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?

Thanks Ripley, that is reassuring to hear. My DS was 7lbs 11 so not crazy big. He also measured not too big on the growth scans. He didn't have any low BGs after birth so really I did quite well there.

However this baby is measuring on 97th percentile and big around the tummy in particular. So I'm just not so sure that the control has been as good as the hba1c would indicate?! Anyway, ultimately I just hope that she is healthy and arrives safely!!

Everyone ok? I'm just checking in. Back to decent sugars now that I'm home and eating and in a routine again! Only need to re-order everything on repeat prescription, I'm going through strips and needles like nobody's business. Baby is moving loads, it's really mad at times.

Fine here! Getting to the really fed up stage and at this point thankful that the diabetes means there is a hard stop end date in site. Only 3 weeks to go. If 'normal' I'd have 5 weeks til due date and then up to 2 weeks over that!!! How the fvck anyone goes another 7 weeks from this point of giganticness and discomfort is beyond me. Maybe that is one teeny tiny good thing about this disease?!?

Good things are settling down for you tea.

*in sight

(See? Baby brain).

Yes I see what you mean! I am grateful I've never had to do the car journey to hospital whilst in labour, I think that sounds horrendous!

Hi all. 36 weeks today and feeling enormous and so very tired. Have been having the odd pain in the nether region so suspect this baby is probably engaged and quite low now (possibly due to sheer bulk ). Also intermittent lower back pain which I didn't have with DS. Have clinic tomorrow so will know more about what's happening then!!

Have to admit have been completely stuffing my face. Prob just getting to the 'fvck it' point now...

Have packed hospital bag today and the way I've done it it's like I expect to be for the long haul like last time!!

How is everyone else?

Hi MrsNucky I'm 35 weeks and so uncomfortable - back, feet, hands plus the pump is driving me crazy - turning over in bed is hard enough as it is without worrying about where the flipping pump is.

Have also reached the fuck it stage - am going to stuff my face full of Nutella pancakes tomorrow. Mornings are a nightmare though and am on ten times the amount of insulin I used to be for breakfast

And definitely agree about having an end date in sight - it's the only good thing!

31 weeks here! On a boiling hot hospital waiting room as we speak. Numbers are ok. I'm getting organised.

Not long now you two! Fingers crossed we get to hear about some more babies soon.

I also had a weekend at a party just there and ate chip butties and had an enormous fry up. I have even written 'enormous fry up' on my blood sugar diary as I seriously can't be bothered writing 'hash brown, toast, tomato' etc on the sheet. Post birth huge pizza and cheesecake are going to taste amazing though.

sugar - one tip is to chuck your DH out of the bed. Mine has well and truly been ejected and it makes it much easier to get comfy when there's only you in the bed. So if that is an option I'd consider it.

tea - you are getting there too now!! Why do hospitals have to be so flipping hot?? When packing the bag yesterday I was looking at my pyjamas thinking about how warm I was going to be trying to sleep!!

Hello all! Sorry I haven't been on for ages but I've just been catching up. Exciting that so many are nearing the finish line! You are all going to enjoy the post birth indulgence SOOOOO much. I have eaten so much pizza since Francis was born. There is a Franco Manca near the hospital where I regularly go for lunch

Ripley, I'm sorry you've been so poorly - I hope things are much better now?

I ended up having a hypo yesterday and had to improvise to treat it as I had nothing on me and no change for vending machine in hospital. So ladies I was reduced to eating.... sachets of sugar . It was not my finest moment. Don't know if any of you have actually eaten a mouthful of sugar, but it is not pleasant! So the moral of the story is, make sure you have nice hypo treatments that you actually enjoy readily available!

Baby Francis is now 9 weeks old (gestational age 36 weeks). He is doing well but progress is slow, with inevitable setbacks. His main problem are his weak little lungs, but he's having another course of steroids now to help him along. He's absolutely gorgeous though and getting cute and chunky

Great update Esker! Glad things are going in the right direction.

What happened to your insulin needs after you'd delivered? DSN said yesterday after delivery they might not want me to use any short acting insulin! When I asked why she said that the targets could relax obviously but also that you'd risk loads of hypos with breastfeeding and that it might take a while to get the correct ratios established again. Which I can understand but it would be really weird not taking any for meals!

tea what I did last time was just go back to my ratios and long-acting levels from before conception. That's also what I've been asked to do this time and will do.

I personally didn't find breastfeeding had a huge impact on blood glucose levels.

Personally I think your DSN sounds like a bit silly!!

Yes I think that sounds more sensible MrsN. I'm planning on eating a lot of food post delivery!

I went onto pre-pregnancy settings immediately after birth and on top of that was on extra reduced ratios & basal for a good few weeks after delivery. The first few days especially for some reason.

