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5 or 6 weeks pregnant, high A1C, care

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#1
VivianG

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Hi, my wife just found out she is pregnant. She is about 5 or 6 weeks. We know that her A1C level going into the pregnancy is around 9. Has anybody here been in this situation and have had a successful pregnancy? She is now taking a lot better care of herself to bring her A1C down. We are just a little concerned on what we should expect. We just found out she was pregnant and have a schedule with the doctor tomorrow to see what they will tell us. Thank you, appreciate any feedback.

Also does anybody have advice on how to lower the A1C quickly.

#2
Jan B

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Welcome VivianG,

Ideally, a woman's A1c should be 6 or less before conceiving. However, there have been many healthy babies born who didn't start out in the ideal setting. In most cases, it's not a good idea to lower the A1c too fast; it can cause problems for the mother (eye trouble as in bleeds for example). I'm glad you are getting to the doctor. We have several pregnant women around & others who should be able to give you some pointers. There are some sad stories, but mostly good outcomes, so I hope you don't worry too much.
Jan

Type 1 since 1979
Diagnosed at age 18

#3
aiah23

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Hi, my wife just found out she is pregnant. She is about 5 or 6 weeks. We know that her A1C level going into the pregnancy is around 9. Has anybody here been in this situation and have had a successful pregnancy? She is now taking a lot better care of herself to bring her A1C down. We are just a little concerned on what we should expect. We just found out she was pregnant and have a schedule with the doctor tomorrow to see what they will tell us. Thank you, appreciate any feedback.

Also does anybody have advice on how to lower the A1C quickly.


I tried to send you a personal message but was unable to do so (offering more information on this matter). I can only say that the situation is very dependent on a number of things without more info on your wife. Also, is she a type 1 or a type 2 diabetic? Is she on blood pressure medication (that's almost always changed for pregnancy).

Fawn

#4
VivianG

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Hi aiah23, she is a type 1 diabetic and she is not on blood pressure medication, she is 25 years old

#5
aiah23

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Hi aiah23, she is a type 1 diabetic and she is not on blood pressure medication, she is 25 years old


The docs will give her target levels for blood sugars pre and post meals, there's a very tight range (I think it's 70-90 pre-meals and my endo told me 130 at 1 hr post prandial for pregnancy). She should be on pre-natals and drinking tons of water, eliminating or severely reducing caffeine, and you both should find a perinatologist covered by your insurance (since they deal with only high risk pregnancies, they're also called maternal and fetal specialists). She should be testing between 8-10X/day minimum to figure out where her blood sugars are running and to prevent going longer periods with undetected high blood sugars.

Fawn

#6
Jan B

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Fawn,

Is there any danger in lowering the A1c too quickly?
Jan

Type 1 since 1979
Diagnosed at age 18

#7
aiah23

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Fawn,

Is there any danger in lowering the A1c too quickly?


That I'm not sure of. The higher it is during the first trimester (especially weeks 5-7 for organ formation) seems to be the most damaging (which is why docs want ladies below 7 pre-conception). I guess it would depend on pre-exisiting conditions (the poster didn't mention whether or not his wife had any signs of retinopathy). If there were issues with retinopathy (I believe another poster under the type 1 diabetes and pregnancy sub-forum had this issue) then you have to be regularly monitored by an ophthamologist during pregnancy. I don't have retinopathy but I have high eye pressure due to a botched surgery back in the 90s so I have to go see my eye doc every month to monitor eye pressure, can't be on the eye drops for that during pregnancy.

Fawn

#8
cassandrajade

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My HBA1C was 10.6 going into pregnancy, it was unplanned and therefore unexpected.
I have dramatically changed my thinking and done everything possible, now suffering some bad lows instead which have doctors breathing fire out their noses.
My last HBA1C had lowered to 9.6 and that was within a month.

I had my first ultrasound today at 8 weeks 2 days and saw everything looking amazing :) a beautiful little blob with a beautiful heart beat of 175bts/minute.
Have faith, and do not let them make you cry like they did me. They can be nasty but as long as she is doing her best she should be proud of herself for turning it all around.

Type 1 Diabetic since November 1992.
Humalog and Lantus Luxura Pen User.


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Lost "Nevaeh Hill" on Saturday, 27 March at 5 weeks, 3 days.
Engaged to my partner, Matthew Hill, of 1 year.


