Type One Diabetic Mums To Be

[cupcakebakerer]

Hi,

I am nine weeks pregnant and have type one diabetes. I would love to find a network of women to discuss the trials and tribulations of coping with it all!

Hi! I'm 8 weeks along and type 1 as well. How are you finding it? I have a pump, and my blood sugars are much better than they used to be, but I am more vigilant since getting pregnant too. I don't want to do anything that I'll blame myself for later!

Hi Josie!

I'm actually only nine weeks on Tuesday, so we're actually the same along! Ah what a relief to be able to talk to someone who knows what it's like. I'm 28 but have only been diagnosed about six months. I got given the go-ahead to try when I'd got my levels down to 6.7. I'm not on the pump - just testing like a maniac and injecting before meals and on a night time.
My sugars have been good but obviously not perfect - but I suppose that's the nature of the best. I just find that being pregnant is stressful enough but knowing you can actually do something that can harm your baby makes it 100 times worse! Is that how you feel? I panic at every 'high' and as I'm trying to keep my sugars under such tight control there have been loads of hypos (although I'm told these don't affect the baby). Arrgghh! Sorry for the essay!

Hi ladies, am type 1 and am 21 wks pg. The advice I will give is to be conscious of your sugars and maintain a good control but don't beat yourself up about the occasional high and don't get too anxious about getting your hbalc perfect (I was told that between 5 and 7 is acceptable) as anxiety can cause your sugar levels to rise. I had ok control b4 I conceived but not perfect cos baby was unexpected so i tightened up as soon as i found out and the midwife was happy with that. Take your 5mg folic acid religiously and at 12 weeks get some dispersible aspirin to help protect against pre eclampsia. I too felt terrified in the early weeks about all the stuff that could go wrong for me as a diabetic but worrying gets you nowhere. Am now half way, through 2nd trimester and baby is happy healthy, normal sized and v wiggly with everything where it should be.

cupcake I too am on the pump and its has been the best thing I have ever done. My control is more consistent (last hba1c 5.6) and the freedom with your diet and eating is great especially when and if the M sickness kicks in. I intend to keep it after my pregnancy. Ask your diabetes specialist at your next appt.

And most of all congratualtions. Feel free to keep in contact if you need anything xx

Cupcake: I'm going to be 9 weeks on Friday, so we're really close! I'm 28 as well, but a bit of an old pro, as I was diagnosed at 13. It must be more difficult for you, as you will still be getting used to being diabetic, let alone what the pregnancy does to you. I second MissCKitty that you should ask about a pump - you have to learn how to carb count, but it makes control so much easier. I feel exactly the same as you, though. I had a problem with my insulin last week that led to a really high sugar, and I spent the next 12 hours worrying about it!

MissCKitty: Thanks for the reassurance! I haven't heard about dispersible aspirin, but will ask my midwife about it, as I have an appointment this week. I managed to get my hba1c down to 5.8 pre-pregnancy on the pump, which is better than it has ever been, but now my sugars are creeping up a bit because I'm trying to avoid lows (got tons when I first became pregnant). Good to hear that you have a healthy normal sized baby, as I keep horror stories.

And congrats to you both! :-)

Hi MissCKitty! Thanks for answering and your advice. It sounds like you're taking it all your stride and not letting having diabetes ruin your excitement of being pregnant like my worries are tending to at the moment.

Good tip about the aspirin. Did the doc okay this? I'll make a note to mention it to mine.

This pump sounds like a winner. How do they work exactly? Are they hard to get used to? I think they are quite difficult to get hold of in my area due to cost and I've been told I couldn't have one now until after pregnancy (not sure why). Is there an 'alarm' element to them that warns you when you are dropping to low/high? That would be invaluable to me.

My worry at the moment are 'lows' causing probs for the baby. But with such strict control it's rare I go a day without a low or two (not to the point of suffering a hypo though as I usually catch them before I start getting the affects.)

