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Pregnancy and Type 1 Diabetes

Chandra_W

Hey everyone, so this is my *big* reason for getting healthier, my husband and I are wanting to explore trying to have a baby sometime in 2013...

Just some background, I'm 26, and I've been diabetic since I was 12. I'm on the pump, but not on CGM. I'm on metaformin and a few other medications (the metaformin is because my Endo says I have "Insulin Antibodies", which apparently is different than "insulin resistance"). My A1C is usually between 7.0-8.0, but I'm trying to get it down (obviously, lol).

So, my big question/concern/whatever - how possible is it? How hard is it? What do I need to do? What challenges did you have while pregnant? I know it's far into the future for me, but I need the encouragement to keep going (honestly, my endo appt is on Tuesday and I'm scared to death he's not going to like my numbers)...

Anyway, any advice for "being pregnant before getting pregnant" would be helpful...

Replies

beckajw

I just got pregnant in June of this year. My background: I'm 34 (33 when I got pregnant). I've had Type 1 since age 11. I've been using the minimed insulin pump since 1996. I was not on CGM, but did get it after I got pregnant. My A1C was 6.0 when I got pregnant. The doctor wanted it under 6.

I don't think the diabetes had any effect on my ability to get pregnant. I also have graves disease, so my thyroid function did affect it. However, for the health of the baby, you have to get your sugars down. A1Cs that are higher than 6 can result in babies that don't form properly. My doctor told me that even Type 1 mom's with regular A1Cs are more likely to have babies with heart defects and unformed lungs. He said any A1C over 12, he advises to terminate the pregnancy.

The pregnancy is high risk. The higher your sugar, the more likely you are to have a large baby/need a C-section. Higher sugar also increases risk of miscarriage and still birth. I'm in the doctor's office every week (one week for endo, next week for OB). The baby really messes with your sugar. So, you need to have it in control before you get pregnant and then be prepared for it to be haywire for a while. The CGM is helping with that.

My advice is to get your sugar down. My doctor wanted my A1C under 6 for at least 6 months prior to getting pregnant. I didn't achieve that (only 3 months). As far as I know, that's still fine. I think the doctor was a little overly cautious. Get serious about counting your carbs and testing your blood sugars. You have to be a lot more serious about it once you are pregnant. Before the CGM, I was testing my sugar so often, it felt like I was connected to the glucose monitor.

What I did when I knew I was ready to start trying was that I went on an Atkins/South Beach type diet. I cut out processed carbs completely to get my A1C down. Now that I'm pregnant, I'm eating carbs again, but checking my sugar more and still keeping it down. My last A1C was 5.7.

Chandra_W

That's something I'm REALLY trying to do - is test/count/bolus all in one lump. I used to test BG before I ate...sometimes...and then I'd forget to bolus until maybe an hour later....and then I'd be really high, so I'd bolus, and then just roller coaster. So I've been trying to sit down to eat, test BG, count carbs, and bolus before I take my first (okay, honest....second) bite.

If my A1C was over 12...I think I wouldn't even be thinking about having a baby, I hope to never get that high of a A1c, I think my highest was a 9.

I'm hoping that exercise/counting calories/losing weight will help control my blood sugars, I can already tell a difference. Possibly closer to us "trying" I'll look into going on some type of "low-carb" diet, that's good advice! I've always been scared though because I've heard low carb diets can really mess your kidneys up.

Thankfully I have an OBGYN who is extremely comfortable with Diabetics, and she said she likes to work closely with the patient's Endo while pregnant.

Thank you for responding, do you mind if I add you as a friend? I'd like to see how you're eating and what/how you're doing.

