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?

Tea, your food sounds good. Watch out for granola though which can be very sugary. I often have raspberries, Greek yoghurt and a mixture of seeds and nuts on top with a drizzle of honey. Nice and low carb. Eggs and avocado with a small slice of rye bread can also be a good one!!

Indian takeaways are much better than Chinese - they tend to be packed with sugar. Takeaways and restaurants can be a bit of trial and error sometimes. When out I tend to avoid pasta dishes and things with mash or rice. I don't inject in restaurants until the food comes (or at least some of it) just in case it takes forever!!!

Sounds nice! I like rye bread.

The granola is 10g carb for 22.5g cereal so think with some yoghurt or berries it's probably ok.

Do you do any lower carb baking? I've made a few things like muffins with almond instead of flour they were nice if a bit fiddly!

Did you breastfeed? What happens with insulin requirements when you're breastfeeding? I fed my other children for a long time but that was pre diabetes and insulin.

I view something which is nearly 50% carbs as quite high carb and it also depends how quickly it makes you peak. Having said that if your readings after an hour are good just go with what you like!!

I'm not much of a baker so haven't bothered. I used to be a regular poster on a diabetes forum (www.diabetes-support.org.uk/) and one of the lovely ladies who ran that was an amazing baker. They have a whole section of the forum for low carb recipes and she put tons of baking recipes on there. Worth a look if you're keen! Her name is Patti - if you go over there tell them that 'Lady J' said hello! Note it is not the diabetes uk forum (ie the charity) which I found full of nutters dispensing dodgy advice!!

I breastfed DS for two years. To be honest by the end of pregnancy your insulin is so different to 'normal' it is hard to compare what that's like vs breastfeeding vs before if you see what I mean. I do remember some hypos at the start but once the supply is established it settles down nicely... I think!

I bake a fair amount but after the traumas of childhood & being forced to use fructose (euuuugh) to make the end results more diabetic friendly (hah), I go for full whack these days. Just tend to lower sugar amounts.

I breastfed 15 months. Loads of hypos in the beginning - the effect was like going for a proper run. Mostly soon after the feeds, sometimes later (bit chaotic so not always sure where the hypos came from). But as mrsnucky says it did settle after a while, tho having glucojuice scattered all over the house (reachable when unable to move) was useful until had completely finished with bf.

One of the advantages of the pump is being able to put a temp basal rate for the feeds, to counteract the 'exercise'.
MrsNucky amazing control! But at a cost if you are having to get up during the night to treat/correct. DP is not on the nice criteria I think, but there is another list of recommendations where it is mentioned. Input website is useful for all this, but sounds like your team is supportive & pro-pump so you are hopefully ok if you want to try it. I really like mine & wholeheartedly recommend giving it a shot.

Thanks ripley. I've basically always thought I'd eventually get a pump. But I feel a bit weird about being hooked up to something all the time. Does it feel weird? Is it uncomfortable? Do you have to dress differently to hide it?

I'm guessing that during maternity leave might be a good time to get going with a pump as I'll be at home at least and not dashing about at work (although obvs still very busy!!). But I'll have time and privacy to do all the testing in the early days etc etc.

pump heavy post warning
Yeah, maternity leave would be a good opportunity to test the pump. Took me about a month to get a proper hang of the settings, tho this was without the complications of a new baby... But then you'd soon hopefully get the benefits with night feeds etc.

For the first few weeks I did kind of feel more disabled/faulty than I had for a long time as the pump was like a constant, visible reminder. Especially the tubing. But it was not a bad thing, just took a while to adjust from injections to this. Now I'm very used to carrying it around tho I still occasionally storm past a door handle with the tubing hanging loose and yank it all out. But much less often than I did in the beginning.
There's also a pump without tubing.

I tend to wear mine like a pager, in a holster/case on the belt so I don't really try to hide it. If I'm wearing an evening dress (not very often!) I sometimes have the pump on a leg or a upper torso strap. But they are easy to hide in normal clothing & you can use your phone or meter to bolus so you dont need to dig the pump out every time you eat.
My current pump is waterproof but I still take it off for showers and swimming.

The only thing I've struggled with are the infusion sets. The type I was using kept on kinking (teflon cannula which can bend/kink when inserted and you end up getting no insulin, and it can take a while for the pump to warn you so unless you keep an eye on levels it can be bit disastrous...). Now I'm using metal sets (hated the idea originally) which have been brilliant, even tho I am a bit more aware of them. But for the security it's worth it.

Hope that helps... Not that relevant for you at the moment MrsNucky I guess but am happy to share more if needed.

Thank you ripley that is so helpful. The issues you describe are just the sorts of things I'm worrying about like yanking out tubing!! Guess I will do my research during pregnancy and take it from there...!

Yes thanks for all the advice Ripley. This is something I've been thinking about too... I guess for the time being in going to try and make it work with pen injections, but am definitely open to the possibility of a pump.