What I found with the pump is that my hypos pretty much stopped entirely, been on it for about 8 weeks now and have had one hypo, where as before, like you, I was having 2 or 3 a day and I was losing my symptoms too so was getting really low, like 1.9, before I realised. Fortunately hypos are not dangerous for baby but obviously not nice for you. The good thing with the pump is that it drip feeds a very small amount of insulin regularly throughout the day and then you bolus a measured dose for what you eat, thus meaning it mimics the way the body works so it is far easier to keep your sugars level. Carb counting was a challenge at first but you get used to it quite quickly and now I have an idea of bolus amounts for most meals. I also love the fact that there are NO banned foods with the pump. As long as you know the carb content you can have a slice of cake if you so wish You do have to be quite strict with yourself in terms of glucose testing regularly before and after meals and during the night too when you first get the pump.

The one thing I noticed when I got the pump is it is a total re education about my diabetes and its control. You will need to change the way you think as things are v different when on the pump but as I said before I love my pump. I would definitely ask your diabetes team. Mine is being funded by my local PCT.

The hospital gave me the aspirin as first time moms are apparently more likely to suffer pre eclampsia and diabetic moms even more so. Just one a day helps keep your risk down but only from 2nd trimester onwards.

Its taken a while but now I have started to feel baby movement and had my 20 week scan my worries are (mostly ) alleviated and the fact that as a diabetic I have seen my midwife, diabetes team or obstetrics team at least once a week since I got pregnant gives a lot of reassurance.

Keep me posted with your progress xx

Hi Cupcake,

Where do you live? And who said you could not get a pump? When I moved to London, my GP was adamant that I would not get one, and did not want to refer me to the hospital for diabetes care as they hold a diabetic clinic in the surgery. I insisted, however, and my specialist at the hospital approved me for a pump almost immediately based on the number of hypos I was having (1-3 a day) and the fact that I was TTC. It is important to make sure you are speaking to the right person, and not let your GP tell you how to manage your diabetes, as they often don't know much about Type 1. My GP has told me many things that the specialists at the hospital have said are wrong and applicable only for Type 2.

That said, if you are a new diabetic they may be worried about overwhelming you with information, as some people have problems with the technology of the pump and carb counting. It was really easy for me, though, and my diabetic nurse said that usually it is people who don't have much exposer to technology and gadgets that have problems.

Hi Josie, I live in the North East. I'd actually gone to my GP asking for a continuous glucose monitoring system (that sets off an alarm if you're too high or too low). They are expensive but would give me some of my confidence back as at the moment I'm on a constant hypo watch at work, when shopping etc. Basically he said I didn't have a cat in hell's chance but that, due to the amount of hypos I was having, could possibly qualify for a pump - but not until after my pregnancy (perhaps 'cos there is an adjustment period of sorts?).

In terms of carb counting I've repeatedly asked to go on a course but our GP won't allow it until you have been diagnosed 18 months (perhaps until your pancreas has totally given up the goat?)

P.S. Had a diabetic nightmare the other night - I was convinced I'd doubled up on my doseage after forgetting I'd already injected. Ended up in hospital at 2am, poor hubby in tow. Still don't know if I did or not but my sugars suffered as a result as I over compensated with Lucozade. Ahh if only people knew the shite we have to go through!

xx

Oooh also Joise - didn't see your earlier message. How funny we're the same age too! Yes I am still totally getting used to being a diabetic - let alone this pregnancy malarky! I have put my heart and soul into getting it sorted but there are still days when I feel I just can't bloody crack it. My poor husband is dememted! x x

cupcake you can do your own carb counting practice now. There's a Rosemary Conley diet book which tells you the glycemic index and carb content of pretty much everything you could fancy to eat

Thanks Miss C. How do you relate that to the insulin you take? At the moment my only frame of reference is that I know how much to take with a slice of bread which is about 23g of carbs and so if something is say 56g double the dose. Is that carb counting or am I completely off?

I'm not pregnant right now but i do have type 1 diabetes (diagnosed when i was a kid) and now have 2 healthy children so i do know what you're going through!...I don't have a pump, did it all on MDI

If i can help at all ask away!!

