Pregnancy and if possible don't worry be happy [Archive]

sirius

08-04-2005, 12:41 PM

At this moment I am trying to get a better sugar results, because I want to become a mummy. I use Humalog and Landus. I have better blood sugar results and getting better I believe. The last HA1C was 7.7 (June 2005), the best result I ever had.
I am diabetic, type one for almost 7 years. The doctors told me that LANDUS is not tested for pregnancy, so from September I’ll have to change the insulin to Prophane in combination with Humalog. The doctor said that I have to be controlled up to 5.5 (HA1C), so that I won’t have risks. I changed my life habits, but one thing I did not change is to stop smoking… maybe the most important thing. I think I didn’t stop smoking because I have a stressful job – TV productions. You’ll tell me probably …”It’s an excuse - who hasn’t a stressful life? Anyway, I think I didn’t want to stop that, but know I have to. I have some worries. I will tell them to you as bad as I see them. Will I be able to accomplish 5.5 HA1C ever, since the best I did was 7.7 and should I wait and have patience to have this result and after that to have a baby? I am starting really to feel frustrated about it. My worries don’t stop. The fact that the diabetic person has to change all the time the life habits and accommodate to this crazy illness gives me a headache. I have to change again. No problem, I’ll do my best, but from the other side this is what my analytical mind is thinking: Will I have to stop to work? Will I have to just sit and lay down only, because if I do anything I’ll have hypo? If I have hypo or the opposite what should I do? I mean for 9 months I need to be careful not to have them????!!!! If I do, what happens? Will I have to measure 8 times/per day the blood sugar until my skin doesn’t feel anything? I was advised that I have to adjust the insulin units, depending on the sugar level I have at that moment. I have to stop this bad thinking of mine.
My husband and I, we are doing the same job. Our life is full of stress from the nature of our job (the company is ours and everything depends on us). Simply our life is love, stress from work, too much travel, speed…. I will try to change that, you know for which reason, but my husband can’t and I am not expecting that from him. He is supportive and doesn’t want me to feel different from others. My parents leave in another country, his parents leave in another city. I can’t expect them to help me. Until now, I was able to take care of myself and manage any condition I had (hypo & hyper). But pregnancy is something other, something unknown to me. So, we are leaving alone and my husband can’t be my babysitter and stop to work. We are living 50 km away from the city near to the sea. We rent house outside from the city to have calm. For a period of one month we stay at home from 10-15 days. I sometimes work from home, but usually travel to the office we have in the city or in other cities or countries where necessary. All the houses around are villas and some of the people are living here permanently. This is what I picture: I am home alone and I have a hypo and I can’t help myself and ……???!!! Who will take me in the hospital, if my husband is away? And the hospital is away too. Do I need to find doctor who will be 24 hours available on the phone? I have a very good discipline in the food regime and always take insulin on time. I don’t have any other health problems except for the diabetes. Maybe after all I am exaggerating in order to get ready to the fact of being pregnant. I asked these questions to my diabetes doctor who is not a specialist for pregnancy he said “everything will be fine, don’t worry too much”. He recommended to me other doctor for diabetes and pregnancy who did not have too much time and was too arrogant. I am thinking to change her. Am I having an imagination about the difficulties that are expecting me and make things worse by myself? Anyone have experience or knows anything about pregnancy and diabetics? Guys, I would like to hear and your opinion too. I think the best thing to make these fears disappear is to talk to people similar to me. I was never like this before! I NEED YOUR SUPPORT. THANK YOU ALL!!!!

“Don’t worry, be happy”

jdstein11

08-04-2005, 01:13 PM

I think that with exercize you may be able to help lower your BG (if that's the effect exercize gives you) without other changes, but you should absolutely always keep tablets on-hand to control any hypos. You shouldn't have to lie down in order to manage your BG. As for the smoking, you should start planning on other ways to control stress, as smoking will definitely not help you with your diabetes or your interest in having a child. I don't think we need to get into those risks!

Have you ever had to go to the hospital due to a hypo? If not, I think you should plan more positively and believe that you should be able to handle your diabetes, pregnant or not. If you're tracking your BG levels throughout the day, I hope you've been able to handle your doses to prevent hypos as much as you can; if not, start tracking to identify causes of hypos so you can better deal with them.

As I'm a guy, I can't give you any advice on pregnancy and diabetes, but I'm sure there are plenty of others here who can. This site has PLENTY of people willing to offer helpful advice! Good luck!

soremom

08-04-2005, 07:33 PM

I have two boys, 14 and 4. I had gestational diabetes with my first and then diagnosed T1 8 months after he was born. I figured with every thing I read I would never be able to have another child, didn't want to risk it and not be there for my son. We were a happy family and having one child was fine. Then my husband brother and his wife got pregnant, well that was it I wanted another one. Talked to me doctor, and she said as long as I had tight control, which I did so that was a problem, and to go on the insulin pump, there shouldn't be problems later in life, of course there is never any guarantee when you are pregnant. So that is what we did.

