Any type 1 diabetics out there?

[MissCKitty]

Hi ladies got a bfp on bank holiday monday. however it wasn't planned so my sugar levels haven't been perfect and i haven't been taking folic acid. Since i found out tho have been doing everything right and my sugar levels are perfect but am wondering if there's any diabetic ladies out there who've gone through a pregnancy. What should i be doing/not doing? Anything i need to look out. Am seeing the early pregnancy unit on tues but in the meantime any eexperience or advise you can offer would be greatly appreciated
Cat x

Hi Cat, I've been type 1 for 32 years. I have a 2 year old DS.

I'd get yourself referred to the specialist ante natal team at the hospital ASAP, mine were brilliant with me. You need to get ultra-strength folic acid too, I can't remember exactly why but it's something important! Keep doing what you're doing, you might find you have fewer hypo warnings, and your insulin intake will go through the roof as your pg continues. You'll have lots of scans for various things, I had the normal ones, and a very early one to make sure that everything was where it was meant to be and that it looked ok, a scan to check the baby's heart and at the end of the pg, regular growth scans.

The specialist team at the hospital, will really look after you and make sure you know what you need to be doing/what you need to know.

And congratulations!

I don't have diabetes myself but I am a diabetes specialist who has done lots of antenatal clinics.

I won't step on the toes of your doctors, other than to say make sure your hospital team know ASAP or that you are referred to be seen urgently by them.

Most important thing over the weekend is to be obsessive about checking your blood sugars, particularly before driving. As Knitter says, your hypo awareness can go right down during the first trimester.

Are you taking folic acid now? You should get 5mg tablets on prescription but if you've not got that yet, start taking the 'normal' strength, better than nothing.

The final thing I'd say is not to get too stressed or guilty about how things have happened. It wasn't planned and you would probably have been doing things differently if you had been planning this, yes. BUT you are pregnant now, congratulations, and the important thing is that you are doing all the right things now. You can't change what has happened, so don't let yourself get down or feel guilty about it now. (I do hope that comes across okay written down - always difficult when you are typing something rather than saying it :-)

Anyway, congratulations again and enjoy it.

MrsGangly have been religiously checking my sugars and they are averaging out at around 5.7. My diabetes nurse said aim for 3.5 to 6.5 so am doing ok. Had a couple of minor hypos but as of yet my hypo warning signals are still strong. I got the 5mg folic acid off my GP on friday but as soon as i found out i went and got some pregnancy vitamins with folic acid to make sure i was taking something. I see the specilaist medical/obstetrics at my local hospital on tuesday morning. Am excited but so nervous at the same time. Trying not to think too much about things cos I know that stressing out is counter productive.

Will keep you posted
Cat xx

Then you are doing a fabulous job - well done! Have a lovely weekend and a lovely uncomplicated pregnancy! :-)

Hello Cat! Congratulations on both your bfp and your sugar control. And, MrsGangly we're so lucky to have you on here!

I'm not type 1, but it seems I must have pre diabetes. My sugars are generally fine, but the minute I get pregnant, my sugars shoot up and started getting unpredictable. I'm only in the end of my fifth week, but I've been on insulin for two weeks now (4 times a day). I've had both highs and lows despite strict compliance with the diet I was given, my timing and my meds. It's very frustrating and insanely scary. I'm terrified of what can happen to the baby- every high sends me into a bit of a panic. However, through the diabetes clinic at my hospital, I'm relieved to have met many diabetic mothers of healthy, beautiful babies.

I would love to find more people who have dealt or are dealing with, diabetes in early pregnancy- I just feel like it's really different from getting gm in later pregnancy.

Hello, can I join in? First of all congratulations Cat!

I'm a type 1 diabetic (since 1985) and have just returned from my first "pre-conception" clinic at the hospital. I'm feeling a bit frustrated tbh. Control is great and has been for years(HbA1C 6.2) but they are trying to get me to switch insulins as they don't have many people going trhough pregnancy on mine (levemir). But the insulin they have most evidence about was not a good one for me. I have been offered a pump but I just want to get going with it! They've given me a prescription for folic acid but told me to wait ttc until the next appointment, which is 6 weeks away. Why?! I thought good blood sugars was the most important thing and I really get along with my current treatment.