Hi Paddyclamp - thanks for your message. It's lovely to hear from someone with diabetes with two healthy children! The most scary thing for me is looking on the internet at scary statistics - baby is eight times more likely to have a birth defect etc. I just don't know how I would cope! At the moment I just feel it would be a miracle if I was handed a healthy baby. Did you have natural births?

I am currently working on a 1 unit of insulin to every 10g of carbs and that works for me right now but the trick is understanding that as your pregnancy progresses and your insulin resistance increases, your insulin needs can double, even triple! However your diabetes team will work that change through with you. I have been given loads of info and a huge file of instructions and guidance. Its a lot to take in definitely but well worth the time and energy.

That sounds about where I'm at too Miss C as I have 3 units for 30g (a slice of bread). Are you on Novorapid and Insulatard? I have had appointments at the hospital every two weeks with my diabetes 'team' (diabetes consultant, diabetes nurse and obs) but they don't really give me any new info - just look at how I've been doing blood sugar wise...

Hi cupcakebakerer..i was told they would like to induce me at 38 weeks and i had a lot of extra scans eg the heart scan and then monthly scans after 20 weeks

With DS i went into labour spontaneously bang on 38 weeks..DS was 10lb despite all the growth scans saying other..of course we are prone to bigger babies..everyone was surprized because my hba1c had been good throughout the pregnancy..but they did say diabetes wasnt the only cause of big babies..it was a text book labour but of course because of DS's size there was a bit of difficulty getting him out!!!

I had been warned that his blood sugar levels might have been very low at birth..they were on the low side but not low enough for him to have to go to SCBU

I had insulin and glucose drips all through the labour and we were both fine after the birth!

DD was born at 36 weeks and she was a C-section (for non diabetes reasons)..she was 6lb 14 and her blood sugar levels were very low so they gave her formula in the delivery room..i loved the C-section even though it was unplanned and if i had more kids i would defo have another one!

Diabetes was a complete pain throughout the preg with the constant worry that every dodgy reading was gonna harm my babies but they were, and still are, totally fine!

It's hard work but it's worth it :)

Hi Paddyclamp - thanks for that message, it has given me real reassurance. I'm glad you said that about C-Section. I know this is going to sound like I'm a bit of a chicken (well I am maybe a bit) but that's honestly not the reason I really want one...I just think there are so many things to worry about as a pregnant diabetic that it would be useful to take some of the drama out of the birth and have a date, relaxed medical staff around you etc. I am already worried about waters breaking somewhere random, not being able to go to my own hospital who know all the issues etc etc. I just don't know how to go about explaining all this to the consultant without them thinking I'm just after an easy ride! Do you have any advice?

I don't know if any of you can help but there is another little worry I'm having at the mo...I've been told to get blood sugars down to 7.8 within an hour and a half after eating and to test for ketones if over 10. My reading is usually under 7.8 after around 2 hours but I find it nigh impossible to hit the one and a half hour mark. I've tried explaining to the consultant that if I had any more insulin then I'd be looking at repeated hypos but they seem to dismiss this. On the other hand my GP (who is a diabetic specialist) has said to ignore the one and a half hour target as my insulin doesn't really start working until the two hour mark and that I'm doing fine. Arrgghh! The other thing is if I test about an hour after eating (say if I'm driving and need to) it's always over 10. Consultant says I need to test for ketones, GP says to ignore the reading that early on as it's the nature of having diabetes. So confused! Does anyone else have this problem?

Hi cupcake and all
i too am type 1 have been for 34 years and i am 5 weeks pg 2nd pg.
I have a pump and this was given after i had complications in my 1st pg.
Under NICE if mdi fails you can get a pump and especially if trying to conceive or are pregnant. Speak to your hospital and push if you want it. EVERYTHING boils down to available money so ask them to take the ruddy green plants out for a week and you would get one. Sorry to grip about money but i have had years of experience of shoddy spending in the nhs. i would check the ketones if after 2 hours your bs is still high. for me i get high sugars 1st and then come later lows but so far on the pump no build up of insulin. My consultant also wants the 7.5 1 hour after meal this is ok if i only eat veg and rice or pasta goes in and no chance but 2 hours spot on. take care all x

Hi cupcake,

Thanks for starting this thread...it is really helpful! And thanks for sharing, Paddy.