I had a few problems with my pregnancy, I won't go into them now, but if you want to know please ask. It was alot of work, you go to the doctor constantly from the beginning, I had a different ob and endo but I didn't mind. He was a month early but perfect. He is know a very active 4 year old. We didn't realize what our family was missing till he came into it. My oldest was just shy of being 10 and was thrilled to death to becoming a big brother (that is what the youngest calls him "big brother", he dont' call him by his name, it is very funny). I can understand your fears. I have always heard that diabetics shouldn't have children and so on, well it can happen. Tight control is a definite, and it will be a challange with you bgs throughout the pregnancy. The biggest thing you can do is test constantly. I didn't have any problems with lows during the pregnancy. With the pump it helps keep you more constant and easier to correct, atleast for me.

Any other questions, please ask. Each pregnancy is different for everyone but we can shed some light for you. Good luck and if this is what you want, relax, and just take one day at a time. It makes things go much easier than worry about 9 months from now.

Kim

sirius

08-05-2005, 03:06 AM

Thank you for getting back to me. Jdstein11, I never had hypos for which was necessary to be hospitalized. And, Kim I would like to know your experiences and problems during the pregnancy. Sorry but I do not understand what is ob and endo, please explain. First of all, I think we don’t have insulin pumps here in Greece, I am using injections (insulin pencil). I eat every day at the same time, take insulin at the same time, try to use same carb units for every meal and still have hypos. Maybe I should pay more attention to the energy consumption. But again I may sit all day or have a calm day and still have hypos. I also write my results in a note book, but maybe I should open agenda and do a study, write not only the BG results, but also what I eat, what I do during the day. I do the measurements myself, I have my own machine. I would like to know what were you told for hipers and hypos BG’s, during pregnancy? Did you manage to control the BG in normal levels during 9 months (5.5-6.0 HA1C)? Was it necessary to have this good results and before pregnancy? Did you plan your pregnancy? As I said I don’t have other health problems, I did a checking and I am fine. Have to stop to smoke, for sure. I went to a gynecologist and he told me that I don’t have problems, but I need to work on the BG and stabilaze it. I would like to know.....Is it better the gynecologist and endocrinologist to know each other, or work in the same hospital? Were they available for you anytime you needed them? Thanks!!!!

ksa01

08-05-2005, 08:46 AM

I'm 11 weeks pregnant now, so I'll share my experiences to date as well as my planning process.

I talked to my endocrinologist and gynecologist about planning a pregnancy a year before we started trying to conceive. My endo recommended that my A1c be as close to 6.0 as possible if not just below 6. He did tell me, however, that he has had women with A1c in the 7's and 8's that have had normal pregnancies and healthy babies. My A1c were usually around 6.8 at this time.

I tested 8-10 times a day, kept a log (bs readings, carbs eaten, insulin taken, exercise) and worked with him to lower my A1c to the new goal of 6.0. For me, my bs before eating were good (70-100), but 2 hour after eating were too high (180-200) which were creating the higher A1c. I adjusted the amount of insuling I took with meals and worked on being below 140 withing 2 hours of eating. Once I did this, my A1c dropped and I was consistently between 5.8 and 6.2. It took about 6 months to reach this goals and then he wanted me to maintain them for at least 6 months before trying to conceive.

I want to stress that in order to maintain such tight control, it is essential to test frequently because you are more likely to experience hypo's. If you insulin amount is set correctly, you should be able to reach this goal without a lot of hypos. I use an insulin pump, which I believe is easier to adjust than injections, and rarely had hypos.

Now that I'm pregnant, things have changed. When I first found out I was pregnant my bs were running high (150-200), which is very normal. My endo gave me new goals to work towards: pre-meal 60-80, 1 hr post-meal <130, 2 hr post-meal<110. I had to adjust my insulin rates again to meet these goals. Now, my basal rate is lower (insulin that drips into me all day to maintain bs level - doesn't account for food eaten) but my boluses (insulin taken to cover food eaten) has doubled.

I check my bs 12-15 times per day, because I do have a tendency to have more hypo's (40's-50's) so I catch them early and eat so I don't go lower. I've found that if I eat a meal or snack every 2-2.5 hours I don't have any hypos (I don't take insulin for snacks of 20g carbs or less).

Once becoming pregnant, I worried much more about high bs than low bs because the highs can harm the baby. My doctors all told me not to worry about the occassional highs-there is no way to avoid them completely-it being high consistently that can cause problems. When I'm high, I take extra insulin to come back to normal and don't eat anything for about an hour when I see the numbers coming down (highest so far 286). The first trimester is also the most important to keep as tight control as possible because of all the fetal development going on.

