Scared

Hi- I am 31 and have been diabetic for 30 years. I would like to have a baby but am so afraid of what can go wrong. My a1c’s are consistently between 6.5 and 7, but I am trying to get closer to 6. I was taking Lantus, but my doctor switched me to N because Lantus isn’t approved in pregnancy. I felt that it was easier to keep my sugars stable on Lantus, so my doctor suggests that I switch back to it. I am scared of fluctuating blood sugars during pregnancy and I am scared to take a drug thats not proven to be safe. I would feel so guilty if I had a baby with defects due to my diabetes. It’s hard for me to feel excited about having kids when I feel so nervous. Does anyone else have these fears?

I am 40 and pregnant with my first. I have been type 1 for 32 years and have used 'N' my entire life. My blood sugars are not perfect, they never have been. My A1C was 7 and the doctor wants it closer to 6 but while I have been pregnant my blood sugars have gone way down. When you have had it for so long your body often does not give you the warning signs that you are having a reaction. Someone I know has had type 1 for 15 years. She delivered a healthy baby boy the old fashioned way. She rarely took insulin, ate cupcakes, and drank regular Pepsi all the time. She is overweight and always has been. Her son is now 4 years old and the teachers at the daycare have been telling her they think the child is gifted. If you want to get pregnant, go for it, your blood sugars are at a healthy level! Good luck with everything!

Have you thought about getting on an insulin pump?

I talked to my doctor about the pump, but I don't want to get it unless I have to.  I don't like the idea of having something attached to me. Although, I do have a CGM and I love it.  Does the pump really help control sugars, or is just more convenient than doing shots?  

I actually felt the same way. I've been type 1 for 21 years and had no desire to have to rely on a piece of equipment when I did just fine on shots. I've been on an Animas pump now for about 5 months and had my first A1c under 7 without even really trying. I'm at a 6.3 and I'm 10 weeks pregnant. It doesn't mean perfect blood sugar by any means, but it has meant much tighter control than I had with Lantus.

Having a pump really depends on the type of person you are. I have a pump and have had it four years now and would never go back. It is not inconvenient, or at least it never has been for me. Dresses have been my only issue with the pump. My levels also went into even better control on the pump. Granted I too have always taken good care of my levels. If you feel you want the pump, go for it. If not, do not worry about it.  

How long does it take to get used to the pump? I have been trying hard to work on my sugars for the past couple of months to get ready for pregnancy. If I get a pump, will it take me a long time to get adjusted to it? I was hoping to be ready for pregnancy in the next few months.

Well, when I first started, I immediately had a difference in my glucose levels, a good change. The first few days of being on the pump, I was calling my educator every three hours making sure everything was going well. The doctors will guide you through the process till you are used to it. If an adjustment is needed, they will tell you how to do it. It is great. Right now being pregnant, my levels are perfect. But we had to adjust my pump just right to the changes in my body. But everything is going well. :)

It didn't take very long to get used to it. I had some issues with my infusion sets at first. Everyone is different, but it took me a month or two to get "used" to it. For me personally, having the pump deliver basal insulin instead of taking a shot of Lantus every night made the biggest difference in my numbers. That and the ability to use a combo bolus with meals. That has kept me from having spikes after meals. With my pregnancy, I haven't had to make any huge changes yet, I've actually reduced my basal rates slightly. I'm sure that will be changing soon though. Its a big step, but if you're already used to watching your numbers, it shouldn't be a difficult adjustment.

OK, this is a little unrelated to the original question, but since you are talking about getting a pump... to anyone who has one: what is it like trying to be intimate when on the pump? Can you disconnect it? Is there still a wire or insert or something? I'm used to being completely free of anything attached to me (except wedding/engagement rings) when having s-x and I'm concerned it would be a distraction or inconvenience.

What do you all do? What has been your experience? Has your man thought it un-sexy?

Thanks!

I have never had a problem. My guy said that he didn't care, he said it is sexy. My pump is pink and he thinks it is cute. I have both worn it and had it off during sex. I suggest to have it off though because I have accidentally hit my guy wearing it. lol. When it is off, I still have the part attached to me in, but the tubing and device is off. Having a pump did not change what he thought, as I am sure your guy would be the same. It has never been a distraction.

I agree! If your man loves you for who you are he won't care what your wearing as long as your healthy! It doesnt get in the way for me since i wear an omnipod and its wireless!

I am 27, diagnosed with T1 Diabetes in October 2005. I have two daughters. The first was born in 2007 and the second in 2009. I was on Novalog and Lantus from 2005-June 2011. Throughout both pregnancies. None of my doctors said anything about the Lantus not being approved. Both of my children were and still are completely healthy. I now have the Animas One Touch Ping Pumping System (got it in June 2011) and wish I would have had that when I was pregnant.

My pump has never gotten in the way during sex. Like Marian Tow, I've worn it during and disconnected during. I was a little worried that my husband would find me less sexy, but that is not an issue at all. He is actually turned on by me being able to handle things that he doesn't think he would be able to (needles and such). TiffS is right "If your man loves you for who you are he won't care what your wearing".