Right. Now for an abstemious low carb dinner. I went a bit mad in Carluccios at lunch and ate foccacia and lasagne . Actually did well on the post meal readings however now, 5 hours later, it's on the rise!

Ha! Pasta does that to me too. At least as it was lunchtime you've enough time to sort it!!!

I was at a birthday party with DS earlier and managed to avoid all of the delicious looking pizza, cake and popcorn so feeling quite virtuous. Having some potato dauphinois this evening though so will need to get bolused up!

Afternoon. Just checking in, no news. Everyone ok? Have antenatal diabetes clinic tomorrow and midwife booking appointment on Thursday. Good run of numbers to show off to them this week. Not sure this weekend will be the same as I'm away with friends. Any ideas on Chinese food? I'm thinking of having something non sweet like beef in black bean sauce and just vegetables and skipping the rice completely.

Ripley it was so reassuring to read your post. i've been waiting to get a pump for a while and got it last month, which coincided with my being about 7 weeks pregnant. It's been amazing for my BS but tbh deep down I'm having trouble adjusting to it - I hate seeing it sticking out of me and reminding me of my illness; that I can't even pull down my knickers to go to the toilet without being conscious of pulling out the canula/dropping it; changing it every 3 days (such a hassle) and the fact that it gets caught on something and yanked out at least once a fortnight.

But those BG numbers don't lie and it has been absolutely amazing for that so I am grateful. The first month of pregnancy when I was still on pens was a nightmare - constant up and downs, I am in awe of all you ladies who are doing it!

On a side note, having had pretty amazing control for a few weeks, I was surprised that over the last few days for no reason I've started to get really high readings from about 11pm to 2am - well after dinner. Is this pregnancy related do you think?

And last thing - anyone interested in CGM. I've been self-funding the Freestyle Libre for a year and it was an absolute life changer, can't recommend it highly enough. It lasts two weeks at a time, which costs about £60, and works with a little tamogotchi-sized scanner which I can swipe across the sensor on my arm to get a reading. In between swipes it still stores info so you get a graph you can look at. The best thing is it doesn't even need to touch the sensor on my arm so i can swipe through a coat/jacket/jumper whatever.

However my doctor has now put me on a CGM that talks to my pump for a few weeks to get some data and also to hopefully prevent frequent hypos. That one costs £60 per sensor but each sensor only lasts 6 days. It's also way more faffy to get on and off.

But if anyone has CGM questions I'm happy to answer them if I can!

PS Teainbed Sadly i've sworn of Chinese food because in the past it's always made my sugars go crazy but chicken and sweetcorn soup should be OK right and also how about spring rolls?

sugarcoma is it the enlite (2) sensor? The 6 days can be extended quite easily, can describe how if that's the one.

Got the harmony results today and all good, gender is in an envelope which we are yet to open. Bit weird...

Yesterday's low carb meal discovery: finally tried courgette pasta (courgette cut into thin spaghetti-like strands) with pesto and mushrooms. It was surprisingly good! Needed a lot of cheese, mind.
Not had Chinese for ages, but am now thinking about tofu in black bean sauce and cashews...

Hope the booking appointment goes well esker - I liked how normal it made me feel, nice & sensible midwife and very little talk about t1.

I love courgetti, especially as carbonara. I sometimes add a tiny bit of spelt spaghetti. Yes to lots of cheese! I like cauliflower rice too, if only I could take that to the restaurant!

I seriously wouldn't have chosen Chinese but got to eat something I suppose. Soup and spring rolls sound good. Even if it was Italian I could have had a salad or something!

Sorry teainbed - Monday evening brain messing up with names - good booking appointment to you !

I got really into courgetti over the summer but haven't had it for a while!! Must get some more. The butternut noodles are also good and a bit less watery. Agree lots of flavoursome sauce and cheese needed!

I tried a pouch of cauli rice once and hated it. Am sure made fresh would be better - do you all just blitz up your own?

I definitely want to look into the sensor meter. I find I don't test nearly often enough any more. Used to be so much better at it but with DS, work, house I just don't do it as much as I should. Probably 4-5 times a day instead of 7-10 during pregnancy. Would be great for it to be so much easier!! How does the sensor get in there? Does it have to be inserted by a medic?

Meanwhile - had my 12 week scan today. Turns out I'm actually 13 weeks exactly and due 27 March. All seemed well on the scan. Ended up telling my boss at work today as it has felt like a heavy burden and I knew she'd be supportive. Guess I should have waited for all clear on bloods but felt it was time to 'come out'! Baby was in all sorts of weird positions and at the very end of the scan actually turned face on to the monitor and waved both hands at us. Slightly terrifying as it looked like a little skeleton!!!

Currently debating when to tell DS. Think probably this weekend. He's 3 so god knows what he'll make of it!

Oh the pouches are horrible, fresh stuff is nice. Just blitz the florets in the food processor or grate and microwave for 6 minutes. Then you can add spices to make it a pilau or egg fry it or chop herbs through it more like couscous. Have also done mashed cauliflower instead of potato which is gorgeous and the pizza base which is bizarre but actually quite nice!

