you!