I recently found out I am pregnant and my A1c is right where I want it to be, it’s been at a 5.5 for close to a year (thank God). I have had a few highs lately, but I correct and move on. My endo uses a lot of scare tactics and makes me worry, she said I should never have a high over 140. With my A1c as low as it is, I can’t imagine how she talks to those not so well controlled… I just need some reassurance as I am still early in pregnancy (only 9 weeks). I unfortunately lost a baby several years ago due to my T1D not being well controlled but I am doing every thing possible this time to have a healthy baby. It’s just been hard not letting the fears of what happened before creep back in. Does anyone have any advice or reassurance that can help calm my nerves?
Congratulations! It’s certainly scary. I just had a pre-pregnancy appointment with my high-risk ob, and after tears, because lets face it, it’s an emotional topic, I left feeling more empowered about controlling my glucose.
She explained that during pregnancy, non-diabetic women tend to have a lower glucose… fasting at around 70! When she said this, I just about gave up; usually I was happy with 110. We talked about diet, about changing medication, eating on time and having plenty of snacks.
It really has made a big difference in my numbers. My targets are: 80-fasting, and 130 or lower an hour after main meals.
If you can, I highly suggest making an appointment at perinatology. On my first pregnancy, I thought I could just go on to a regular OB. Things did not work out on that pregnancy, but I learned that a medical degree doesn’t necessarily mean they are well versed in diabetes. OBs at perinatology have much more experience with pregnancies with diabetes.
Best of luck!!
Oh! I also suggest asking your family to help out, not by reminding you what not to eat, but by preparing snacks and taking you on walks.
Pregnancy is a team effort, engage your teammates.
@Nstroh – HUGE CONGRATULATIONS!
I am a T1D still TTC and am just happy to hear other women like me are expecting. Your HbA1c shows you are doing things right and that you know how to react to different glucose situations. From everything I’ve read and my own perinatology appointment, the most important thing seems to be to keep an even closer watch on your levels all the time and react appropriately. (I see from your profile that you use a pump and CGM, so these tools should give you the flexibility to do so.)
One specific new idea that Cheryl Alkon’s book Balancing Pregnancy with Pre-Exisiting Diabetes gave me (for when I do get pregnant) is to incorporate more, even if shorter, workouts/walks after meals to prevent spikes. We just bought an elliptical so that I can do that at the convenience of our house which should come in handy in the evenings. More generally, if you haven’t come across this book yet, I highly recommend it. It summarizes recent medical advice in a way appropriate for general readership and contains a lot of individual stories from women with diabetes (T1 mostly) from their pregnancies.
Don’t let your doctor scare you; just do all the things you know how to do already! At the same time, if you do need assistance in making adjustments, do not worry to call them and ask for it.
I’ll be happy if you post updates here when you feel like it during the next months.
All the best on this wonderful journey!
If you’re feeling nervous maybe my story will help you. I made a post about it a while back. But basically, I had a successful type 1 pregnancy blessed with an entirely healthy baby last spring. I had whacky sugars throughout the entire pregnancy, plenty of highs and lots of lows. At 8 weeks along my a1c was 8.3 (garbage I know!) & The best I got it down to was 5.8 and for me that was a major accomplishment and not easy. My diabetes is ridiculously brittle and all over the place despite my best efforts. Point being though, even with less than perfect blood sugars everything was a success. I was induced at 38 weeks and 1 day by choice and delivered vaginally. I’m sure your sugars are already under a lot better control than mine ever were. I did however take LOTS AND LOTS of folic acid. I was not prescribed it, just recommended it, and I took a lot of it. Idk if it is related at all but yeah. Pregnancy with type 1 is not an easy road at all and personally I’d never wish to do it again lol but it will be so worth it in the end! Any questions feel free to ask lol
Congrats on the pregnancy! I just had my baby girl 3 months ago so I’m very familiar with these scare tactics! I think my a1c was 7.5 in beginning of pregnancy. In the beginning my sugar tended to get low and after the 1st trimester they started getting a little higher. FYI- I was told as the placenta grows & release of hormones it was a heck of a lot harder to control my sugars. I was more on top of them after becoming prego; I got down to 7.2 even with better #s. So my advice with all the scare tactics is just to keep doing what you’re doing. You seem to be on top of your #s & don’t stress out about any highs. Like you said, correct and move on. Drs would tell me all the problems that tend to happen with women with diabetes during pregnancy & not to say I didn’t listen, I heard what they said, but I put it out in the universe that this wasn’t going to happen & im not a statistic (bc it felt that’s what I was going to be at every visit). Meditation helped me stay on track with my goals during my pregnancy. Hope this helps!
First off, congratulations! I am very happy for you, and slightly jealous.
Your a1c seems to be great. My doc said my a1c had to be below 7.0 before we could start trying, and I did it in about 6 months, and have been going down ever since. My last was a 6.2 and my endo was very pleased… so I’m really not sure why your endo would start with a scare tactic?!? I hope that calms your nerves a bit.