mamamadusa

I wasn't diagnosed Type 1 until I was 21. I had already gone through one pregnancy with no diabetes and she weighted 7 lbs. 5 ounces. I had two children after the diagnosis. It is considered a high risk pregnancy which means you have a lot more check-ups, ultrasounds, and both times I had a special ultrasound to make sure the baby's heart was o.k. Insulin adjustments are the biggest obstacle in my pregnancies. Hormones fluctuating required more and more insulin the further along I was into the pregnancy (and just the weight gain required adjustments). I was induced 2 weeks early with my 2nd child with no complications. She weight 8 lbs. 15 ounces. My third child was delivered 2 weeks early by c-section due to the fact they believed by ultrasound she was over 10 lbs. She was 9 lbs. 4 ounces. Both children were healthy as can be and I was much, much more tedious with my blood sugars throughout the pregnancies. Being that I had one child before being diabetic I know the difference diabetes can make during pregnancies. Other than the excessive dr. appointments and tighter blood sugar control there was not much of a difference. I did have fetal stress test 2-3 times a week toward the end of both pregnancies just to make sure baby was doing well. Also, I had to collect urine over a 24 hour period for testing. Since I had multiple ultrasounds I watched them grow in my belly

Both diabetic pregnancies I had amniocentesis done before inducing and the c-section due to proceeding 2 weeks early to make sure the lungs were fully developed. The girls are now 8 and 5 and you'd never know their mom was Type 1!

Italian_Buju

I had my son in 1998......I have been a Type One since 1986.......

The main difference, I felt, was the amount of time I had to go to the DR compared to a non-diabetic.....and the amount of tests I had done....

I was literally at the DRs office two or three times a week my entire pregnancy, between the OB/GYN, the diabetic DR and the family DR.

I lost a kidney when I was two years old, so I also had to see a kidney DR three times during my pregnancy, I felt like I was ALWAYS at the DRs, it drove me mad.

Right away, they switched me from two 30/70 mix insulins, to DMI which I am still on. That gave me much more freedom as far as when to eat and such, so it worked out better.

My baby was huge, and so was I.....by the time I was five months pregnant, I looked like I was ready to go, and by six months, I heard "OMG you must be having twins" everywhere I went. Turns out, I was having one, the size of twins.

By the time I was seven months pregnant, the diabetic DR, who's obvious main interest was me, kept wanting me to deliver, he was worried that the longer I was pregnant, the more harm done to do my kidney. He also was TOTALLY against me having a baby to start with, and actually wanted to tie my tubes upon my 18th birthday. He said I would never survive a pregnancy, and if I did, I would lose my good kidney from the stress of the baby.

On the other hand, my OB/GYN, who's obvious main interest was the baby, kept wanting me to wait as long as I could, so that the baby's lungs and such would be fully developed. It was an interesting tug of war, esp when I would hear them on the phone :ohwell:

Because of this, starting at the seventh month, I went to the hospital every Monday, Wednesday and Friday, for a biophysical profile. What a pain in the *kitten* that was. The OB/GYN said that as soon as the baby looked 'ready' we would move. I was pretty sick my entire pregnancy, did not really do much except go from DR to DR and then back home.

My due date was March 10th. On Feb 10th I saw the OB/GYN, and he said to get one more biophysical profile done on the Thursday of that week, which was the 12th, and he would met me at the hospital on the Monday, the 16th, to start the induction. When I went in the 12th to get it done, they were PACKED and told me that I would be waiting at least an hour and a half or more. I considered leaving. The secretary told me I might as well, as I was finally having the baby Monday anyway. (They had gotten to know me quite well over the weeks, of course).

I decided to stay, as the day before the DR had said he wanted it done, and I was worried that he might cancel my birth if I did not get it done. And I was SO ready to not be pregnant anymore, I was so sick of being sick. When I went into the room, the technician turned the screen away, and it scared the crap out of me, as she had never done that before. They called a DR in the room, who started asking me all kinds of questions about when I was giving birth, and who my OB/GYN was, and when I told her, she said “They have you booked for a C-section, right?” I told her no, I was did not want a section unless there was no other choice. I did not want the problems healing if I could avoid them. She then called ANOTHER DR in to take a look at it. At this point, I was freaking out, because they would not tell me what was going on. The second DR came in, and asked again, “Why are they not doing a C-section?”

When I finally got out of there, I just felt sick, I wanted to go home and lay down since I was so worked up over the stress of what was happening, and not really knowing what was going on. A while later, my OB/GYN called me and told me that the baby could not wait until Monday, and that I would have to have him in the morning, to meet him at the hospital at 6am. OMG, I was stressed, I stayed up the entire night cleaning and getting things ready. I thought I had the weekend to do that, but it turns out I had about 12 hours before birth.

