Sad... not what i wanted to hear

So I went to a NP today that specializes in pregnancy and insulin pumps.  The meeting itself went well but she wants me to think about changing my insulin pump from an omnipod to a medtronic bc its a better pumping system.  Which i am okay with, I just dont want the hassel of the dealing with the insurance company.  Also, my A1C was only 7.8 and not good enough to try to conceive yet. Made me really sad on the inside bc I really want to start trying to have a baby. just makes me sad... I go back to her on Jan 24th. are there any tips on how to lower my A1C below a 7 by then? I want to aim for a 6.5.

Don't be discouraged.  When it's the right time you'll become a parent.  You're being really smart to have your diabetes well controlled before all the challenge of managing it through pregnancy and parenting.

Red blood cells provide the A1c number.  They live 2-3 months, so if you make a change now and have a huge improvement, will still take a few months to be reflected in your A1c.  

I'm not sure if Omnipod is really worse than a Medtronic.  Frankly, as long as the pump gives basal and bolus rates it should be okay.  You just need to use pump to its best advantage.  A couple ideas:

* Fast and test your basal rate, including overnight basal.  Pump won't do you much good if basal isn't correct.

* Make sure your insulin duration time, insulin sensitivity factor and other pump settings are accurate.  

* Have a lower target blood sugar.  I usually aim for 100 and have an A1c of 6.5.  But when I was pregnant I set my pump target blood sugar for 80 and had an A1c of 5.1.  IF YOU DO THIS, MAKE SURE TO TEST OFTEN BECAUSE YOU ARE MORE PRONE TO LOW BLOOD SUGARS.  

* Carb count accurately.  Look stuff up on an app or Calorie King book.  You may have to avoid some high carb or high fat food (baked potatoes make my blood sugar high, no matter what I try).  

For more details of any of this stuff, read John Walsh's book "Pumping Insulin" and Cheryl Alkon's "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby."  

Thank you so much for all the advice!

as far as the switch from the omnipod to the medtronic goes i have to be honest- it seems to be that the medical field is obsessed with medtronic.  i am on the omnipod- 35 weeks preggers and have been on it the entire time.  last a1c was a 4.7%.  i can't imagine a different pump bringing down your a1c any better than the omnipod- like jennagrant said, as long as the pump does a basal and bolus it doesn't matter.

what i might consider is adding a continuous monitor- your endo might even let you do the ipro for a few days just to see your trends so you can tell where your higher bg's are.  i eventually got the dexcom seven+ and that helps me a lot.  i don't wear it all the time, or even most of the time, just if i suspect something isn't right or if it has been a while since i have worn it to make sure i'm not missing anything.

good luck hun!

oh- and i LOVE jennagrants book suggestions!  also, if you haven't ever read "Think Like a Pancreas" it might be time to check it out too. ;)

Jenna, where can you find the "Balancing pregnancy with pre existing diabetes" book???

I bought that book actually! I got it on Amazon for like $11 plus S&H! It is very informative!

ALso, Rachel... where do you wear your pump? I seem to only wear mine on the lower back.

when i first got it i tried it every location once and LOVE it on my arms so that is the only place i wear it now.  it works out great for pregnancy b/c you don't have to worry about expanding tummy.  only thing i have to watch is that they check your blood pressure at every appointment (which there are plenty) and i have to make a point to remember which arm has the pod on it.  

have you tried the arms?  i think i get faster insulin uptake there too.  i also knock it off more frequently though- but i am a major klutz.

good luck!

i haven't tried it! I am scared it will hurt bc i dont have much fat there! lol

Rachel- What tips do you have using the omnipod to keep blood sugars below 140 an hr after you eat? I seem to have troubles with that! Any help I would appreciate!

Insulin duration is a little different for everyone, so your 1-hr post meal may be a little high.  You'll get best results if you take insulin about 15 minutes before eating.  Then an hour after finishing test and give a correction bolus if needed.

I don't believe that there's any evidence whatsoever to support the recommendation to change from Omni Pod to Minimed (and that's a 4 year contract). Use what you know and what works for you. If you've had DKA with the OmniPod, then perhaps question it. However, there is nothing to support that recommendation to my knowledge other than provider familiarity.