Other than changing how I take my insulin, I still take about the same amount as I did before getting pregnant. I'm told that I will need more as the pregnancy progesses. Otherwise, life has not changes too much. I still work and do all my normal things for the most part. I have been very tired, lacking energy, and decreased exercise but this is due to the fact that I'm pregnant not diabetic. Again-very normal for all pregnant women in the first trimester. I'm told this will be better by the 2nd trimester. Honestly, dealing with morning sickness all day and night is harder than dealing with being diabetic.

Anyway, my advice would be to track your bs reading and work with your doctor to see if you can decrease you A1c more (I think 5.5 is too low of a goal) before trying to conceive if you can. Also, talk to a doctor that specializes in pregnant women with diabetes if you can to find out more about the acutal risks associated with pregnancy. Most importantly, try to stop smoking. Smoking can have more of an effect on a developing fetus than an A1c in the 7's. Don't worry about what hasn't happened yet and all the what ifs -- you can only control the here and now.

sirius

08-05-2005, 09:44 AM

Thank you Karen for your reply with so much useful information! As you said step by step is the best way and to concentrate on here and now. My first step is to find doctor specialized for pregnancy and diabetes, to start to get control of the blood sugar and most important stop smoking. I would like to stay in touch with you and exchange thoughts and experiencies. Good luck with your pregnancy.

sirius

08-06-2005, 02:49 PM

My conversations with my endo now are like this: talks only if I had lows or highs and then he says “well try to do this or that” or I say do you think I should increase or decrease the bolus or the basal….Answer: “well, try and see what happens and call me tomorrow”. So, when I get that kind of answers I say why should I call him?! I’ll try myself and see what happens! This is one of the reasons, why I am feeling unsecured and I have fears for my future pregnancy.
I should find some endo and at the same time specialist for pregnancy to whom I can count on. I found one and I was so disappointed. Here’s the story….
My endo recommended her to me. She is working in a state hospital and on the first meeting I waited her for 3 hours to take some directions and start with the new therapy (Prophane & Humalog) vice (Landus & Humalog). She was very arrogant and her answer for the delay was that I had to mention (which I did when I asked for her) that my endo, send me to her?!!! I said to myself ….” Maybe I am exaggerating and imagining things. She didn’t give me any telephone, but gave me a new diet and some table with BG’s results and insulin units that I should stick on according with my BG’s results. For example if it is < 60 mg/dL, 0 units insulin; 60-80 BG , 2 units insulin; 80-120, 4 insulin, 121-160, 6 u insulin, 161-200, 8 u insulin …….(My opinion is that the BG’s and the insulin work different for everyone. I am telling this because when I have 80 BG and I take 4 units insulin I will have hypo. So, this may not work and for me. This is because I don’t know my “numbers”- The first is, if I take one unit of (Humalog) insulin, how far will it lower my BGL? The second number I need to know is how many grams of carbs will one unit of humalog take care of? How its possible to find out more about this “numbers”?
....We appointed the next meeting on 21 June. I couldn’t go because I had to be on work that day and out of country for hole month (Confederations Cup Germany). So because I didn’t know her telephone I called my endo first to contact her and tell her that I want to move the date for the meeting and to give me her telephone too. He gave me a telephone from the hospital on which I had to speak with two people to find her. Just to mention that I have a mobile from my endo and he is working in a state hospital too. He told me it will be better to communicate with this woman only when she is at work. So what happens when I am pregnant, have a big BG problem and she is out of work. Who will help me? At the end when I called her she was so ruthless and the first thing she told me was….” Why did I call my endo to contact her on her telephone”. I said: “because simply I don’t have your phone. I asked her when we can rearrange a meeting. She said I can’t see you in July, call me from August.” So, that’s why I haven’t start with my new therapy yet. I am thinking to change her. Maybe a private specialist can help me? They are usually more careful, but it costs. I am concerned.

soremom

08-06-2005, 07:17 PM

Sorry, I tend to abberviate alot. Ob would be the baby doctor, endo my diabetes doctor, I have trouble enough saying the full word as I do typing it, endo is less of a mouthful for me, lol.

I had a test done between 14-16 weeks to test for down syndrome or other possible problems with the baby. I was 32 at the time and felt with my age and health I wanted to know. I would rather find out in the beginning and deal with it and get the best possible care when the baby was born, then finding out after he was born that there was a problem then dealing with it. That is just me though. I believe it is called an alpha maternal fetal test or something very close to that. The first one came back abnormal, had to wait 10 days to take another. Same results, this was signifying that the baby could have spina bifida (spinal abnormatilty). We were sent to a specialist. After all the tests were done, we were told he was perfect (plus we were having another boy). The checked his heart valves, internal organs, fingers and toes, brain. We were told there was still a slight chance of a hole in his spinal column, but doubtful.

