Need advise for unplanned pregnancy

Pregnancy
1

I am posting on behalf of my fiance who is type-1 since age 12.  She is 25, on the pump (since 5 months ago), with her last A1C of 8 point something.  She is now 7 weeks pregnant (just got it confirmed yesterday) .  Her BGs have been running really high for about 2-3 weeks now (200s-300s).  We have done nothing to prepare for pregnancy.  We are going to see an OBGYN tomorrow.  From what we've read so far, it seems pretty risky to proceed with the pregnancy at this point.  We are going to have to make a decision soon and could use any input/opinions we can get on the the issue of possible complications.  We would really like to hear about actual cases that people have witnessed and what the outcome was.  Thanks for your support,

Kevin

2

My advice is don’t do anything drastic! And if your ob is like mine, she will know very little about the diabetes side of things and will only be able to speak to how the baby looks right now on the ultrasound. Talk to the endocrinologist. Mine eliminated a lot of my worries. She had many patients in a similar situation or worse that she helped get their a1c’s below 7 quickly, and then they went on to have successful pregnancies. A lot of what is on the Internet is worse case scenario or old information. Diabetic women used to be told not to ever get pregnant at all, and now are having multiple successful pregnancies! And the hormones can do crazy things to sugars, so that will be part of what has been going on. I’m 26 weeks and even though I panic every time it’s high, baby boy is looking great and is growing perfectly. Ive been told there is a sort of filter so not everything that happens to mom is happening to him the same. (his sugar is not = to mine). Like I said, just wait. You have time to really figure out if anything is wrong. And you should see a perinatologist/high risk ob/someone who can do a detailed ultrasound in a few weeks & give you the low down.

3

Pregnancy usually catches a couple off guard. It's normal to feel a little freaked out and overwhelmed.  But that doesn't mean you won't adjust to the idea and be good parents.  

There's no reason your fiance can't have a successful pregnancy and that your baby won't be perfectly healthy.  Every diabetic mom has a few high and low blood sugars.  Don't stress about what happened before your fiance knew she was pregnant.  She should just do her best to be in good control from this point forward.

No pregnancy is easy or trouble free.  I stressed my child would be hurt by my diabetes or become diabetic; my husband stressed our child would get the heart disease prevalent on his side of the family or turn out like his weird uncle who never had a job.  =)  Diabetes does bring challenges to a pregnancy, but thanks to insulin pumps and modern insulins it's unlikely your fiance or child will have diabetes related problems.  If you do, you will deal with them just like any other mom and dad.  

With a pump your fiance should be able to get into tight control.  A couple things I'd recommend:

- Get Cheryl Alkon's book "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby".

- Sign up for weekly updates on babycenter.com or similar websites.

- Work with your doctor to set a lower, but safe target blood sugar.  

- Test frequently or use a CGM to quickly catch a dropping blood sugar or correct a high.  

- Get a carb counting book or app and carb count carefully.

- After the tiredness of the first trimester wears off, consider doing a mom's workout class offered through many hospitals.  

- Work with an OBGYN that you really like.

- No that no matter how tightly controlled your diabetes is, a diabetic pregnancy is considered high risk.  You will have more doctor appointments and ultrasounds  than a non-diabetic mom and may be encouraged to induce early.

I was diagnosed with diabetes at age 4 and never planned to have a child because I thought it would be too risky.  Thankfully God knew better and I became pregnant unexpectedly after having diabetes for 28 years.  My A1c was around 7, but once I learned I was pregnant I aimed for a non-diabetic A1c and had a target blood sugar of 80 with no lows.  My A1c quickly dropped to a 5.1.  My pregnancy was healthy and I had no complications during the pregnancy or since.  I had a great male OBGYN and though  I was his first type 1 mom, he was quick to get advice from colleagues and he trusted me to manage my diabetes.  I also had a great moms-in-motion yoga and water aerobics classes that helped me feel good and meet other expectant moms.   My son was born at a normal weight with a normal blood sugar.  He's 6 now and is perfectly healthy.

I was extremely worried about passing diabetes to my child and was glad to learn from the American Diabetes Association that Type 1 does not have a strong genetic link.   "If you are a woman with type 1 diabetes and your child was born after you turned 25, your child's risk is 1 in 100.  Your child's risk is doubled if you developed diabetes before age 11."

I wish you and your fiance the very best and hope you'll keep us updated.