Type 1 Diabetes Pregnancy Support Thread

[MrsNuckyThompson]

Wow - with a catchy title like that, who could resist? I was part of a lovely supportive thread like this one during my last pregnancy which was nearly 4 years ago now. I'm currently around 6 weeks pregnant with my 2nd DC. DS is 3.4

Anyone want to join me?

Aw Esker what a lovely update!! Glad to hear things are going well if a little bumpy along the way.

Think of you often and am amazed - as you say - that your baby is out while I'm still humphing mine about.

Feel officially enormous and getting lots of comments about size and am I sure I haven't got twins in there. On the other hand some days people willl seem amazed that I'm 'only 29 weeks' or whatever. You can't Win.

I'm still fighting the hideous fight with fasting glucose. Some nights high, some hypos and completely unpredictable morning readings (this week have ranged from 4 to 13!). During the day pretty stable tho.

Nucky the twins comments are annoying aren't they? Like why comment at all, is that ever a nice ring to say!

I'm experimenting with new ratios, have upped the evening meal one with good success so feeling a bit more confident.

Growth scans booked.

Hope everyone else is well.

I was 29 weeks on Friday and to be honest my sugars have been out of control since before Xmas. I'm seeing the nurse every week and we upped my basal and bolus again (with instructions I'm to gently increase basal amount every day in between seeing her) but she also put me on metformin, which is usually given to women with gestational diabetes apparently.

It seems to be helping but is also yet another variable to have to take into consideration when bolusing, eating etc etc - does anyone else have any experience with it? And why didn't they give it to me before if it's so good!?

She also suggested I go low carb but I'm really struggling (am blaming the cold and dark) and I'll be 'good' during the day and then have a mini-binge on biscuits in the evening which obviously I bolus for but still feel terrible about because sugars will rise to 11 or so and take ages to come down...

That sounds really hard sugar. Metformin works on reducing insulin resistance in type 2 and gestational diabetes, I think someone else on here might have tried it. It can cause terrible diarrhoea, have you started it yet?

I ate really low carb before I went on insulin and before I was pregnant and the start was the hardest bit but once I'd been off the really high carb stuff for a while I sort of forgot about it! Typical day was eggs or bacon or Greek yogurt for breakfast, snacked on cheese and nuts, salads for lunches with chicken or fish or soup and protein and veg dinners. Stuff like the cauliflower rice and pizza wasn't that bad and celeriac 'chips' or mash also nice. Occasional dark chocolate or low calorie hot chocolate with cream for treats. I'm still fairly low carb now.

sugarcoma that sounds really hard. If it makes you feel better I have had to up and up and up my basal and bolus. Taking around 30u Novo for a 'normal' breakfast.

My overnights and fasting sugars are erratic. There was some talk on me going onto metformin because of fasting readings. As tea says it helps T2s who are resistant to insulin rather than not producing it like us. T1s don't normally get it because it is a bit pointless (for most) if you are already injecting insulin. However they must have decided that you've become very resistant.

Ultimately we decided that I shouldn't bother because, while it might help at night when I do seem to be very resistant (or more precisely from 3am onwards), it lasts all day so I risked totally throwing out the day time readings.

If it's any consolation the nice thing is that everything goes back pretty much to normal as soon as you give birth. Or even you will be low if breastfeeding (good excuse for chocolate). Assuming you'll have your baby by 38 weeks that means only 8 weeks or so to go!!!

Thanks tea and MrsNucky it just feels like I was 'good' for so long and then when my blood sugars went out of control (and nothing I was doing was helping) it's almost like, well what's a couple of biscuits going to do? But then of course I feel terribly guilty especially as baby is measuring big and the bad feelings caused by the guilt just make me want to eat more bad things! But looking at it like '8 weeks to go' definitely makes it more manageable (although also terrifying!)

They've started me on a low dose of the metformin so fortunately no diarreah yet but they want me to up it over about a week. It is definitely helping but just makes it harder to calculate exactly what to bolus because it's a variable I can't really quantify for in the way I can weigh some potatoes, calculate the carb in them and bolus for that.

