Type 1 Diabetic Pregnancy

[k53559]

Hello, I am currently 29 weeks with my second child but also got diagnosed with T1D at the start of last year so has been a very different experience to my first pregnancy - just looking for other T1D mums to chat about this crazy experience with?

I'm Type 1 and currently almost 20 weeks with my 2nd baby - I've only been type 1 for 3 years but had my first baby last year. Happy to answer any questions I can, it is a really tough time for diabetics, especially newly diagnosed!! X

Hi! thank you for your message, I don't know anyone else with T1, let alone pregnant with it so have felt a bit lost and alone with it all at points! How have you found both pregnancies? And may I ask how you delivered your first? Feel like I am now really starting to hit the insulin resistance and feeling terrible about any highs I have! Just hoping everything turns out ok in the end!

I'm finding the second tougher mentally but I had a crappy experience with a new DSN who told me I should have a flat line constantly and no highs. She told me spiking to 10 after meals was putting my baby at risk of deformity or stillbirth, I was mortified. I've changed nurses and they have confirmed that they expect highs.

I've also got background retinopathy from this pregnancy already in the first trimester. My sugars are actually well controlled though! It's so stressful isn't it?

I had an elective c-section with my first and plan to with this baby too. She was large for gestational age weighing 8lb 10 at 38 weeks but other than that all was fine! She is a very happy, healthy 9 month old now.

How is your hypo awareness? I lost mine with both pregnancies around 17 weeks! Are you on a CGM? X

It is impossible not to spike sometimes! I have cut out bread, pasta, rice etc. and try and be really careful with what I eat but I have still had a few random 10/12+ etc. overall I feel well controlled, my last Hba1c was 37 but they still make me worry with the random highs!

The retinopathy must be tough and worrying, so far I have been ok but I am very aware how quickly things can change.

I am planning elective as well, I had a terrible experience with my son and ended up with an emergency one but under general so missed the entire birth, wanted to at least be awake for this one, I guess the date will depend on my growth scans? Did your first have any issues with low blood sugar at birth? I would love to be able to have my baby with me straight away this time but all too aware that may not be the case again!

Hi all can I join. About to try for DC2, been t1d for 6 years now (since before DD). Getting my sugars under control for conception is a real struggle, I’ll have a brilliant week then a few really shit days. Do you mind if I ask your HBA1C at conception? Feel free to ask me any questions in return!

37 is amazing! Well done you!

They generally aim for around 38 weeks, but obviously that could change depending on growth and also we're at increased risk of pre-eclampsia. Depending on your trust you may need to be admitted around 36-37 weeks for steroid injections to help baby's lungs. If so, you'll be put on a sliding scale and be closely monitored, they check your sugar readings every hour, even through the night.

No she didn't have any issues. I harvested colostrum from 36 weeks and got a decent amount before I went in which I'm glad I did - I had a large bleed which caused my temperature to plummet. I tried to get her to latch straight away in recovery but I was shaking so much. I had to get the midwife to give her colostrum from a syringe as again my hands were too shakey for me to do it. She struggled to latch and because of the bleed it took 5 days for my milk to come in so the colostrum was very handy while I'm hospital.

Just be aware, I almost fainted when they told me her sugar level was something like 1.8 - newborns have much lower sugar levels to us in the first couple of days and it is considered normal x

@Cheekypeach mine was 43 before DD and 46 before this current pregnancy. We weren't actually trying for either but I've found my sugars so much harder to control since DD.

Oh that’s fab but mine was 60 odd when last checked - I expect it to be somewhere in the low 50s after improvements, but I’ve got the blood test to check at the end of the month. I’m personally comfortable trying with 50 and under, so hoping a few tweaks and I’ll be there 🤞🏻

Did anyone else have a vaginal birth?

That's' interesting, I was hoping to try and harvest some colostrum if I can - silly question, but how did you store it and take it to the hospital - can they keep it somewhere for you?

I was diagnosed back in February of last year and at that point my Hba1c was 159 (ridiculous!) but they told me I had to get it down to conceive, I was incredibly lucky and my work pay for me to have a Dexcom which I had almost straight away and it has been a godsend!! I got my Hba1c down to 37 by June. I am looking forward to being slightly more relaxed with everything when the baby is here as I have felt constant pressure since my diagnosis what with wanting to conceive and then being pregnant.

@Cheekypeach its been so hard with HbA1c especially with COVID! You're doing amazingly.

@k53559 you can get colostrum packs from your midwife or order sterile syringes on amazon. I'd fill a syringe over 24 hours then label it and stick it in the freezer. I took all mine in in a cool bag the morning of my section and the midwives put them in the freezer on the postnatal ward. If you have a common surname like me, be careful to check that it's actually your colostrum - it happened a couple of times where I was given syringes of another lady with the same surname as me and the thought grosses me out 😂 x

How are you all doing? I am currently waiting on a date for a c-section but feel like the end is in sight! Despite feeling like my numbers have been good and trying so hard, little one is still measuring over the 95th centile for his tummy last week, trying not to worry too much!

@Tigerlily08 thank you for the advice about the colostrum, the midwife gave me a little pack at my last appointment, few more weeks and I will give it a go!

Hello, another type one here ☺️

I am 18 weeks +2 with my first baby, and my HbA1c was around 54 when I conceived. I'd been diabetic for 20 years and most of that really struggled with my control, so also have proliferative retinopathy and macular oedema - had about 7 injections into my eyes in the lead up to pregnancy, and have had an implant in one of them during pregnancy. I also have Hyperemesis Gravidarum so was throwing up all food and most water from weeks 5 - 16ish. Thankfully the last 2 weeks have been better (with the right anti-emetics!) as I'd been admitted for fluids 3 times in a week at one point so was getting very depressed!