That was a LONG day. They started two IV drips at 7am, one with the oxytocin and the other one with an insulin/sugar water mix. I had an external monitor around my stomach, an internal monitor on the baby’s head, a blood pressure cuff that went off every 20 minutes for the ENTIRE day. Also, an oxygen monitor on my finger and some device on my ankle to monitor my heart rate separate from the baby’s. I could not move around at all, and when I did have to go to the bathroom I need two people to help me. At one point, my bladder was so full and I could not release it because the baby’s head was pressing on it, and he could not pass because it was full, so they had to catheter me too.

I had five people in the birthing room with me, and thank God I did, because we needed them all. When it was finally time to push, I had one person holding my head up, and two people each holding up my legs and feet. I was so tired, that I actually was falling asleep between pushes. My friend that was holding my head told me that I would actually start to snore, and everyone at the other end of me would be chatting and such, and then when the next contraction would start, she said my head would start to move back and forth, and she would be like, hey guys, here we go, and then I would wake up and start to push again. The DR told me when I started pushing, that it would take ten or fifteen minutes to get him out. I pushed like that for almost an entire hour before he came out.

He was 11.6lbs and 22inches long. My placenta, which is normally one to two pounds, was over ten pounds. The DR was so amazed at the size of it that he could not stop talking about it. Altogether, it took 16 hours between the IV going in, and me giving birth. We were in the hospital for six nights, were the average stay here is only one night. However, he was in the ICU since he was premature, which was always pretty funny, since he looked like he was three month old, lol. In fact, they used to tease me, and tell me he could just walk home from the hospital.

However, in all that, the only problem he had, was some low blood sugar in the first two days after birth, which is common, and a pinched nerve in his right arm, because he did not move it for a good while in utero, quite frankly, because he had no room. That fixed itself over a couple weeks. He is now 14 years old, and while he is still a big boy at 6 foot 1 and wears a size 14W shoe, he is healthy as a horse. Ironically, I have had no major kidney problems, and still have my one kidney, which is fine.

Edited to add: The OB/GYN told me the next morning, that the reason we had to have him early, was because his placenta had expired, and had we waited til Monday, he would have died over the weekend. I thank God that I stayed and had that last test done.

sunnykt

Thank you for that story, it was insightful. I worry about having a baby as a diabetic.

Italian_Buju

Thank you for that story, it was insightful. I worry about having a baby as a diabetic.

You are young, and as long as you are fairly healthy, I would not worry too much, just make sure you keep your bloodsugar in check, and see your DR regularly....also, tell you when you want to have a baby BEFORE you start trying....that way, you can make sure everything is good to go.....I changed my insulin and started taking pregnancy vitamins three months before even trying....

tarakay84

Hi there.. I'd like to start off by saying that just b/c some ppl have GREAT or HORRIBLE pregnancies that everyone's is different.

My background: I'm currenlty 28, found out i was T1 DM when i was 15. I got preggo with my daughter when i was 23 and delvered her 12 days after my 24th bday. I was not on the insulin pump while preggo, i was on humalog, lantus and metformin, but when i found out i was preggo they took me off everything except for the humalog. I'm now on the minimed pump and oh man how it would of been awesome during pregnancy.

I was always told i'd prob never be able to have a baby or be able to live through a pregnancy. I've had some kidney issues so everyone always advised not to get pregnant. Anyways i wasn't trying to get pregnant when i did get preggo. I was on birthcontrol religiously. So she's just my little miracle baby. I was freaked out and was soo scared i'd have a sick baby. When i found out my AIC was 7.9 TOO HIGH, I obssessed with checking my BS and taking shots. I was taking about ten shots a day, but my AIC was 5.2 most of the pregnancy, so it paid off.