Hi greviousangel, well done on 6.2, that's brilliant! Mine was 7.9 at my last pre-conception clinic appt and they said that it wouldn't be the end of the world if I got pg now, but I'm trying to tighten it up a bit more before we go for it.

When I got pg before, they were happy with my quick acting insulin but said that they didn't have enough testing done with my long acting to say that it was fine, but I decided to stick with it as I know it works well for me and I didn't want to upset my control by switching insulin and then having to find the right amounts etc.

I agree with you, I wouldn't be happy about having to wait to adjust to a new regime when the one I'm on works fine!

Can I join too please?! Am type 2, taking metformin, 1st baby due 4th feb 2011. Frustrated that most of the diabetes in pregnancy stuff is about gd.

Have met consultant at local hospital (was supposed to be preconception appt - oops!) and have 1st appt with diabetic antenatal team tomorrow. Sounds like I will be well looked after though.

My sugars were not very controlled either in first couple of weeks, was away and had no idea I was pg.

Have been told to aim for 6 fasting/before meals and 7.8 1 hour after meals. Not sure if this would be different for type 1?

Have told work today even though only 6 weeks. Most people are supportive, some are too wrapped up in themselves to even congratulate me! Just rude! Everyone else has been good, they've taken copies of the nhs hypo leaflet so they know how to help me if it happens.

Where are you guys from? Would be good to keep in touch with people who understand!

Not pregnant right now..i'm done with that!! But i do have DS (6) and DD (4) and have had type 1 since 1983

I went through both my pregnancies with levemir and novorapid...nobody ever queried it! I maintained a good a1c throughout and had healthy pregnancies both times

By the way i never went to preconception clinic..both of my pregnancies were unplanned!

I agree with Knitter, i def wouldn't change a regime i was happy with and had good control with!!

Congratulations!
I have been type 1 for 25 ish years. Have one dd 2.5 and am currently 8 wks preg. Think last HBA1c was about 6.9. I haven't attended a preconception clinic with either pregnancy. When preg with my duaghter I was on novorapid & lantus. This time I am on a pump. I had really good antenatal care last time. As knitter said you have lots of growth scans later on and I also had to go to the eye clinic quite a bit. I just found that pregnancy made the diabetes a bit harder to control, although my HBA1C was fine throughout, I was just constantly worried that any highs were damaging the baby.
NICE guidelines on diabetes in pregnancy came out in 2008 after the birth of my daughter. Am going to read up on these when this pregnancy is further along the line, as I wasn't happy with all aspects of the neonatal care.

yeh i had lots of hypos in the 1st 12 weeks...and think my insulin needs trebled at least by the end

as for the birth (i know it's a long way off!) the only thing different from everyone else was that i had to be monitored throughout so couldn't have a water birth (not that i especially wanted one!) .. and had drips for insulin and glucose during labour

DS didnt have to go in SCBU but DD did cos her blood sugars were very low, but she was born a month prem

How have you been feeling?

Hello, I've been a type one diabetic since 2005 and have two DC 2yrs 6months and 7 months. I use Levemir and Novorapid. My top tips would be:

1. Test 1 and 2 hours after eating/applying insulin, if you find you are having swift highs or lows, you can correct more quickly. Be prepared for the unexpected. Your body will not behave like it has done up to now.

1. Check at night, every time you get up to go to the toliet (I assume that like me you've not slept through the night since you've been a diabetic). I found I often had unexplained highs or lows around 1 am or 5am.

1. In your first trimester you will need more and more insulin as the weeks go on. Then when your baby starts producing his/her own insulin early on in the second trimester, your needs will drop. Suddenly. And with no warning whatsoever. You need to be on your toes with frequent testing in those first weeks of the second trimester as to avoid a nasty low. Your need will then start to rise again nearling the 6th month and will just go on rising until you give birth.

1. Don't panic. Trust yourself and what you know about your body's behaviour. Remember brief highs, even very hig highs, will not harm your baby. It is days and days of uncontrolled sugar that will do that. This is not to say you shouldn't take care -now more than ever you need too- but don't beat yourself up if things go wrong once or twice (or three or four times).