With me breastfeeding did have an impact, like proper exercise for several months I think. It calmed down at some point but was going hypo constantly to begin with.
Guess you just won't know how your body will react, but make sure you have hypo treatments scattered ALL over the house - within easy reach if you are unable to move...

That's a good tip Ripley. I've just discovered mini bags of jelly babies, each packet has got 6 in with 24g of carbs. Stops me eating a whole bag!

Rapid - I think the key thing for you is to understand how very very hard it is to tightly control diabetes when pregnant. Pregnancy hormones play total havoc with blood glucose levels, pregnancy can make you massively insulin resistant AND you're also dealing with all the usual issues with pregnancy like morning sickness (plays havoc) and cravings/ hunger (plays havoc).

The sheer work and effort involved in keeping on top of this is exhausting, depressing, guilt-inducing. I mean, type 1 is all those things anyway although most of the time it's just your own health you're dealing with, not the health of your precious unborn child. We KNOW what we're meant to be doing, but it doesn't always mean it is easy or even possible to do. It is complicated, multi-faceted and really quite an art so please don't just quote the targets and assume that we're just being lazy in not hitting them.

The diabetic midwife I've had this time really 'got that', was supportive and sympathetic. Others I have come across when during my first pregnancy and this time when she was on holiday or whatever have often just been so glib with comments. For example:

• testing fasting urine, finding 1+ of glucose and then saying something like 'you need to watch that' or worse just a raised eyebrow and 'you've glucose in your urine'. I have horrendous dawn phenomenon and huge levels of insulin resistance in the mornings. Most days I CANNOT EVEN HAVE BREAKFAST because it is simply impossible for me to eat anything without risking a massive spike in glucose. When you're pregnant and tired that is hard going without 'helpful' comments like that.

• repeated comments about bruises on my bump/ stomach. I inject into my stomach, I'm not being beaten. Get used to it.

• having a cursory glance at my blood glucose diary and then commenting on one or two hypos I might have had and questioning me on how on earth I might have allowed them to happen. The targets set for pregnancy are almost impossible to hit without either eating very low carb OR effectively injecting too much insulin and then having to snack an hour or two later to 'catch' the dip. It's horrible and hard and I swear to god a little hypo is nothing so good lord stop going on about it.

My mind actually boggles that anyone thinks that something relevant about diabetic pregnancies could be taught in a one day course. A little knowledge is a dangerous thing. Etc etc.

However good to know that you're interested and I hope it goes well for you!!

Rapid I'm guessing you work on the wards or in acute area from what you've said. I would echo what MrsN said but also would add a few things based on stuff I've seen in other groups. I think women need really accurate information about what they need to do in different situations. So do you give long acting insulin the night before a C-section? What do you advise if someone is fasting for a section and they have a hypo, how should they treat it? Your hospital will probably have a protocol for T1's on the ward and in labour, do you know it and who to call for help with T1? Finally you'll have no control over the catering in your hospital but understanding the different food choices diabetics make and why. Some will eat 'normally' others will choose low carb and all these choices are valid. Hospital diabetic menus don't sound great so support women in making a choice that suits them. No food is bad or banned. Hope that doesn't all sound patronising!

Great comments tea.

Reading mine back I realise I came across as quite harsh. I really didn't mean it to come across like that, just some of the exasperation coming out.

rapid - I'm likely to go in for steroids this week and I honestly can't for the life of me understand why the HCP professionals think that a highly skilled midwife who is at the same time almost completely untrained in T1 is qualified to monitor and potentially even treat blood glucose levels in these circumstances.

Sliding scales are beyond me as well except in really dire emergency. If it was so easy to get it right as to just follow a chart and give dosages of insulin resulting in great blood glucose levels, why on earth would we not be doing that all the time?!? Actually if you get the chance to ask this at your course I'd love to hear the answer!

I refused a sliding scale the last time. Unless a Diabetic Specialist Nurse or Endocrinologist is going to personally adjust my insulin I'd far rather just do it myself thanks!!

MrsN it doesn't sound harsh, more the voice of experience! You are right though sliding scales should be for emergencies like DKA but in reality they seem to be used routinely for pre and post operative care and in situations where a well diabetic could probably manage things much better. But junior staff feel in control because all they have to do is set it up and let it do its thing!

Good luck with the steroids, assume you're heading for induction soon?

tea - going jn for final examination tomorrow. If cervix favourable for induction they will start there and then (using cooks balloon, not pessaries/drips) but if not they will schedule a section for the end of the week. Steroids only needed for section.

37 weeks tomorrow. If delivering vaginally they don't want to leave it much longer as baby is a little bigger. They're happy to wait til closer to 38 weeks for a section.

Either way seems like this week is the week!

Ooh good luck MrsN! Will be thinking of you.