I am pondering the whole CGM thing, I am not bothered by the money but the wearing something constantly, though it would be nice not having to do finger pricks all the time. But it your control is very good what else would it add? I think we'll all end up with pumps eventually, the technology is incredible and it's probably just a case of when not if there's an artificial pancreas that will do it all for you.

MrsNuckyThompson The CGMs - both types I've used - are designed to be applied by yourself at home (although my DH helps me as I hate doing it). They both basically have an applicator with a sort of stapling motion that you press down and attaches them to your body, and they stay on there with tape.

With the Freestyle it's a plastic disc about the size of a 50p coin (although thicker) and goes on the back of your arm - incredibly out of the way and you forget it's there although I am a little self conscious of it when wearing t-shirt. It comes with sticky stuff on the back so once you 'staple' it on it pretty much stays there for two weeks (it used to peel off occasionally mid-way through the two weeks and I would have to stick plasters over it to keep it on but I think they've improved the stickiness since I haven't had that for a while).

The Medtronic CGM I'm now using is much more faffy. Similar applicator to the Freestyle but that's to insert the filament bit (that checks your sugars) and then you attach a transmitter type thing to it afterwards (so it can talk to your pump) and then you have to stick like 3 stickers on top of it to keep it all in place. It's on my stomach and looks terrible so I'm not v impressed with it atm, especially after the Freestyle.

Apart from only having to finger prick twice a day (to double check calibration) the thing I love the most about my Dexcom CGM is that it gives me a little arrow indicating if I am rising or falling.

So if it says 4.2 with a diagonal upward arrow I know I don't need to eat any carbs immediately, but just keep an eye on it.

If I was 4.2 and level arrow I would keep checking to see what was going on but not necessarily eat any carbs.

If I was 4.2 and diagonal downward arrow I would have a small portion of sugar.

4.2 and pointing straight downwards arrow would mean a slightly bigger portion of sugar probably in liquid format.

Has meant that I can really control my bs below 4.0, which has hugely helped my hypo sensitivity and awareness, which whilst I hadn't lost, was beginning to become a little less clear when my HBA1C was below 40.

Not sure if all the CGMs do this though!

Wow the rising and falling indicator sounds AMAZING! That alone is enough to tempt me. Often after meals containing carb and fat I have a faux low, and later BG shoots up. Would be good to have an indication of what is going on behind the scenes.

Thanks for all the tips CGM people!

Finally found a non problematic breakfast (in terms of BG): egg mayonnaise. However as I eat breakfast in my office with others, I think it is socially problematic. I don't want to be 'the person who stinks out the office with sulphurous eggy breakfast' . But better for my baby so so be it!

esker - I've been having hard boiled eggs as well the last few days. I find that the smell just 'hits' when I take the lid off the tupperware and soon disperses. At least that's what I'm telling myself ;-)

so easy to take with you on the go and also nice chopped up with some avocado!

today I had a pretzel - not my best day carb-wise really!

Have had antenatal clinic and community midwife booking this week. It's all very nice but feels like total overkill! I'm not complaining obviously but nothing is happening just now and I have another appointment in two weeks!

Community midwife schedule is virtually identical despite being seen in the hospital fortnightly.

Was pleased to hear the cardiac scan will definitely happen and I'm starting aspirin at 12 weeks and going to have growth scans too. Blood sugars are very good, consultants were pleased. But I'm planning an epic post delivery meal.

Good for you tea. I would double double question the need for you to see the community midwife. I see the diabetic nurse and nutritionist fortnightly. At the same appoint, I see either the consultant OR midwife. So I'm seen fortnightly, but only one per month by the consultant and on the alternate fortnight the MW. Does seem like total overkill at this stage - you do have a life to live!!

tea what is your post delivery meal of choice? The other day I actually messaged my husband with the following list of demands (for late March):

Pizza (both filthy Dominos deep pan kind and naice thin based Italian kind)
Pasta (esp tagliatelle and spaghetti)
Tortellini
Crunchy nut cornflakes
Cheesecake (any kind of cake actually)
Milkshakes

As for today, it has been v straight laced:
Breakfast: melon
Lunch: salmon salad and more melon
Snack: tangerine

Nucky I have to mass boil another batch of eggs... Getting through them fast. Good idea with avocado. Makes the idea of a lone boiled egg seem less bleak!

I've got a secret confidante at work who is also pregnant and has gestational diabetes so we have been having whispered conferences in the staff room comparing notes about our hospitals. So nice to have someone to conspire with.

Haha definitely cheesecake for pudding! Something disgusting like salted caramel. Main meal, probably pasta too, something like tagliatelle with a creamy sauce, bacon maybe OR a real disgusting pizza like BBQ chicken and bacon can you tell I've thought a lot about this

Are you on any of the pregnancy and diabetes FB groups? They're quite US focused but interesting reading nonetheless.