When i was almost six months pregnant i went in for my normal check up, my blood pressure was 180/100 and my dr. freaked out. He wanted to put me on bedrest, i told him that i coudn't afford it, he said i could try doing desk work at work (I'm a nurse) and so i went to desk work. But that didn't work well enough. Eventually my bp just kept getting higher and higher, i was diagnosed with PIH ( pregnancy induced hypertension) and then eventually started having to go in for NST's ( Non stress test) three times a week, every other time i'd get hosptialized due to my bp. And then i eventually started spilling protein threw my kidneys. So then I had Precampsia. I started getting really bad headaches, vision changes, etc due from the bp and preclampsia. So i eventually was put on full fledge bedrest, and still did my nst's three times a week, and then i'd get hosptialized every other time i'd go in, sometimes for a couple days sometime for a week. i was better in the hosp but it was b/c I wasn't aloud to move i could only get up to go to the bathroom, and i had to lay on my left side, when i did was better. They gave me the shots to make her lungs mature enough. Eventually my dr. decided to schedule a c-section and just take her b/c i wasn't getting better. They took her six weeks early. She weighed 8 lbs even. She did have to go to NICU due to respiratory issues and low BS. that was hard, but thankfully she was only in there for five days.

My hubby and i have decided that i won't have anymore babies, due to the complications,He's afraid i'll die, which i've decided that I guess it's not worth the risk. But it took me awhile to agree to that. Now that she's four I guess that it's just getting easier the older she gets and i'm not sure i want to got threw that all and if something happened to me she wouldn't have a mom.

My point is, you can do this.. You should make sure you are the healthiest you can be before getting pregnant and hope things are good for you!! Good luck!

sunnykt

Thank you for that story, it was insightful. I worry about having a baby as a diabetic.

You are young, and as long as you are fairly healthy, I would not worry too much, just make sure you keep your bloodsugar in check, and see your DR regularly....also, tell you when you want to have a baby BEFORE you start trying....that way, you can make sure everything is good to go.....I changed my insulin and started taking pregnancy vitamins three months before even trying....

Well I'm not even in a relationship so no plans to even have children for many, many years. I've just always thought I'd be better off adopting since I'm maternal enough to love any child.

It's still interesting to see the potential complications though.

Italian_Buju

Thank you for that story, it was insightful. I worry about having a baby as a diabetic.

You are young, and as long as you are fairly healthy, I would not worry too much, just make sure you keep your bloodsugar in check, and see your DR regularly....also, tell you when you want to have a baby BEFORE you start trying....that way, you can make sure everything is good to go.....I changed my insulin and started taking pregnancy vitamins three months before even trying....

Well I'm not even in a relationship so no plans to even have children for many, many years. I've just always thought I'd be better off adopting since I'm maternal enough to love any child.

It's still interesting to see the potential complications though.

Adoption is great too, my daughter is adopted.....whichever you choose, it will be great

wicklc

I am 23 years old and have been T1 diabetic since I was 5. I was on an insulin pump in middle and high school then went off of it when I went to college and used Novolog and Lantus insulin pens. I lost control of my glucose levels and my A1C went up to almost 9. This past February I went back on the insulin pump (medtronic) and was only on it 2 months when I found out I was pregnant- it was not a planned we were trying thing but we are thrilled! My doctor was not so thrilled and has been pushing to get my A1Cs down to a healthy level. I have gotten them down to 6.4 and now I am 31 weeks pregnant and so far the baby is healthy! There are a lot more risks to the baby and me but I see my doctors frequently and they are constantly making changes to my pump settings. 2nd trimester was the hardest I was dealing with a lot of low blood glucose levels- like 30s and 40s and almost ended up in the emergency room. The higher your glucose levels the more risk to the baby. I did have to have a fetal echo at 21 weeks but so far her heart and spine are fine and starting next week they do 2 ultrasounds a week until I have the baby to make sure everything is fine! I know this is kind of long winded but with a lot of hard work and controlling your glucose levels you can definitely have a healthy baby

We only have a few weeks left I can't wait to meet my little gal!

beckajw

I am 23 years old and have been T1 diabetic since I was 5. I was on an insulin pump in middle and high school then went off of it when I went to college and used Novolog and Lantus insulin pens. I lost control of my glucose levels and my A1C went up to almost 9. This past February I went back on the insulin pump (medtronic) and was only on it 2 months when I found out I was pregnant- it was not a planned we were trying thing but we are thrilled! My doctor was not so thrilled and has been pushing to get my A1Cs down to a healthy level. I have gotten them down to 6.4 and now I am 31 weeks pregnant and so far the baby is healthy! There are a lot more risks to the baby and me but I see my doctors frequently and they are constantly making changes to my pump settings. 2nd trimester was the hardest I was dealing with a lot of low blood glucose levels- like 30s and 40s and almost ended up in the emergency room. The higher your glucose levels the more risk to the baby. I did have to have a fetal echo at 21 weeks but so far her heart and spine are fine and starting next week they do 2 ultrasounds a week until I have the baby to make sure everything is fine! I know this is kind of long winded but with a lot of hard work and controlling your glucose levels you can definitely have a healthy baby We only have a few weeks left I can't wait to meet my little gal!