How long did it take you to get pregnant?
Thank you for all your replies! @yourstruly do you remember how much folic acid you took? @CallaNicole my doctor wanted me below a 6 for 6 months or more and because I lost a baby in the past I was paranoid and waited closer to a year so I felt comfortable maintaining a lower A1C but anyway, I stopped taking birth control near the end of September and I closely tracked my ovulation in December and that is when I conceived so it didn’t take me long at all! I have my first prenatal appointment on 1/27 and I hope after that I will feel better. I didn’t know anything was wrong last time until closer to 20 weeks and it’s hard not to carry that baggage around but I am declaring that I will deliver a healthy baby this year!
@Nstroh I too had a previous miscarriage at the 20 week mark! Omg I’ve never ‘met’ a t1d who’s gone through the same thing. I had another one like a month later around 6 weeks. At that point in my life, I was not ready for children, or trying for them, so my a1cs were around 8. My doctors claimed that t1d had nothing to do with the miscarriage, but I’ve always felt like it did.
I’m glad it didn’t take you long to get pregant this time around. For me, it’s been about a year, and it’s been such a struggle. I feel like I’m loosing hope, but stories like yours make me realize it is possible. Stay positive & try not to stress out… Not good for you, the baby, or your blood sugars! Lol
@Nstroh, I’m at 9 weeks also. I’m 33, first pregnancy (took us 2+years to get pregnant). I’m definitely nervous, but I try not to stress myself out about an individual number, and just try to correct any patterns in highs and lows and move on. Stress is not good for us either, both in diabetes and pregnancy. I saw the local high risk OB that specializes in diabetes pregnancies last week, and he more or less said the same thing - my prior A1c had been 6, and just to work on reducing the lows and highs and trying to be as balanced as possible. I am definitely having trouble covering snacks when I eat because I am nauseous, so that’s my goal for this week to work on snack boluses. Just got my labs back and as of Friday my A1c was 5.5, so paying attention to post-meal blood sugars has paid off so far. Now to fine tune the rest as much as I can.
Totally agree with @dessito to not let the endo/dr scare you, just keeping working at it. No one knows your diabetes like you do!
Would be happy to have someone at the same stage to chat with - have a few pregnant friends but none with diabetes.
Congrats! I recently had a baby girl 5 months ago and still breastfeeding. I did have her 4 weeks early, but she was very healthy and never needed a minute in the NICU. My endo was great. I uploaded my pump every other day in the third trimester. That is when it got difficult for me with the placental hormones. If your doc is scaring you with those glucose numbers, consider a more supportive one. The first thing my endo talked about was every other person in the medical profession telling you your diabetes management isn’t perfect when you are pregnant. I could not imagine not having her support and my a1c’s were below 6.5. She even sent a letter to a rude OBGYN on my behalf. You will have good days and bad, but don’t dwell on the bad. There is enough mom pressure out there already!
Ah yes, the ever present scare tactics that they bombard poor pregnant diabetics with. You know what, spikes happen. Right? You’re a1c is BEAUTIFUL! So you spike a few times, and later in pregnancy you will chase high blood sugars all day long in a fervent effort to maintain your a1c. And you will be fine, and baby will be fine. A few spikes are not what cause complications. A consistent high blood sugar is what causes the complications. ENJOY PREGNANCY!! Seriously, don’t let diabetes (or doctors who don’t live with diabetes!) scare you in to worrying your whole pregnancy. I work in Labor and Delivery, and people do a lot worse during pregnancy than have a few high blood sugars, and they still have healthy babies. I had a baby a year and a half ago, and am pregnant with our second. Our first was beautiful and perfect, and never needed to be in the NICU, and I was not perfect throughout my pregnancy (a1c 5.9-6.7). I tried my best, and that’s all I could do. Third trimester really was tough, so prepare yourself for that possibility. I felt like I was constantly bolusing and still spiking.
Many heartfelt congratulations to you! Pregnancy is wonderful! Enjoy it, before you know it you will be at the end and will wonder where all the time went!
First of all congratulations!!! Second of all, I just found out I am 2 weeks pregnant so I completely understand! My most recent A1C was 5.2 and that’s with a few days here and there where my pump malfunctions or what not and I end up 200 out of nowhere. My doctors also worry me because they are so serious about it, but I have a close friend who is also Type1 and just had a very healthy baby. She basically said, ‘You are Type1. You are going to go high and that is just a simple fact. Do your best and don’t obsess. If you go high, treat and move on.’ She said she broke 200 three times because of hormone spikes that make you completely resistant to your insulin. All that matters is you get it down. It’s mostly prolonged highs that can cause problems, but if you have your A1C in the 5’s just keep up the good work and enjoy the ride! We’re in this together!!!