Towards the end (33 weeks), I went back to the specialist for one last examine. My amniotic fluid was very low, but in the hospital with fluids, raised it and was sent home on bed rest. Checked a week later to see if he could come out (have an amino) and the fluid was worse, put back in the hospital with fluids and had him the next day. He was born at 36 weeks, which they say is premature, but he was fine.

It is worrisome the whole time, wondering if I did the right thing, but I did that with my first and didn't have prblems with him till the end, gestational diabetes with the first.

A good doctor is crucial, I would definitely find one first so you are comfortable with the doctor. Good luck and any more questions, please ask.

Kim

sirius

08-07-2005, 06:32 AM

Hi all of you,
I have some questions.........
1. What type of insulin do you or did you use during the pregnancy? I was told that Landus is not tested on pregnant women and his effects are unknown. I use Landus & Humalog now and was told to use Humalog & Prophane (NPH) if I say it correctly.
2. When you say normal level of BS what do you mean? I know that normal is from 80-120 mg/dL, lower then <80 I am feeling the effects of hypo. The hypos I had until now are from 26 to 76.
3.Kim/Karen is/was your endo for pregnancy available for you on the phone 24 hours?
4.The meetings with the endo for the pregnancy, do they depend on the condition of each pregnancy case? How often do/did you have to see your endo during the pregnancy?

soremom

08-07-2005, 07:26 PM

I actually saw my endo about the same as normal. The baby doctor sent my reports from every other week visits to her. If she saw something that didn't agree, then I was in to see her.

I was on humalog because of the pump. I went on lantus after my son was born. I had problems with the pump the last month of my pregnancy, shots actually helped control me better. I don't like going over 120 if I can help it any ways, so she left me alone. I didn't have problems with lows until I went on the lantus.

My endo was available 24 hours, either her or someone covering. We have answering services you call, and they have the doctor can't back in touch with you. I never had to call during my pregnancy, but another time (can't even remember for what). They are good at getting me in quickly if I am having problems. The baby doctor is the same, call the service and they call back. I had to do this once because of migraines that wouldn't go away. They were also good about getting me in immediately if I was having problems, which I had to do a couple times. It seems that because of the diabetes they don't like to mess around. Which was nice for me.

Hope I got everything, again any more questions fire away.

Kim

sirius

08-08-2005, 02:16 AM

I am trying to get rid of these stupid fears I have. The more I know, the fears will go away. I think only by talking with someone and sharing your thoughts for what you feel you are one step ahead to resolve something which you think is problem.
Actually, I have a lot of questions….. if you don’t mind. I’ll ask them one by one. What about the birth of the child? Natural way or c-section?

Only you seem to be interested to reply to my questions. :(
Thanks Kim for your support. You're a real friend. :shakehand

ksa01

08-08-2005, 04:49 PM

To answer some of your questions:

I'm on an insulin pump so I use humalog. I started using an insulin pump within 6 months of being diagnosed with type 1 so I don't really remember what it was like to use injections. I know I used humalog and NPH and didn't really have good control until I went on the pump. For me in control or normal bs readings are between 60-110 now that I'm pregnant, with the exception being 1 hour after eating where I can be as high as 130 and still be good. Prior to being pregnant, normal bs was the 80-120 range and less than 140 within 2 hours of eating. As you can see, the range is tighter during pregnancy in an effort to mimick non-diabetic women's responses to pregnancy and therefore minimize potential risks to the developing baby.
I'm telling you these goal so you know what to expect when you become pregnant, but don't try to attain the tighter goals before getting pregnant. Tighter control leads to more hypos. Pregnancy and all the hormones involved will make it fairly easy to reach the tighter goals as you blood sugar drops pretty easily.

Currently, I see my endo every three weeks. Prior to becoming pregnant, I saw him every three months. I also see the high risk pregnancy doctors every three weeks. As I progress, I will see them more often. By the third tri-mester, I'll have weekly appoinment and possible twice a week when I get close to my delivery date. In the third trimester, the monitor the baby's development very closely for problems and make sure it's not getting too big that would cause other complications for delivery. Besides the frequency of the visits, they said my care is the same as any other pregnant women's. The only test that is routine for diabetic mothers and not for non-diabetic women is a fetal echocardiogram at 20 weeks. This is because our babies can be more likely to develop heart problems.

My endo and pregnancy doctors are both with the same hospital, but they don't really work together. The send each other summaries of my visits with them, but don't really communicate otherwise. The pregnancy doctors told me they could help me adjust my insulin as needed and also make adjustment to my thyroid medicine (I have hypothryoidism too), but I prefer my endocrinologist to work with me on this. After all, these are his areas of expertise. They're ok with that.