Hey sugar, I feel your pain. I've been upping rates almost daily for weeks now. Pre-pregnancy basal was 13u per day and currently it's 26u. Ratios for breakfast and dinner are crazy.
My doc did mention that the weeks 27-34 are the 'worst' due the baby growing most around then, hence causing the insane resistance.

If I go over 10 (happens very easily), I correct with an old fashioned syringe as I find it brings me down faster. Some T1s on pumps inject all last trimester boluses with pens/syringes.

Regards being good... I'm generally low-carb but don't like to think of chocolate/biscuits/cake as a treat or reward or anything special so I eat them as and when I want, obviously trying to bolus well in advance (as with all food) so some pre-planning is required... Helps me to avoid binges, mostly.

Lovely to hear the news on your little boy esker. Hopefully you get a successful try off the ventilator soon xx

I've realised today that I can't have any 'free' stuff anymore, you know those smacks of under 10g carbs that you didn't need to inject for? I don't know if it's made a massive difference overall but I used to be able to eat a small apple or a single rich tea biscuit without insulin but clearly no longer!

*snacks clearly not doing smacks

No freebies for me, ever.

tea - advantage of being T2 and still jabbing some of your own insulin!!

I'm not T2!!!!! I have a slow onset version of T1, so a few functioning Islet cells are left. But definitely not T2 as I have the GAD antibody.

Sorry! I just remembered you just had some insulin left kicking around - couldn't remember your exact diagnosis...! Maybe pregnancy killing off the last remaining bits of your pancreas then?!?

Don't be offended. In any event Im personally not a fan of T2 bashing or any suggestion that T1s are blameless while T2s are not. Much of it still comes down to genetics for T2s and the media obsession with 'lifestyle factors' has I think lead to the point where T2s are vilified completely unfairly.

Don't worry, not offended! Think I'm getting resistant like everyone else in later pregnancy though.

Has everyone got long to work still? I'm 9 weeks and counting!

How's everybody doing? Had a second growth scan, baby is back to measuring normal fortunately - I'm inclined to think the last scan was wrong but my sugars have been much better since the metformin.

I'm 31 weeks today and no one's really talking to me about delivery options yet. I feel either way it's going to be down to an induction or a planned c-section (since baby needs to come out at 38 weeks) and I'm very worried about having a difficult induction and then ending up with an emergency c-section anyway.

What are other people's thoughts on delivery, especially MrsNucky and Ripley as you guys have done it before?

Hello sugar was just thinking about you lot!

Glad growth scan ok. I'm battling lows again for some reason, changed all my ratios but it's a constant game with no end or winners!

I'll be induced, have been three times before and it was fine. Certainly not pleasant and did get the impression that I wasn't ready to have a baby but had high BP so no choice really.

sugar. Talk to them about it but basically what I think is this:

Let them examine you at 36/37 weeks as they will want to do (likely several times). If the baby is head down and engaged and your cervix is favourable (i.e. has softened and perhaps started to dilate slightly) I would agree with them trying induction. However if the baby is not engaged and / or your cervix is not favourable (my obstetrician referred to it as 'long and hard like a carrot) then I'd ask to skip to the end.

In my first pregnancy I was very worried about a horrific induction and instrumental delivery or emergency c section. As it turned out nothing happened at all with the induction as DS was just not in any way ready to came out and I had a calm non-emergency C (although it is still classes as 'emergency' because it wasn't planned in advance).

I think the problem is that unless you know you really really want a section now, no one can really give you any more certainty until nearer the time.

I've told them I don't want another failed induction only to need a section. Apart from anything I don't want to be away from DS for any longer than needed and it took 2 days last time to establish that induction was not working at all (I didn't have a single twinge never mind contraction!). So I want them to give me a realistic likelihood of success and if I have another carrot I just want a section!!!

tea - might be worth a ring to your team. Mine worry about unexplained hypos as there is a very small risk it is a sign of placenta trouble!!! On the other hand it might just be a sign of your ratios changing again.

Hey, can I join please?
I'm 5+5 weeks pregnant, 39 years old and have been T1 since I was 8! This is my third pregnancy, first was fine except for being hospitalised for a month before being induced due to preeclampsia, but my lovely daughter was born at 36+2 after an emcs (because induction was too early in my opinion, and failed) and is great :)
I had a mc at 8 and a half weeks last May, so am really nervous this time around. I have a scan next week and my first appointment at the hospital.