Good luck.

Brilliant post Catitainahatita, all very very true!

My DS had to go to SCBU with low blood sugars (he was 2.5 weeks early, breech/CS birth) to start with, but good to hear that your DS didn't paddyclamp, it means there's hope for my not-yet conceived next baby not having to go!

Wow, so many posts It's great to hear so many positive stories. As we all know, it can feel a bit isolating at times, having these extra issues to worry about.

Lots of levemir users too - you have encouraged me to carry on with it. No point ditching something that works. Think i will get going with things then

Good luck ttc Knitter and hope everything going well with your pregnancies Cat, Alys, Loveable and Ginger. Maybe we can form our own diabetic support group!

Hello! Another T1 signing in! I had the joy of developing T1 during my first pregnancy, and then went on to have 2 more dc. All 3 were fine and didn't need SCBU.

I found my insulin requirement just went up and up through each pregnancy, to quite incredible levels (more than 5 times higher than usual by the end!). The only answer for me was test, test then test again. I did go on to a pump during my 2nd pregnancy as I was getting to the point of having to inject anything up to a dozen times a day to attempt to keep in range. The flexibility of basal rates and the ease of doing small boluses as needed was so much easier with the pump. I've never looked back and still have the pump today.

As with the others I was monitored a lot at hospital, I was induced with dc1 & 2 at 39/39.5 weeks. Gel didn't do huge amount, waters were broken, then oxytocin drip. After that all reasonably straightforward, no instruments, stitches etc. Dc3 I went into labour at 38.5 weeks naturally and ended up with emergency csection as her heartrate dropped - nothing to do with the diabetes though, just badluck and her being in odd position, she had an APGAR score of 9 at birth though so no after-effects.

After birth each time, for a few days, I found I needed only a tiny amount of insulin. This gradually then built back up to pre-pregnancy levels.

I can say quite honestly my blood sugars were most certainly not perfect ALL the time, when your ratios are constantly changing it is just not possible to get it 100% right all the time. Do not beat yourself up about the occasional bad day, just try to get it more right the next day. The odd nightmare read is unlikely to harm your baby, try and remember the bigger picture not stress yourself too much.

One last thing - do make sure you drink lots of water, I found this really helped with my levels during pregnancy for some reason!

Good luck!

Forgot to say, prior to going on pump I had been swapped back to Humulin I from Lantus, which I found tough. I was going to go back to Lantus if I hadn't got the pump as I felt the "risk" from Lantus was lower than the "risk" from less well controlled levels.

I found going on pump during pregnancy totally do-able but maybe not for everyone, it depends how confident your diabetes team are as well with pumps and your PCT policies...

In your situation, if a pump is not an option I think I would probably opt to stay on the Levemir, rather than risk losing control of levels.

I forgot to say in my post that although with DS (no. 1) I had a complicated birth that ended in a CS, he was fine when he finally made it out. DD was supposed to be a planned CS but as she decided to arrive quite suddenly and very quickly the day before the op., she ended up being another ECS. She was also fine

I live in Mexico and the policy was to bottle-feed diabetic mother's babies at 2 hourly intervals in the first 48 hours to ensure that no they suffered no lows. I also bfed before (and in the case of DD, and after) each feed. Once we got home, I bfed exclusively for 9 months (DS)) and am still bfing DD. I'm mentioning all this because I don't want you to think that you won't be able to bf if the hospital insists on bottles while you are there.

If you do bf, it will mean that you will need much much less insulin than you did pre pregnancy at least for the first months. Now now DD is on solids I'm back to my usual dose. BF also causes hypos at first. So always have a juice or sweeties handy whereever you plan to feed.

Oh yes, BFing... we had a nightmare to start with but I was determined, and told the MWs that I didn't want DS having any bottles. I didn't have any colostrum immediately after he was born (waters breaking to him out = 2 hours) so he was syringe and cup fed formula, then tube fed up on SCBU. We had trouble getting him to BF as he wasn't bothered by trying to suck, having been tube fed directly into his tummy every hour to start with (for blood sugar), and didn't even have to wake up for that!

