Pregnancy planning

I am currently in the pregnancy planning stage. I am 27 and I have had t1d for ten years. My a1cs for the past several years have been around 7. My goal is to lower that to the six range. My current endo practice does not see patients for maternity so I will be searching for a new endo for pregnancy. At this point I am researching Hospitals and ob GYNs in my area. I want to have my doctors or practice and delivery hospital chosen before trying to conceive. I am a planner and want to do anything ahead of time that can reduce stress. Does anyone know if all t1d pregnancies are considered high risk? This will help me narrow my search for an OB GYN if I need to search specifically for a high risk doctor or practice.

Hello!  Congrats on beginning the process of planning for pregnancy!  I was the same exact way when my husband and I decided we would begin trying to conceive months down the line.  I am a planner and wanted to be as prepared as possible for what pregnancy would mean for me and my type 1 as well as for the baby.  First of all, as far as I know all type 1 pregnancies are considered high risk.  That being said, many general OB/GYN practices will see and treat you...I am currently 25 weeks and am seeing a general OB/GYN who also treats certain high risk cases.  He has thorough experience with type 1 pregnancies hence why I felt comfortable seeing him.

I will tell you that most endos will want your a1c in the low 6's for pregnancy, if not lower.  I HIGHLY recommend you read "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby" by Cheryl Alkon.  Alkon is a type 1 diabetic herself and this book is a collection of things she learned through her own pregnancy, interviews with other type 1 moms, and interviews with OB/GYN's and endocrinologists.  It's extremely informative and I found it to be extremely helpful.

Good luck in your search!!  Just try to be patient and know that you may have to try several doctors before you find the one that suits you the best.  I had to switch once halfway through my pregnancy because I was not happy with the original OB/GYN group I started with.  Keep us all posted!!

Type 1 diabetes makes your pregnancy high risk, no matter how well controlled you are.  My endo recommend a male OBGYN because they are less popular than females. Though my OBGYN had not had a type 1 mom before he frequently consulted with colleagues who had and was an excellent doctor.  He trusted my judgement, sought answers for my questions, and gave good advice.  

My A1c was around 7 when I (unexpectedly) conceived but having a baby on board is amazing motivation for getting in tight control.  I quickly dropped it to a 5.1 with no bad lows.  I tested often, bolused as needed, and took an expectant moms exercise class after the first trimester tiredness ended. But I wasn't obsessive and didn't stress over my pregnancy.  I ate pretty much what I wanted, included lots of mint chocolate chip ice cream, and just made sure to look up the carb counts for everything.   My son was born healthy with a normal blood sugar.  

Being a mom is a wonderful blessing!  I never wanted to have kids because of my diabetes.  Wish I had known how possible it is to have a healthy pregnancy.  

i m trying to plan baby now,my HbA1C is now 5.8,i m not using pump,i have to face high level around 250 - 300 mg/dl  before taking insulin for dinner.i m trying my level best to over come it but some time it useless.i dont want to rise my A1c level again,so much worry about it,any suggetion i appriciate it,, thanks a lot

Hi Fouzia!  First of all, that's an amazing HbA1C, especially for having numbers that high!  You should be proud!  Secondly, have you ever considered getting on an insulin pump?  I know when I was doing shots it was difficult to maintain lower numbers and I would sometimes skyrocket before my next insulin dose.  Do you have those highs often?  I can't imagine you do with your HbA1C being that low.  If you don't want to be on a pump or it's not currently an option, I'd say keep doing what you're doing.  Maybe track when you have those highs, talk to your doctor about them, and possibly discuss increasing your insulin dose?  Hopefully you have a doctor who is knowledgeable and helpful and can help you find the best option for you.  Try not to get too bogged down, diabetes isn't easy, but you can do it, just take it a day at a time!

By the way, I've been on an insulin pump for the past 10 years and LOVE it.  I highly recommend trying one if you can.  It has helped me keep tight control of my blood sugars and keep my HbA1C down as well.  I also love the freedom it gives me compared to shots.  Just something to think about!