Fear not! I'm a type 1 who is currently 22 weeks pregnant with a very healthy little boy, and as long as you're willing to do the work, you can have a 'normal' pregnancy. I'd say to research type 1 and pregnancy because from the second trimester on, blood sugar levels and insulin needs will start to change rapidly. If you are really opposed to a pump, you can still take Lantus but it is a little less reliable than what a pump can deliver but by no means unsafe.  When I found out I was pregnant, I was totally unprepared and had an A1C of 8.9 (in September) but I've managed to bring that down to a 5.9 (which is exactly where my doctors want me). To get to this point, I saw my Perinatologist (high risk OB) and a diabetic educator or my Endo every week during my first trimester, I got on a pump back in October, and I accepted that I have a rollercoaster ride ahead. I now see my doctors every other week and they're supportive and brag on me every time I go in (which they should cause I'm doing rather well). I would advise getting on a pump at least while pregnant because it's truly simplified my life... I'm testing 10 times a day to keep track of my sugars but I had no idea I was testing that often at all. I was hesitant when my doctor told me she wanted me to get on a pump but after some research I jumped on board and I'm so glad I did. My biggest concern is that my little guy's sugar will bottom out after we're detatched, but birth defects... neh....  and Lantus (and all other insulin) does not pass the placenta (hell, it doesn't even get processed through our kidneys or liver), so your doctor is wrong to say it's not approved... although for the first few weeks before I got on the pump Lantus did cause me a lot of lows,  it is seemingly less reliable than a Basal dose from a pump.

Nobody has had an infusion set slip out during the baby dance? I usually disconnect my pump and put it on the night stand. Imagine how funny it was to find out my set had come all the way out of my stomach! Found it a couple days later...TMI, but I thought it was funny.

Wow! Nope never had that happen.  Must not be doing something right lol ;)

I'm 29, T1D since 2000, 31 weeks pregnant with my first baby. A1C was 6.9 pre-pregnancy and has dropped to 6.2 (my endo says it is natural for A1Cs to drop in pregnancy, even in non-diabetic women due to increased body mass).

I use multiple injections and started on a CGM at 13 weeks. I love using the CGM. Although sometimes the readings are a bit off, it is helpful to seen how I am trending throughout the day, and nice to know an alarm will wake me up if I go low during the night. The CGM sensor is looks pretty similar to the MiniMed infusion set I used years ago (more about my pumping experience in a sec). My hubby is not great with hospital/sickness type things (although he is so amazing and supportive regarding my diabetes both pre and now during pregnancy). He is also very open and honest. When I started with the CGM he said he was a bit weirded out by the sensor and he and I were both worried about hitting it or pulling it out during our intimate time. Anyways, we are now both completely used to it and it has not disrupted our sex life at all :) He is just as attracted to me as ever, even with my now huge belly, and especially with my growing breasts ;)

Regarding Lantus... it is has not been sufficiently studied in pregnancy for it to be "approved" for pregnancy. That being said, it is thought that it should act similarly to other insulins which do not increase the risk for birth defects. I have been taking Lantus for years and throughout this pregnancy. So far everything looks great on ultrasound! An important note... every pregnancy has a 3-4% risk for birth defects (this is for all women, not diabetics)... the main risk for diabetic moms are heart defects and spina bifida, but my understanding is that with A1Cs <8 (and especially <7) the risk is not significantly higher than background, so if you are doing your best with your glucose and are in a range your docs are comfortable with, you are pretty much in the same boat as all other women on that front. Of course glucose control is important still for your own health, baby's size, fluid levels, placental function, baby's glucose after birth, etc.

Regarding insulin pumps. I used one for 2 1/2 years staring in 2002. It took me a while to get used to (a few weeks?) it because the particular infusion set I started with didn't work for some reason with my body... the catheter would get bent so I would get no insulin, and was running sugars in the 300s for days. I finally found an infusion set that worked and was pretty happy with the pump. I sometimes got sore at the infusion site after a day or two, and was annoyed with the tubing especially when trying to put on a seat belt. Also, some outfits were problematic. My pump ended up malfunctioning and while waiting for a replacement I went back to multiple daily injections. I realized that I actually didn't like having something attached to me 24/7 and have stuck with injections ever since. I don't' mind taking 7 injections (sometimes more a day) to cover snacks or correction boluses, and my endo seems happy enough with my A1C. I have heard great things from other people about pumps/omnipod, so I think it is really a personal decision.

Sorry for the long response!! I read posts all the time and don't' write often, so guess I wanted to get it all down at once!

Here's my 2 cents on everything mentioned so far...

I didn't plan to be a mom because of my diabetes but had an unexpected blessing, after having D 28 years. Had a healthy pregnancy and my non-diabetic son is a completely healthy kindergartener.  With modern technology, there's no reason a type 1 woman can't have a healthy pregnancy.  

A 6.5-7 A1c using shots is wonderful.  A pump will still help you do better.  With my pump I'll correct a blood sugar of 130, which wouldn't have happened with shots.  While pregnant I had a 5.1 with few lows... almost impossible with shots but wasn't a big deal with a pump.  

I worried about being attached to something too and didn't get a pump until I was 29.  Wish I hadn't waited so long.  Took less than a week to adjust to it.  Now after 10 years pumping I'd never go back to shots.  Main advantage with the pump is you can tailor base rate of insulin to what your body needs.  I can easily skip a meal and have fasted for 24 hours with perfect blood sugars.

During sex it's easiest to disconnect from pump and put the little cap on the infusion site, so it won't scratch your partner.  Blood sugar ususally drops anyway, so being disconnected prevents sex lows.  

Someone may have mentioned it already, but if not you should take a look at the books "Pumping Insulin" by John Walsh and "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby" by

Cheryl Alkon.  Good information that might help you as you decide what to do.

Thanks so much to everyone who commented about their sex lives while wearing a pump- you've helped put my mind at ease. I'm still in the "honeymoon" phase, so I don't know if it's a good idea for me to consider a pump just yet, but I will keep it in mind as time goes on.