Control is ok, apart from morning dawn phenomenon, which I always struggle with, but my basal rates have already increased, as have my ratios for eating...ahh hormones!

Thanks sugar and MrsNucky - it's just so helpful to know (to some extent) what to expect.

MrsNucky How did you find the recovery from the c-section? And tea How long were your labours with induction? Did you also need forceps/ventouse?

Hi Zyla Welcome and congratulations on your BFP! How old is your DC1? Are you on a pump or injections? And do you have a CGM?

So many questions for everybody! :)

oops I just thanked myself in my previous post when I meant to be thanking tea* Can you tell I've had two hypos today??

sugar my daughter is nearly two. I've just turned down the pump after looking at them, I don't need it to improve control (and after discussions have been to,d that it wouldn't be better than my current control as I am good anyway ;) ) because I didn't want something that size permanently fastened to me, I'd rather inject. But it's been left open so I can change my mind at any time. No CGM, though I'd quite like one, but they aren't on the NHS yet are they? So my poor fingers suffer from lots of tests. Probably 15 a day when pregnant! (I like the assurance).

Welcome zyla!

sugar they varied. The first was the full 24 hours of pessaries, 12 hours of drip, epidural and forceps. The second they just broke my waters and I had DD 6 hours later. The third I had pessaries and again they were able to break my waters and I had a four hour labour. No forceps for the last two.

MrsN I was at the hospital on Tuesday and everything checked out ok, think things have levelled off again!

Welcome Zyla. Interesting you've been offered a pump. My hosp are very 'tight' on offering them and only tend to do so for those with high hba1cs OR lots of hypos. So I've never been considered! Good for you that it is an option.

sugar - I found section recovery very easy. It is a little painful at first but my scar healed very quickly and cleanly and I was signed fit to drive after 3 weeks. I felt ready sooner. Never had issues with picking up DS and can't remember any particular issues (nearly 4 years ago!!). Compared to friends who've had stitches or other horrible problems with vaginal births I feel I got off lightly!! Of course compared to an uncomplicated natural birth it is far harder on you...

Hello all, old and new.
sugar - Like mrsN, I really was not ready for the whole thing at 38 weeks. Growth scans were fine and there was no other reason for induction then other than the (well controlled) T1.
Baby was head down but very high, cervix not much better - don't think they managed a sweep the day b4 the induction. Few people did suggest I ought to just request a cs and skip the induction as it was unlikely to succeed but I wanted the chance to at least try for the vd.
And the drugs etc did eventually work. It took a few days (started Wed afternoon - delivery Fri morning) and we ended up in the theatre, very close to a cs but episiotomy & forceps did the trick. I know loads of folk have horror stories with those but for me they were fine, no trauma.
The hormone drip and lack of epidural was a problem (after the dose got doubled). I will want to clarify the procedure on that as it just seemed bit insane to not be able to lower the dose when it clearly was too much. Had a rubbish midwife on duty at that time which didn't help (she thought beheadings was a suitable topic of conversation...). All the others we had were absolutely brilliant.

So yeah, there. Not sure if that's of any use... You just can never know how your body will react to it all! MrsN's suggestions sounded good tho.
And just try to keep an open mind :).

32w growth scan on Wednesday, bit nervous as my numbers have been all over the place. Curious to see the position tho - I simply cannot tell which way the baby is...

Interesting you're talking 38 weeks, haven't the NICE guidelines changed to 37 now? My first appointment is on Wednesday but when I saw my consultant last year for the pregnancy I lost, she said it'd changed to 37 weeks now?

Not sure about NICE - it's probably a bit flexible number i'd imagine?
In the beginning of the pregnancy I was under a different hospital and they let you go till 39 weeks, growth scans permitting. Current one aims for 38.

I'd be surprised if it was 37 weeks on the dot across the board tho, as even if babies are classed as 'full term' about then, their lungs can be bit behind in development with diabetics from what I've read.
And I've seen no new studies about placenta failure which is the thing that is always cropping up when delivery dates & weeks are discussed...

But these things do change - got my obs appointment on Wednesday too so will check! Considering how unready I was at 38 weeks, am sure induction attempt at 37 would have led to a cs for sure. And very small baby.