Hi Leah,,thanks a lot for replying me,you first lady who giving me answer,with my diet control i over come my high levels,now i am trying to plan baby,i had history of three misscarrages  ,so much worry about it,and i live in pakistan,and there is no availability of pump yet,so i have on insulin injecting pen,i want more guidelines  about healthy pregnancy,

with lots of thanks........  

Hi Fouzia!

I'm so happy to hear that!  Way to go!!!  I'm terribly sorry about your miscarriages and the unavailability of the insulin pump...but it sounds like if you keep doing what you're doing your diabetes will continue to do just fine!  Keep up the great work!  I will be hoping and praying that you're able to get pregnant and have a wonderful, healthy pregnancy!

As far as guidelines for a healthy pregnancy, from what I've read the best thing you can do is what you've already been doing, and that's maintain a healthy diet and keep your HbA1C down!  I have a book at home that has some great advice in it and I will try to fish it out and send you some of the information I found helpful.  My biggest tip to you is to try to stress as little as possible.  Diabetes is difficult and trying to get pregnant can be an anxious time...but just know that you're doing all you can and it will all work out for the best!

If there's anything else you need or want to talk about please don't hesistate to ask!  I wish you nothing but the best!!!!

Good luck and lots of happiness!


Hi Leah ,

How are you?

Thanks for your well wishes,may GOD bless you.

my every thing is going very well,but i have a simple question that,How many times should i check my sugar levels per day? Now i check  it 2 to 3 times per day,but is it right quantity in pregnancy period ?

Again i have a problem that the sugar test strips are so expensive here,so i cant check it so many times.

And i am taking 60 units per day ,40 in am and 20 in pm,is it normal dose?

with lots of thanks.....

Hi Fouzia!

I'm great, how are you doing?  I'm sorry it has taken me so long to respond, life has been extremely busy lately especially as I get further along in my pregnancy.  How have things been going for you??

As far as checking your blood sugar, the more often you can do it the better.  I understand that supplies are limited for you and I'm sure test strips are expensive, so try to make sure not to worry too much if you can only check 2 to 3 times a day.  With pregnancy especially, you want to  monitor your blood sugar as closely as possible, so just try to do it as often as you possibly can without damaging yourself financially.

As far as how much insulin you take, it's different for each person!  There's really no such thing as a "normal" dose...whatever dose your body needs is the right dose!  As long as those doses are keeping your blood sugars within range, that's all that matters!

It sounds like you're doing your best and taking care of yourself to the best of your ability, so good job!  Just keep doing what you're doing and hopefully God will bless you with all of the desires of your heart!  I'll continue to be praying for you!!

Good luck!


What type of ob did you ladies see during your pregnancy? I know there are regular Ob GYN, maternal fetal medicine doctors, and Perinatal doctors? Also do these types of doctors work with you to adjust insulin levels during pregnancy or did you continue to see your endocrinologist for that? Thanks for all of the information, it is very helpful.

To find an endocrinologist who with care for you during pregnancy, I would look on to check out good doctors (patients can rate their doctors on several different factors and leave comments) or look on your insurance's website if you just want a list of doctors to call, and ask them if they handle pregnancy.

I have only had one pregnancy so far, and my endo took care of my diabetes. My OB wanted to, but I did not trust his advice (told me to take insulin in increments of 5 "since it's easier" only test 4 times a day, take insulin at lunch without testing, have your BG lower than 90 at all times, etc.).

I am now planning for baby #2 and I have a different endo, but he is also willing to take care of my diabetes. Which is god, because I'm planning on using a midwife and homebirthing this time! Woohoo! Hoping for no more c-sections! (That may sound radical, but if you, the hospital and the OB, gave me terrible service last time, creating all kinds of problems, why would I trust you and go back to you again?!)

Good luck!