Both my endo and pregnancy doctors are available all the time - just as Kim (soremom) described. Whenever I've called either office, either a nurse or doctor has returned my call by the end of the day. So far I've been happy with this, but I haven't really had an urgent situation occur. The high risk pregnancy doctors have emphasized that they want to be called if I have any problems, illnesses, or start experiencing many high bs readings for extended periods, etc. Hopefully, I'll never have to call them.

I'll try to answer any questions you have and hopefully ease your fears a bit. I was terrified of being pregnant with diabetes too, until I talked to others and my doctors. For me, it's reassuring that many diabetic women have had babies and I'm not the first. Most of these babies have been perfectly normal and healthy despite their mother's diabetes -- so the odds are on you side. Sometimes it's hard and frustrating, but all you can do is you best and try again the next day and next.

ksa01

08-08-2005, 05:16 PM

My opinion is that the BG’s and the insulin work different for everyone. I am telling this because when I have 80 BG and I take 4 units insulin I will have hypo. So, this may not work and for me. This is because I don’t know my “numbers”- The first is, if I take one unit of (Humalog) insulin, how far will it lower my BGL? The second number I need to know is how many grams of carbs will one unit of humalog take care of? How its possible to find out more about this “numbers”?

You're right-everyone is different and your insulin needs must be adjusted to best suit you. Unfortunately, I don't know how you figure out this information for non-pump users. I'm not sure if it's different but I don't want to give you wrong advice since I'm clueless about insulin via injections. I would suggest posting this question elsewhere on the forum where others are more likely to respond. In addition to finding out the answers to you questions above, you also need to know how to check to see if your long lasting insulin (Lantus) is set at the correct dosage for you.

Once you figure out this information, you should be able to experience much more stable bs readings without a lot of hypos.

On the same subject, you doctor may be able to help you figure this out or at least offer you a starting point. From your previous posts, it seems to me that you are, however, expecting too much from your doctor. The doctors can only offer you general suggestions/guidelines based on their experiences and knowledge of their fields. But ultimately, you know your body and it's reactions to food and insulin and therefore are the only one truly capable of perfecting your own care. When I see my endo, he can never tell me what will definately work to control my bs. Like you doctor, he says try making this change and see what happens. What I do then is follow his lead by making slight changes, charting my results for a few days and making more changes if necessary. The important thing is to write down results and the changes made so you can see a pattern and never make more than one change at a times. If you're not comfortable making the changes yourself, this is where your doctor can offer you guidance.

Good luck. With patience, persistence, and good record keeping you should be able to figure this out.

soremom

08-08-2005, 05:51 PM

I had c-sections both times. The first I was induced and after two days, I made no progess, I didn't diatlate at all (sorry for spelling). With the second, they gave me the choice. Frankly, natural childbirth scared me. I know what to expect with a section, so I opted for that. The doctors also said there was a good chance that the same thing would happen with the first.

If your baby becomes too big, they may decide to do a section just to make it easier on you and not have the baby get stuck coming out. This is really something the doctor will have to go over with you, each one is different on how they handle this.

The doctor helped me figure out my carb ratio, which I may change depending on what I eat, but that was by trail and error like ksa said. This did change the further along in my pregnancy, you need more insulin the further along, but after giving birth it starts going back to normal very quickly. I did all my own insulin adjustments, I would go over this with the endo and she usually agreed with me. I know my body better than her and she understands this, which is so nice. I was just surprised by how much insulin I need versus what I would normally take.

Again asky away. I love talking about this, I loved being pregnant. I didn't have anyone to talk to that had gone through this and had first hand experience so I love being able to give someone advice. Just remember what worked for me may not work for you. Unfortunately it is all trial and error.

Kim

sirius

08-09-2005, 06:35 AM

Can somebody tell me more about the insulin pump? As I said I use pencil to inject insulin. No insulin pumps here in Greece. Maybe I can order it or buy it.
As far as for the basal insulin (NPH) I should take during the pregnancy, I was told that has similar effects like Insulatard. Is this true? I used to take Insulatard and changed my insulin therapy with Landus, because my bs was not so good. Will I have to go back to bad bs again?
Can you tell me where can I find answer for the "numbers" here or somewhere else? If you don't have an idea I don't mind I'll try to do my own search too.
Very good! I learned so much and have to learn more. "Life is learning all the time". Don't mind that. :hello:

sirius

08-09-2005, 10:26 AM

Kim how big were your babies?

What about your weight during pregnancy? I suppose the weight can be controlled by the diet you have, if you start to have problems. Right?