Congratulations! And, thank you. I love to hear positive stories from other T1s. I'm worried all the time about what will happen with my pregnancy.

kithalloyd

Ive had two babies and type one one at 25 and one at 30 and guess what when Im preg the numbers are much better. Dont worry about it things will come you will see. As far as your numbers now try to get it down to more like a 6 because the baby is affected before you even know you are preg so before you try get them down a bit. Remember that this is a high risk preg which means lots of trips to the doct and lots of ultrasounds. I went to the doc weekly twice a week starting at 20 weeks. Remember that diabeties is hard on not you but the baby as well and that your numbers mean double so keep them down as low as possible but not to low. Babies dont like to high or to low and both can lead to still births. I was on the pump novolog during preg and it did great the 2nd time the first time I was on the shots novolog and lantis and my numbers were much better. Kee pup the good work!! And remember that this is possible!! my a1c averaged at 5 during my first preg and 6 the sec. First baby 6lbs 14 oz sec 9 lbs so keep in mind. They say we have a hard time having kids but dont worry about that either I had two kids just fine only tried a few months with the first and the 2nd slipped up once and bam there he was lol

kithalloyd

I am 23 years old and have been T1 diabetic since I was 5. I was on an insulin pump in middle and high school then went off of it when I went to college and used Novolog and Lantus insulin pens. I lost control of my glucose levels and my A1C went up to almost 9. This past February I went back on the insulin pump (medtronic) and was only on it 2 months when I found out I was pregnant- it was not a planned we were trying thing but we are thrilled! My doctor was not so thrilled and has been pushing to get my A1Cs down to a healthy level. I have gotten them down to 6.4 and now I am 31 weeks pregnant and so far the baby is healthy! There are a lot more risks to the baby and me but I see my doctors frequently and they are constantly making changes to my pump settings. 2nd trimester was the hardest I was dealing with a lot of low blood glucose levels- like 30s and 40s and almost ended up in the emergency room. The higher your glucose levels the more risk to the baby. I did have to have a fetal echo at 21 weeks but so far her heart and spine are fine and starting next week they do 2 ultrasounds a week until I have the baby to make sure everything is fine! I know this is kind of long winded but with a lot of hard work and controlling your glucose levels you can definitely have a healthy baby We only have a few weeks left I can't wait to meet my little gal!

the lows are very dangerous just as the highs and kill brain cells so be careful I passed out and fell with my last from lows. You have been one since 5 you know your body better than any doct out there

Chandra_W

Thanks everyone for your stories. My appointment went really well, and the Doctor is really pleased to hear that I'm trying to take better care of myself so we can have a baby.

Since I'm the only person in my family with T1D, and really don't have many friends/contacts with it - I feel like I'm blind to what's going on because I don't know what to expect. I know everyone's situation is different, but in hearing everyone's situation, you can get a general idea of what it is like.

kimosabe1

Hello ladies-my name is Samantha and I have been T1 diabetic for 27 years now. I got pregnant at 25 and had lows so bad my pump thew me into a 6 month diabetic coma all due to low blood sugar. They had to deliver my son 1 month premature but I did not have any problems after that time. My son William is 8 years old now and I did have my tubes tied after birth. Although I do wish I could have another, he will do just fine considering my overall health. I am now on MFP because I hit 165 pounds at 5'5" and had to go on blood pressure and high cholesterol medication. I have now lost 11 pounds and my endocrinologist told me not much longer until I'm off these medications. It is somewhat difficult having a low at the gym but all diabetics understand the downfalls so I am looking for as many diabetic pals as possible. Thanks ladies!
Samantha