TTC and not using a pump...yet. Advise please!

I am 35 and have had diabetes for 20 years. I’ve used the pump two different times and didn’t like the feeling of being attached to it constantly. It seemed to cause me anxiety. So…since December I have worked to bring my A1c down from 7.7 to 6.9 in April. I go today to get the latest number. There is a possibility that I am pregnant this month but I can’t really test for another few days or so. My endo is very smart but not very personable and forgets who I am every time I see him. He wants me to be on the pump and even though I say I’m working hard by checking my sugars 6-8 times a day and changed my whole diet, he doesn’t seem to listen. I will do whatever is best to have a healthy baby. I currently eat only organic whole foods, nothing processed, and tons of fruits and veggies, and have almost completely cut out all rice and gluten.

Is it too late to get back on the pump if I am already pregnant?
Has anyone had success with their sugars during pregnancy while not using a pump? If so, what advise do you have for me to keep sugars normal?

Thanks sooooo much! This forum has been so helpful and knowing that I’m not alone!


Hi Stephanie.  I'm currently 21 weeks pregnant, and not on a pump (injecting 4 times a day).  However, I was only diagnosed with T1 last year (at 29!).  My first A1C testing in June of 2012 was a 13.0 - my last one in April was a 5.7 - so i do believe that it is definitely possible to manage your sugars without being on the pump.  Like you I don't like the idea of something being attached to me constantly, and I find them very cumbersome.  My endo is fine with me injecting (although my initial endo - i've since switched since becoming pregnant - was very pro-pump, and seemed to think i NEEDED to be on it).  The past two weeks I've experienced quite a few lows - I'm not sure if this is because of pregnancy horomones or if i'm just still producing sporadic insulin since i'm so newly diagnosed.  I'm curious to see how my body reacts in the third trimester, when insulin resistance is a huge issue for T1 mamas.  Either way, I would reccomend doing whatever makes you feel most comfortable - and finding an endo that you really trust and are happy with.  Good luck and i hope this was helpful!  And I agree with you, this forum is the best!  

Hi Stephanie.  I am 34 weeks pregnant and am not on the pump.  I've had diabetes for 15 years and have never actually been on the pump for various reasons.  My A1c's have been in the 5's for the whole pregnancy (was in the high 6's pre-pregnancy), so it is definitely doable.  You can definitely can still go on the pump once you get pregnant and many successfully do it, but you certainly don't have to.

The things that have helped me the most have been testing my blood sugars much more often than I ever have in the past (10-15 times per day, and while every doctor tells me that's an insane number, I find it's really really helpful to have the info) and being willing to change my insulin levels often (every 2-3 days).  There were some weeks where I was just low much of the time, and then once I hit around week 30 the insulin resistance really started to kick in (I take almost 4 times as much for breakfast and dinner now and it only seems to be increasing).  Exercise helps a good bit and having an endo who is really supportive and willing to be in email contact at least weekly has been great.

If you want to ask me any questions about my experience so far, please do.  It's been a lot of work (especially while working full time), but it is doable.


Thank you both for sharing your stories with me. I appreciate it more than you know! Its excititng to read that you are pregnant and making it work.  The whole process is so confusing and it feels as though unless I have a doctor that actually has diabetes they will never understand me.  My endo has been evasive and text book- he just keeps repeating to me to use a pump and CGM no matter what questions I ask him.  He gave me a referral for an Obgyn so I'm hoping that they will be my medical resource from now on...along with all my new "professionals" on this site.

I'm definitely comfortable checking my sugars and bolusing as many times a day as necessary.  I will be working full time also, but I have a great boss, and live down the street from my doctors office/hospital, and will be able to take the time necessary to make it work.

I'm sure I will have many questions!

Thanks again for your inspiration.  Please keep me informed of your progress.  


Hi Stephanie,

I just wanted to give a quick update on my pregnancy with mdi...  

The insulin resistance continued to increase, but I kept adjusting the carb ratios and my blood sugars remained reasonable and my a1c's were in the 5 range the whole pregnancy.  I went in for induction at 39 weeks (last Tuesday), was on Pitocin for 2 days, and then ended up with a c-section on Thursday.  They let me stay on Levemir (at a half dose) and Humalog the whole time I was in the hospital, though they had an insulin drip ready should it be needed.  My blood sugars were fine up until the c-section, when they spiked due to the stress of it.  Unfortunately my daughter was born during my higher blood sugar level, but she was monitored regularly and she never went low and has been generally healthy so far.  We came home on Sunday.

I'm back at my pre-pregnancy insulin levels for meals, but my blood sugars dropped to the low side once I really started breastfeeding, and I consume a lot of extra food (without extra insulin) between meals.

I'll keep you updated on the progress, but in the mean time, please let me know if you want to know more about the third trimester or the delivery or anything else really.


I love the pump because shots didn't work well for me; I know it helped me have a healthy pregnancy.  

But if shots work for you then continue with them.  Many type 1 women have had healthy pregnancies with injections.

Get Cheryl Alkon's Book  "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby."  It's really helpful.

Try not to compare your A1c to others.  A decent percentage of people with type 1 diabetes still have active islet cells, especially those more recently diagnosed.  What's crazy is that in the Joslin study of people who had type 1 diabetes for 50 years or more it was found that some of them still had positive c-peptide results.  So that means one person may be able to do MDI and have really steady blood sugars (because his or her body is providing small amounts of supplemental insulin) while another type 1 on MDI (who doesn't have active insulin producing cells) will struggle to maintain that same level of control.  I'm pretty sure my body has active islet cells (even though my c-peptide tests have come back negative) because I had type 1 for 28 years when I was pregnant and needed no insulin for 2 weeks after giving birth.  It doesn't happen for all women with type 1, but I've heard of others who have had similar experiences.

Make sure you have an OBGYN who you like.  Since your endo doesn't sound that great, I'd be a little suspicious that he/she may recommend an OB with a similar treatment philosophy.  Make sure to find an OB  who respects your knowledge since you will be working closely with him or her.  

At some point, maybe after the pregnancy, try to find an endo who you like better. They should be respectful of your needs and to help you find the treatment options that work best in your life.  

I second Jenna's recommendation of Cheryl Alkon's book.  It was extremely helpful throughout pregnancy and filled with lots of great information that was hard to find elsewhere.

I also agree that you shouldn't compare your a1c's to others since everyone has a different experience with diabetes and how well certain approaches impact one's control.  My a1c was 6.7 around the start of the pregnancy and I was honestly shocked that I was able to have them in the 5's throughout.  I suspect a lot of it had to do with just monitoring everything much more closely, and this is really the best advice that I have.  It sounds like you're doing everything right.  Good luck with it all!

Great advise! Thank you!

I am now 10 weeks pregnant and have decided to not use the pump. (I immediately bought and read the Cheryl Alkon book - very encouraging!)  I check my sugars about once an hour just to stay see where I am and can correct it accordingly.  My last A1c was 6.2.  I recently started a new post about whether to use Lantus or NPH or both.  My OB has been great and my endo gives clinical advise, which is helpful if anything.  He did say one time that he thought I was doing a remarkable job so that was reassuring.  My nurse practitioner that works with the perinatologist is also very encouraging and always there if I have a question or concern.  Overall, I'm in good hands, but do get discouraged when I have a weird craving or am grossed out by something that is healthy for me.  I can't remember in which book or post I read but someone had the philosophy of "Correct and move on".  I trying to adopt that!

Courtney, Congratulations on your healthy baby!!!