Willow

08-09-2005, 01:35 PM

Hi everyone

I've been glued to your posts as my husband & I are hoping to start trying for a family later this year. I have found all of the information posted very helpful & interesting.

Does anyone know if having diabetes (I'm type 1) can cause problems with conception?

Thanks

ksa01

08-09-2005, 05:52 PM

From what I know, type 1 diabetes doesn't affect the ability to conceive.

Hypothyroidism, however, can affect you ability to conceive if it isn't controlled as well as affect the neural development of the baby. I believe screening for hypothyroidism is relative standard for all women early in their pregnancy, but it wouldn't hurt to be screened for it prior to trying to conceive. Women with type 1 diabetes do have a higher incidence of hypothyroidism than non-diabetic women and women in general are more prone to this problem than men.

On a similar note, it is recommended that women trying to conceive take a supplement of 400mcg of folic acid either on its own or as part of a multivitamin. 400mcg of folic acid dramatically decreases your chances of having a baby with birth defects such as cleft palate and defects of the spine and brain such as spina bifida.

soremom

08-09-2005, 05:54 PM

For the insulin pump, you can go to the Insulin Pumpers site, they have information on all the pump companies, they will have information for you to contact the companies to see if you can get information and/or the pump in Greece. The address is www.insulin-pumpers.org. Hope this helps. The have direct links to the companies.

As for the comparison of NPH and the other, I really don't know. It has been along time since I have been on NPH. I know it was harder controlling bgs with it.

My first son was 8 lbs 11 oz. He was 18 days early. I gained 11 pounds with him. I had gestional diabetes with him, so I was more scared about what I ate since I didn't know anything. My 2nd was 6 lbs 11 oz. He was 4 weeks early. I gained 30 with him. Mainly because I knew what I could and couldn't eat and with him I was extremely tired throughout most of the pregnancy. I would come home, get dinner, do what house work I could do and lay down. I don't think that is just a diabetes thing but a pregnancy thing, I didn't feel that way the first time.

Hope this gives you a little more information.

Kim

sirius

08-10-2005, 05:53 AM

[QUOTE=Willow]Hi everyone

I've been glued to your posts as my husband & I are hoping to start trying for a family later this year. I have found all of the information posted very helpful & interesting.

Does anyone know if having diabetes (I'm type 1) can cause problems with conception?

Hi Willow,

Me and my husband, we are in a period of planning a baby too. I started these discussions to find out more about what is expecting me and to ease my fears and make them disapear.
My gynecologist and endo have told me that type 1 can't cause problems with conception. I just need to work on my bs levels, that't what they said.

sirius

08-10-2005, 06:02 AM

Women who are diagnozed with more then 10 years with diabetes, have higher risks and may encounter more problems during the pregnancy period and the birth. TRUE OR FALSE?

I have diabetes for almost 7 years (December, 1998)

Willow

08-10-2005, 06:04 AM

Hi ksa01 / Sirius

Thanks for your posts.

Good news to hear that having type 1 does not hinder conception. But, I have hypothyroidism & take 2 carbimazole tablets per day. I didn't know hypothroidism could cause problems with conceiving - I am not happy to hear that! :(

I'm working on really tight control & take a pre-natal vitamin tablet daily.

I think a visit to my doctor to discuss things will be sooner than planned.

Cheers

ksa01

08-10-2005, 11:30 AM

I didn't know hypothroidism could cause problems with conceiving - I am not happy to hear that! :(

Don't get too worried. As long as the medication you are taking for your hypothyroidism keeps your TSH results in the normal range, the disease shouldn't affect your ability to conceive. The conception problems arise when your TSH levels are outside the normal range. From my understanding, it's the women who don't know that they have hypothyroidism that have trouble conceiving until they are diagnosed and treated properly.

I've known two women that were having trouble getting pregnant until they finally told they gynecologist and were tested for hypothyroidism. Within a year of starting medication, both got pregnant. I was diagnosed with hypothyroidism at the same time I was diagnosed with type 1 -- 4 years ago. I had no problems with conception. I got pregnant three months after stopping birth control -- much faster than I had anticipated.

ksa01

08-10-2005, 11:46 AM

Women who are diagnozed with more then 10 years with diabetes, have higher risks and may encounter more problems during the pregnancy period and the birth. TRUE OR FALSE?

I don't beleive that length of time that you have been diabetic means that you have higher risks or will have more problems.

What does matter is any complications you may already have due to diabetes -- kidney problems, eye problems, heart problems, etc as well as your blood sugar levels prior to conception (generally 3 months prior) and during the pregnancy (especially the first trimester when all major organs are being formed).

Your family medical history and your age also help determine your potential risks during pregnancy. Women over 35 have higher risks than younger women.

