[mma2charlie]

My husband and i would like to start trying to get pregnant in the near future...my A1C isn't perfect (last test 7.8%).

questions are: where do i need to be, numbers wise, in order to safely start the process? and how long beforehand should i get down to that magic number, and how long does that magic number need to hold steady before trying to conceive?

i know the docs will tell me their prof opinions...just wanted to hear from some real diabetic women who have gone through this first.

Thanks!

[Keezheekoni]

Okay, so from my sources they want 6.5% or lower for two cycles before TTC. So basically be good for six months, then be good for another nine. I like to have my A1c in the 5s, so my care team really doesn't care about my A1c since it's usually in check. All of my kids who weren't preemies were normal sized babies because of this. They also didn't need to have formula shoved down their throats because they were hypo. (Which I don't believe in doing, but most hospitals don't give you a choice if your baby is hypo. I prefer breastfeeding because there's extra sugar in the colostrum and will get the baby up more quickly than formula will...)

I did have a preemie not due to diabetes, she has Langerhans' Cell Histiocytosis which typically causes prematurity and PIH in the mom. She's 5 and fine now, though still itty-bitty.

Now, my opinion is that if your next A1c is below 6.5, go for it. Since for three months you'll have been in a good range, you're typically not going to go off track when you know there's a reward 40 weeks later.

[csad]

Originally Posted by Keezheekoni

Okay, so from my sources they want 6.5% or lower for two cycles before TTC. So basically be good for six months, then be good for another nine. I like to have my A1c in the 5s, so my care team really doesn't care about my A1c since it's usually in check. All of my kids who weren't preemies were normal sized babies because of this. They also didn't need to have formula shoved down their throats because they were hypo. (Which I don't believe in doing, but most hospitals don't give you a choice if your baby is hypo. I prefer breastfeeding because there's extra sugar in the colostrum and will get the baby up more quickly than formula will...)

I did have a preemie not due to diabetes, she has Langerhans' Cell Histiocytosis which typically causes prematurity and PIH in the mom. She's 5 and fine now, though still itty-bitty.

Now, my opinion is that if your next A1c is below 6.5, go for it. Since for three months you'll have been in a good range, you're typically not going to go off track when you know there's a reward 40 weeks later.

This is well said- pretty much exactly what I was told. (I have one child.) The only thing I'd add is that I couldn't have achieved the goals without the insulin pump. I know some people do - more power to them! But I was around where you are now before going on the pump (don't know if you're already using one...), and my A1c came right down to 6.5 in the first 3 months on the pump (a bit more varied since, but almost always below 7.0, and below 6.0 during most of pregnancy). Pumping can have its own challenges, though, so get informed before trying if you want to add the challenge of pregnancy soon after going on the pump. I was pumping for about 6 years before becoming pregnant. I'd say at least 6 months to get used to the pump before getting pregnant, if you want to go that route. If you're already on the pump and are still at 7.8, you might need better information on how to use it. Either way, check your overnight BGs (preferably with continuous monitoring), I found that was a source of problems no doctor or educator ever seriously considered!

[mazea]

I was told my blood sugars needed to be stable for about 6 months after getting type 1.5 in May last year. I had a HBAC1 of 20 and since August it has been 5ish on multiple daily injections so the docs were quite happy for me to fall pregnant.
That said, it is easier for some people to maintain low blood sugar levels than others but the general rule is keeping your HBAC1 below 7 statistically(proven) minimises the chance of fetal abnomalities. Above 7, the risk of fetal abnormalities starts rising.
My endocrinologist had an idea for pregnancy. She suggested to make sure I woke up with a blood sugar level of 5 or lower. So in order to wake up 5mmol, I started going to bed on 5mmol at night. I started doing correction shots before going to bed on 5.5 or lower and my HBAC1 dropped 5 points. I believe this was the best idea I heard in a long time as it set me up low in the morning so my blood sugar levels would be lowish for the morning phenomenon rise and all day.