In terms of you sugars post meal, have you spoken to them about taking your insulin earlier before eating (like 15 min or half hour before)? That's what I was told to do when I was on MDI.

Since becoming pregnant my numbers have become more unpredictable. I'll have multiple lows for a few days, and then for no apparent reason start running high. Luckily, my high numbers on the pump still tend to be under 10, which is good.

Hi Josie, no problem - it's so lovely to hear from people in the same situation for some reassurance.

What a great tip! No one has ever mentioned taking insulin early to me. I had considered doing it but thought that there must be some reason why not to and so haven't. I am definitely going to ring my diabetic nurse today and ask about this.

That's really good that your high numbers are below 10. By that do you mean 1-2 hours after eating? I just can't stop mine going over 10 in the first hour/hour and a half after eating and now I'm worried that the damage has already been done to bubba! [:(] 99% of the time they are spot on 2 hours after but I'm concerned that's not good enough. What do you think?

Hi Cupcake:

You're getting some great advice here.

I'm a longtime type 1 who is pregnant with my second child, and had a medically-intensive but healthy first pregnancy three years ago.

You may want to check out some other resources, such as diabeticmommy.com, the pregnancy boards on diabetesforums.com, and the Yahoo groups PositiveDiabeticPregnancies and DiabeticMoms. They are all women with either diabetes talking about every aspect of diabetes and preconception, pregnancy, delivery and new parenthood.

My book, Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby, came out earlier this year from Demos Health. It's the insider's guide to pregnancy with type 1 (though I talk to type 2 women as well) I wish I had when I was first thinking about pregnancy. I talked to more than 50 women with type 1 and type 2 about their experiences. Email me if you'd like more details.

Good luck with everything!

All best,
Cheryl Alkon
author, Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby
www.cherylalkon.com/book.php
Lyrehca AT gmail DOT com

Thanks Cheryl!

I'm going to check out those resources as soon as I get chance. It's a worrying time being pregnant and diabetes increases that a hundred fold I reckon. And - as supportive as family and friends try to be - I think it's also a time when you feel quite alone as it's only really you who understands how it feels.

I am going to message for more details as soon as I get a spare minute.

Thanks again for posting that information.

I, like Paddy have 2 children and did both pg's on a pump. have had diabetes for over 30 years, since 1. If I can help, please ask.

Hi girls - just wondering how you're all getting on. I have just had news which has put a beaming smile on my face and needed to share with people who understand. Had my HBA1C back for first trimester and it is 5.9! I am relieved but, as always with me, still worried. We've also had our 12 week scan and all looked well. Let me know how your pregnancies are doing!

Hi all- I am also type 1 and was diagnosed at 28 - I have threee children (now 6, 4 and 2). The first two I had MDI and the third I got a pump as I was struggling. I did have problems with all three pregnancies - pre eclampsia and induced at 36 weeks with first, pre eclampsia and c - section at 37 weeks with 2nd and had emergency section with 3rd at 34 weeks. My Hba1c was around 6 for the first two and around 7 for the last. I think I was just unlucky in my pregnancies BUT I have three very healthy children. I also fixated during each pregancy on problems and what would happen at delivery e.g I didn't want the sliding scale, didn't want to be induced etc. Do try and relax and enjoy the pregnancy - it is so stressful managing the blood sugars and I was always so jealous of friends and the 'normal' pregnancies.

I would def be prepared for the baby's blood sugars dropping after birth - this happened with all of mine and it always suprised me. I expressed colustrum for the few weeks before having each but they still ended up with top up formula feeds in the early hours.

If I can help at all please ask.