To put your mind at ease, prior to trying to conceive you could have a complete physical exam and bloodwork to see if you have any issues, if you don't already stay on top of this stuff.

sirius

08-10-2005, 01:39 PM

I don't beleive that length of time that you have been diabetic means that you have higher risks or will have more problems.

I agree with you karen. I think this statement is something similar or provides the same effects as when a child doesn't do something and he is told "if you don't do that the witch is going to take you".
It's always nice to hear your opinion. You already gave me so much useful information.

sirius

08-10-2005, 01:54 PM

I understand that before conception you should try to have HA1C aroun 6.0. Three or five days before PMS, my sugar levels are out of control usually. Now, I have highs and as much as I increase my bolus insulin, I don't see some improvements. Sometimes I have for change lows during this period.
AM I having insulin resistance before PMS? Maybe.
How can I deal with it? Anyone have that experience? Should I do more exercise, eat more or less adjusting insulin doesn't help me.

soremom

08-10-2005, 05:47 PM

From talking with my doctor, I don't believe PMS causes insulin resistance. Those wonderful hormones are to blame. I actually start having lows a few days before I start. I have to really cut back on my boluses, basil dosen't seem to be too bad. I usually don't go high with them, so I really don't have any advice. For me it is just cutting back on insulin. I do limit running around and such, especially in the summer, tends to make me go low without warning even on the pump. I am lucky though, my schedule each month is about the same each month. Helps with planning for the lows.

Kim

sirius

08-11-2005, 12:27 AM

Thanks Kim for getting back to me . Anyone have other ideas? For three days each morning I wake up, the BGL is higher. This morning I had 174, before one day 143, before that 75, before 116. And during the day my BGL's are bad now.
What were your H1Ac's three months before and after your pregnancy?

soremom

08-11-2005, 04:46 PM

I honestly don't remember what my A1Cs were. I know that there wasn't much difference, otherwise they would stick out better in my head. I know I was in the mid 6s before, throughout, and after my pregnancy. Sorry I can't get give a better answer, this brain don't hold much any more, lol.

Though I did go to the doctor today and got my result of 5.5. Up from last time of 5.3, but I have been more consistant this time on didn't have lows screwing up my results, so I was pleased.

Kim

sirius

08-12-2005, 01:27 AM

Very good HA1C! My last HA1C was 7.7 (in the beginning of June) and I was happy for the change of 8.7-9.9, which were my results before I started to take Landus. From September I am thinking to start with my new insulin therapy for the pregnancy, check my BGL's and hopefully obtain better control. We'll see how it goes. I have found here a good gynecologist he is working in a private hospital and he reccommended to me one endo specialist for pregnancy. If I choose this option I may feel secure that I'll have the appropriate support (24h available), but it will cost, i'll have to pay each visit with them. I suppose I'll have more visits with my endo, then with my gynecologist who told me I don't have problems to conceive, I just need to take care of my bgl. Everybody is on holidays now and I think September is a good month to start with necessary preparations and planning.
Thank you Kim for the info on the insulin pumps. I've made a contact and waiting for reply. Also I found usefull information for the pumps on www.cozmore.com. It would be nice if I could take one and have better control.
(Just to keep you informed) As far as my PMS and the high bs (from 160-225) I have lately during the day, I did the following....yesterday 2.30 h after my lunch I measured, my bs was 185, done exercise for 15 min only, measured again after 15 min and it was 186, before dinner 201, before landus 146 at 2330 h. In the morning hypo 53. :hmpf: What can I say?!

Here is my new question: Did you stopped drinking coffee during the pregnancy? If no, what kind of coffee and how many cups per day? I drink usually 2 coffees with milk and sweetner / per day. It doesn't make me problems with my bs, as far as I know, but during my pregnancy I don't know.

ksa01

08-12-2005, 07:14 AM

What were your H1Ac's three months before and after your pregnancy?

For 1 year prior to trying to get pregnant, my A1c ranged from 5.7-6.2. My most recent A1c (last month; 8 weeks pregnant) was 5.5. My A1c decreased becasue I was having a lot of hypos the first few weeks after finding out I was pregnant. For two weeks before I suspected that I was pregnant, my bs ran consistently high (150-200). I didn't think much about it because I normally have high bs before my period then they usually drop significantly. Of course I panicked about this when I missed my period. Apparently, many diabetic women experience high bs during the first couple weeks of pregnancy so what I experienced was pretty normal-including the panic.

In my opinion, a low A1c isn't necessarily good if it means that you are having a lot of hypos. My personal goal is to keep my a1c close to 6.0 without many hypos. Prior to being pregnant, I rarely had hypos so they really scare me know.