After much stress and expressing, offering a breast then cup feeding the expressed milk, we got there in the end and he stopped of his own accord 3 weeks before his 1st bday.

I don't remember needing lots less insulin while BFing in the early days, but maybe that's because I was so hungry I was eating so much I needed more insulin anyway!!

Wow hi to all you diabetic ladies, good to hear other experiences. My sugras are still doing ok had a couple of blips cos my insulin needs have gone up already. Am about 7 weeks now ( got my dating scan on 22/6)I take humalog and lantus and this is the third insulin programme i've been on since being diagnosed at 20 (11 yrs ago omg i'm old!! lol)and it's reall allowed me to keep my sugars in check. My diabetes nurse has said the my insulin needs could treble as my pr progesses and i might find the pump useful in the later stages but at the moment if it ain't broke why fix it!! Was worrying a little about my highs but its good to read that the odd one isn't harmful especially as i had a mc scare last week. Really made me panic but had a scan and all is well. we should def keep in touch and help each other through xxx

Hello ladies! Just checking in. I've beenhaving loads of highs and hypos lately and am feeling rubbish between those and my general nausea. One thing that makes this all the more frustrating for me is that I had never been on insulin before, so I'm only now learning how my body reacts. It appears that I absorb it very quickly (hence all the ups and downs).

I'm already so sick of my diet. The first couple of weeks weren't so bad, but now, I have no appetite, throw up occassionally, and nothing (that I'm allowed to eat) sounds good. Although the insulin was supposed to make for looser dietary restrictions, my dietician won't budge since I'm so early on. The next 32 weeks are going to be very long.

Aly: in my experience dieticians rarely show much compassion. I have yet to meet a diabetic one, and many of the ones I have met up to now appear not to be very clear on the differences between type 1 and type 2 diabetes. I had one tell me that if I followed her diet I could stop taking insulin .

Diets are also the most depressing thing known to man. They gradually take way the joy from life, in my humble opinion. After I was diagnosed I followed diets faithfully for about 2 years; when I decided that I could not llive like that. Now (and during my pregnancies) I followed my diet pretty much six out of every seven days. On the odd day a week I would have a treat or two; I would let myself have pizza or cake other such no-nos on special occasions.

Anyway I'm waffling, what I wanted to say was that you do not have to follow your diet to the letter for the next 32 weeks: allow yourself some leeway. Don't beat yourself up. Don't panic if you have an occasional high. As I have said, brief highs will do tte baby no harm.

Also: if you can't face eating yet you need to keep on your insulin programme, you need to take in a steady supply of fruit juice to keep your sugars steady and perhaps the odd plain biscuit and toast just after you inject. I used to drink a small glass of watered down juice (half water half juice) wheneever I could face it, and at least every couple of hours. At mealtimes I often just had two rich tea biscuits.

The sickness doesn't last forever. I hope it goes away for you soon.

Nairns do stem ginger oatcakes, I reckon they'd be good... ginger for the sickness and the oats are a good slow release carb. Let's ignore the sugar in them!

Thanks Cat (hope you don't mind the shortened version!) for the words of encouragement. I think you're right about the whole dietician thing. I basically had to cry to convince her that I needed a liquid alternative to the breakfast she wanted me to eat. My thought are that I'll stick to the diet and be as careful as possible through week 10 and then I'll lighten up a little. From what I read, the first 10 weeks are the most important regarding birth defects. Funny, fruit juice sounds like such a treat. I never would have imagined myself feeling that way.

Linda I'm so happy to "see" you again! I saw your post recently about trying to decide what's right for you right now and hope you're able to come to a conclusion soon that gives you a good feeling. I love hearing from people who are diabetic who have had healthy babies. It seems that most diabetics do just fine in the end.

In all honesty, although my nurse and dietician have managed to scare me half to death regarding birth defects and birthing complications, my ob has made me feel much more at ease. He seems to truly believe that it's all going to be fine and nothing will be thrown at us that we won't be prepared for. It makes me feel good that he seems to believe this.

Just out of curiosity, how many of you with DC have managed to have vaginal births? I'm kind of expecting a cs, but am curious.