Way more stressful than I ever imagined it could be, but I am hopeful and excited about when baby arrives!

Is anyone else nervous about how long they might need to be in hospital for (for C-section or labour)? I feel so unsafe when not in control of my own diabetes care (due to some very poor experiences as in inpatient in the past) so very anxious about potentially being in for a week or more

Oh gosh, that sounds so stressful, you poor thing! Just trying to manage my readings without feeling immense guilt when it goes a bit wrong has been hard enough!!

I am very worried about the time in hospital, I have a 4 year old and hate the thought of spending time away from him, especially as he won't be able to visit the hospital but I was in for a week when I had him, will be awful if it's the same this time around.

I was told by my consultant that they had requested a date for my c-section but have heard nothing more and that was 2 weeks ago!

I believe sometimes they book c-sections in the week before so there's still time, not very helpful when you desperately want to know when it will be though, I know!
Based on what I've read it sounds like getting moving as soon as possible after the C-section should speed up recovery time, and I might ask if I can be put on the Enhanced Recovery Programme (assuming they will allow it for those of us with additional medical needs) to ensure my stay is as short as possible. I hope you manage to get in and out reasonably quickly as it must be so hard being away from your older child for so long!
And yes, the guilt is so hard, it sounds like you've done amazingly well with your HbA1c though, and that's key, well done!

I’d love to join this thread! Early days for me (8 weeks) in pregnancy number one…been T1 for 11 years now. Definitely could have always done better with regards to sugars…but finding it really good so far control-wise, now I have the ultimate motivation to eat better and pay close attention. HbA1c was 54 pre-pregnancy, 50 when I found out and 46 last week. Made up as that’s the best I’ve had in years! Have an insulin pump already and self fund CGM sensors (though should be free during pregnancy).

Feeling daunted for the weeks ahead, expecting control to get much harder so will be good to see how you all do ahead of me, hopefully I can glean some advice/tips from you!

Congrats on getting your HbA1c down to 46 so quickly, that's a great improvement. I am still waiting for the sudden increase in insulin resistance that everyone goes on about but so far haven't really had much change in insulin requirements so far. I needed less around the 8-12 week time, but that may have just been because I couldn't hold any food down at all.

Thank you! Interesting to hear your experience regarding insulin requirements. Will just have to wait and see! I was feeling really anxious when I first found out - very worried something will go wrong…but actually now feeling pretty positive and feeling able to discuss things progressing without feeling I’ll jinx things!

I share your fear over not being in control in hospital…I’m definitely hoping for an elective section, so imagine they’ll leave me to it with my pump - but experiences with surgery in the past is that sugars shoot sky high (perhaps adrenaline reaction to the operation)!

I wish you every luck OP. I have been T1 since aged 1, and gave birth to Ds1 18 years ago, then Ds2 13 years ago. So long ago tbf. I was on a pump for both, Both planned electives, but both started to come naturally early, but I still ended up in cs, when they lost trace. Scans, they said he was bigger than he was was, I had huge amount fluid, and then both were just under 7lb!

Urgh had a dreadful day of sugars. Leaving do at work with buffet, nightmare anyway but then I went all fainty and nauseated and panicked it was an impending hypo so ate more! Sugars up to 18 and still at 10, slowly coming down has anyone had these kinds of sugars before and not had it cause issues like miscarriage?

My day has been similar - I had a hypo at 6ish after going for a swim, and then treated the hypo and had my tea, fell asleep and woke up about 4 hours later realising I'd managed to disconnect my pump so was up to 18.8mmol/L 😩 Still haven't come down (have given the insulin but it's taking ages to kick in). I've had a few days like this previously that haven't caused any issues so far, fingers crossed this one won't either. I have a scan tomorrow so will let you know if anything's gone wrong - I really hope not!!

Sorry you had a bad day too, better this morning? Makes me feel less guilty that it’s not just me being imperfect…really resenting the diabetes more than ever now.

Good luck for your scan! Is it 12/20 weeks or a growth scan?

Hi, hope you don’t mind me jumping on here :) I’ve been a type 1 diabetic for 6 years and this is my first pregnancy being diabetic, I am now 20 weeks. I am petrified on a daily basis that something is going to go wrong with the baby. I really beat myself up and get so upset when I have high spikes (sometimes nearly as high as 20). I am finding it harder to control the further along I am getting, but also keep having a lot of lows throughout the day and then really high readings during the night and no matter how hard I try it is never perfect. Even though my recent Hba1c was 5.6 they think this is because of the amount of lows I’m having daily, but it’s the highs that really get me upset at night and I’m finding it so emotionally draining because I can’t help feeling like this is all going to impact the baby. I feel so alone even though I have my family and my partners support, I feel they can’t understand it fully as they aren’t personally going through this. Any advice or even hearing similar experiences to know I’m not alone in feeling like this is much appreciated :)

Have you tried basal rate testing?

It sounds like your basal insulin isn't right and might need to be increased overnight if your constantly high then.

Apologies @Juke1 - I didn't see your reply until just now. I think that was my 20 week scan and everything was normal then, but at my 26 week scan baby was measuring over the 99th percentile for abdominal circumference and 93rd percentile for weight so he's measuring 3 weeks ahead at the moment 😣 My time in range is currently 70% so bang on target but it's taken a while to get here as the Hyperemesis was making blood glucose impossible to control.

Hello @Faz1989 - sorry to hear you're struggling so much. How much support are you getting from the diabetes midwives? Are you on multiple daily injections or an insulin pump? And do you have a continuous glucose monitor?

Has anyone experienced high blood sugars in the first few weeks of first trimester? How did you manage this?