Once I started trying to conceive, I stopped drinking caffeinated drinks on a daily basis, but I didn't drink that much to begin with (1c tea or a soda). In general, dr say its ok to consume caffeine while you're pregnant as long as it's not excessive. Your 2 cups of coffee wouldn't be considered excessive, but I would ask my dr to be certain.

It sounds like you are taking to right steps to planning a pregnancy. Hopefully, you new drs will be helpful to you and you'll really like them. Feeling secure and confident that your drs are available to help you when needed is very important.

sirius

08-15-2005, 10:30 AM

Sorry folks, I've disappeared for a while, due to work.
Thanks Karen for your best wishes. I had and still have so much work (Cypriot airplane crushed here yesterday). I was alone in the office and had to work from 1100 until 0300 in the night and the story still goes on (the others are on holidays).
This work gives me so much stress sometimes when there's a breaking news event. I like it, can't change it, the company is ours. The phones were ringing like crazy, I had to reply to all the clients, resulting to ....I did not had time to eat and put my insulin for lunch, so I was late for 1 hour. My BGL's were going crazy too, from highs due to the delay, to lows today in the morning. (It's not always like this).This is one example which scares me for the pregnancy. That's why I mentioned in my first post, if maybe it's necessary to stop with the work, at least try not to have so much stress. I mean so many things depend on me and my husband. I was telling him to find another person now that we're planning for baby, so things can be easier for me during the pregnancy. I shouldn't have so much stress during my pregnancy. But, who will replace me? What kind of job do you do? How did you handle the stress you had during pregnancy?

"The stress is bad for diabetes"

ksa01

08-15-2005, 12:31 PM

Dealing with a stressful job does make it extra difficult to control your bs. Currently, I have very little stress in my life. I work as a consultant doing bookkeeping and basic accounting for small companies. I make my own hours and work as much or as little as I want. I'm fortunate to be able to do this and it has been very helpful since I've been pregnant. I've been exhausted and dealing with constant morning sickness, so it would have been hard to be working full-time for the last couple weeks.

Prior to consulting, I had an extremely stressful job as an executive director of a non-profit corporation. I worked 60+ hours a week, including many weekends. I was able to maintain good control (A1c's 6.2-6.8), but it took effort. I checked my bs often and always made sure that I ate on a regular schedule. Everyone who worked for me knew that this was necessary for my health and tried to let me have at least 20 uninterrupted minutes for lunch. At times, it was difficult to make time to eat, but it had to be a top priority because I can't function when I'm low and absolutely miserable when I run really high. I left the job because I was burnt out after doing it for 7 years and needed a change.

You may not have to quit working in order to reduce your stress. Perhaps you can hire someone to work with you to pick up some of workload and give you breaks to eat. Before you make any major decisions concerning your work, I would recommend making the changes regarding your insulin doses and see how that affects your bs levels. With new doctors and adjustments in your insulin therapy, you might be able to achieve good control despite your stress.

Try to keep things in perspective. Right now, you are contolling your diabetes reasonably well, especially since you admit that there is a lot of information that you don't know (ex. meal bolus, correction factor...) that would help you achieve better control. I'm confident that you will achieve even better control with time once you learn this information and adjust your insulin therapy to better suit your individual needs.

sirius

08-16-2005, 07:40 AM

What about exercise and pregnancy? I know...it's not recommended when you have a lot of hypos...
Anyway, did you practice any exercise during pregnancy? What kind? I sometimes drive bicycle, play tennis or just put on music and dance...To be honest, I don't have a lot of time for exercise, because I lose a lot of energy anyway while working. When I have time to do exercise, I think 15-30 min it's enough for me. I never actually measured the time duration when I exercise, I just concentrate on what I feel and of course I measure my BGL’s before and after. If I have normal bs I don’t exercise, because I might possibly have hypo after. What about you ?

ksa01

08-16-2005, 11:27 AM

Prior to being pregnant, I exercised 1 hr a day, 4-5 times a week. I alternated between walking, aerobics, pilates, and yoga. In order to avoid hypos, I had to make sure my bs was above 120, eat 30-45 grams of carbs (no insulin to cover), and disconnect from my pump during exercise (no new insulin entering my system).

Since being pregnant, I haven't really been exercising because I've been so exhausted. This week, I've had more energy and started exercising a bit again. Nothing too strenuous--pre-natal yoga or walking for 30 minutes. I still have to eat before hand in order to avoid hypos. I plan on continuing this type of exercise for the duration of my pregnancy if possible.

With exercise, I've always tested before, during, and after to avoid hypos. Exercising actually makes you feel more energetic after you've done it consistently for a while. To avoid hypos, eat a snack before hand. The exercise will also help lower your bs overall and can help your body use insulin more effectively. Unfortunately, you have to experiment and test often to see how much you need to eat and how your body reacts with exercise--everyone is different.