High blood pressure and pregnancy?

My blood pressure has been taken 4 times since I became pregnant. I am now at 23 weeks. Initially the nurse at the first clinic I went to said it was because I was nervous. My blood pressure has gone down significantly since the first time it was taken. Unfortunately the high risk practice where I have been going only has resident doctors. I have never seen the same doctor twice unless I ask for the supervising doctor. I have been prescribed something to bring my blood pressure down. My father has had high blood pressure for most of his life. He is not a diabetic. He has no kidney damage, just high blood pressure. His diet has been modified to low sodium. 

    I am wondering if anyone else had the same experience. I was given a container to collect my urine for 24 hours and then have it tested for protein. The resident who met with me yesterday did not seem like he knew too much. He was telling me that most type 1 diabetics have small babies. I was told they always have large babies and have to deliver early. I asked if I should be on a low sodium diet and he said, "Not as of yet." I suggested I be put on a pump. The resident did not even want to discuss this, mostly because I think he is not familiar with them. 

    For most of my entire life my blood sugars have been in good control. Back when I was first diagnosed 3 decades ago there were no glucose meters and insulin was not made in a lab. I used to have to pee on a stick in the nurse's office at school to check for keytones so the control might not have been as tight back then but I was so young it was left in the hands of my parents. I am concerned at this point because although I think resident doctors have extensive training I am wondering if I should request to see a regular doctor. The type of insurance I am on is very limited because it is through Medicaid so it would be difficult to change practices now.I am thinking of purchasing a blood pressure monitor to see if perhaps my readings go down when I am more relaxed. 

It can be confusing to be tag-teamed by multiple docs. I go to the doctor  once per month, and so far, I see my endocrinologist every two months and my CDE on the opposite months. It's been confusing for me to work with two people. My endo tells me I'm doing awesome, even with some lower BS numbers, but my CDE is concerned with all of my lower readings (60s and 70s). I am going to ask to be switched to the endo only at my next appointment for the remainder of my pregnancy.

In your case, is it possible to request the supervising doctor for all of your appointments? It sounds like the residents don't have enough experience, and it would be much easier to see the same person throughout. Even if you could switch to the same resident throughout, it may be much more helpful than never knowing how much information a new resident knows about a type 1 pregnancy.  

Good luck in switching and happy pregnancy!

  I made some phone calls to inquire about hypertension. My father said that my grandfather had it, he has it and he assumes it might be from the stress of the pregnancy. I did some research and found that a lot of common foods we think do not have tons of sodium do, such as cereal, spaghetti sauce, salad dressing, cheese. I have always had a fondness for salt because I knew I could have very few sweets, if any at all. I became a vegetarian 5 years ago and a lot of soy products have a lot of sodium. No doctors have ever brought it up with me and advised me to eat lower amounts of sodium because it is hard on your kidneys. I plan on speaking to the head doctor at my next appointment. Thank you, for your suggestions. It seems as though this blog really only caters to young women on pumps. The only thing I ever seem to read about on here is issues with pumps and A1Cs before pregnancy. It is always nice to see a story with a happy ending of a baby delivered healthy. So far everything has been good for me.

Type 1 Diabetics do have a higher risk for big babies due to elevated levels of glucose, but there is also a risk for small babies if placental function is compromised. Because the placenta has a lot of small blood vessels it is at risk, just like our kidneys, eyes, etc. That being said, I am 32 weeks along, on multiple daily injections, and everything is looking great so far. I had my first non-stress test yesterday an the levels of amniotic fluid look good, baby's activity is normal, and the placenta seems to be fine.

Regarding high blood pressure, this is a complication both diabetic and non-diabetic women can have, and it is just another reason for the docs to keep a close eye on you, but no reason to expect anything will go wrong. Every time I visit my OB and every time I visit my endo the first thing they do is check my blood sugar. I was seeing my OB monthly, then every other week, and starting soon it will be weekly. I've seen my endo every 4-6 weeks (sometimes on the same day as an OB appointment so I get my blood pressure checked twice in one day!). I know that if you have just extorted yourself or if you are moving or talking during the time they check your blood pressure it can affect your numbers.

Good luck!!

Oh, I have also done the 24 hour urine check, once each trimester. My perinatologist wanted a baseline in the first trimester so they can look for signs of increasing levels of protein later in pregnancy (which would be a problem I guess). My levels were higher than normal in the first trimester, but all my docs said it was to be expected in a diabetic and wasn't anything to be too concerned about. The concern will be if levels go up later in pregnancy.

rishmack's information is right on.

It's important for diabetic moms to have a great OB-GYN.  You need to meet with the same person every time.  You may have better luck getting a male OB to handle your pregnancy, since they're less popular than female doctors.  I had a great one who was quick to contact colleagues at other hospitals for advice when I had questions.  A pump makes handling blood sugars easier, but it's possible to do okay with multiple injections.