#9
NAE^NAE

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hi i am new to this forum i am a type 1 diabetic that has not really controled my blood sugars ....ok honestly they were outta control i found out i was 7 weeks pregnant with a a1c of 11 sense then i have seemed to manage to keep my readings under tight control i go to a diabetic class called sweet sucess which they assist me in monitor my readings closely i do relize cause of my age and poorly controled sugars i am a high risk and i am doing all and the very best i can to try to carry a full term healthy pregnancy i guess i just wanted to hear if anyone has had a sucess with starting with a very high a1c like me

#10
Beth AuBuchon

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I'm a type 1 also... A1C is 8.6... not pregnant yet but I went to an endo. to see what I needed to do to better prepare myself and I basically got told that my blood sugars were out of control:( I was actually happy with 8.6 until I left the doctor's office and now am terrified of "What if I'm already pregnant?" Do you have statistics on how many babies suffer from complications because their mom had a high A1C?? Your post gave me hope!! I am determined to lower my blood sugars and get better control and I can't to post on here that I am indeed pregnant!!

Beth

#11
aiah23

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I'm a type 1 also... A1C is 8.6... not pregnant yet but I went to an endo. to see what I needed to do to better prepare myself and I basically got told that my blood sugars were out of control:( I was actually happy with 8.6 until I left the doctor's office and now am terrified of "What if I'm already pregnant?" Do you have statistics on how many babies suffer from complications because their mom had a high A1C?? Your post gave me hope!! I am determined to lower my blood sugars and get better control and I can't to post on here that I am indeed pregnant!!

Beth


You're not going to find stats on this. With a high A1C it's pretty variable on what it can do to the developing baby. If it's high and uncontrolled long enough, the pregnancy can end simply in miscarriage. So you're not going to find an accurate set of stats on this sort of situation since some of them end in miscarriage. Another thing to keep in mind, approx 1 in 5 pregnancies end in miscarriage (often before the end of the first trimester and a good chunk of those before a woman even knows she's pregnant). This is the average number for women in any health range, not just diabetics. Also worth noting, if you have any kind of pre-existing diabetes (type 1, type 2 or previous gestational diabetes) your pregnancy is considered high risk. If you have asthma, suffer from migraines, have pre-existing high blood pressure, you're automatically considered a high risk pregnancy (same as if you're pregnant with multiples too). If you've had a couple of previous miscarriages, you also fall into this boat so it's a larger pool of people than just the diabetics. Sustained high blood sugars later in pregnancy cause the baby to gain more weight which makes labor and delivery more difficult not only for you, but it can be for the baby as well (and can result in C-sections). Sustained high blood sugars earlier in pregnancy can result in developmental problems (and depending on the week this can effect things such as heart development, circulatory system development, nervous system development, etc). Since docs can't give you definite numbers on how long those high blood sugars cause problems, the rule of thumb is that you avoid those highs b/c they can damage the baby, not b/c they will. There have been plenty of babies born to mothers who didn't plan their pregnancies and started out with high A1Cs. The way I looked at it is as follows:
It is my responsibility to be as healthy for my baby as possible. If I get lax in my control and it impacts my baby (either pre-birth, early childhood, or behavior issues down the line), that is a sense of guilt I am going to carry for years, if not decades. if I do everything possible to be as healthy for the baby as possible, then I know I'm doing my part and increasing my baby's chances for being as normal and healthy as possible. That's all any mother can do. Why wrestle with the guilt I guess is my way of looking at it. You're going to feel plenty guilty as time goes on and at various points in your life as your kiddo grows up wondering if things had been different if you were there at a crucial moment vs _______. You do have some control of your blood sugars during your pregnancy and will have a team following and assisting you in every way possible; it is up to you to utilize them and to take care of yourself and your baby.

Fawn
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Sleep deprived first time mommy working full time! :eek:
A1C: 6.7 as of 04/28/12

#12
jwags

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I think you just have to work with your doctor and be really strict about diet and keep bgs in range. Even non diabetics have problems with pregnancies. I had a compeltely healthy pregnancy while non diabetic and ended up losing the baby. So lots of times , no one knows. Many diabetics give birth to very healthy babies. Just listen to your doctor and do your best. I now have 5 very healthy kids.

#13
Echolake

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I was in a similar situation, my A1c was at 8.4 in August and had pretty much always been in around there. All doctors advised me not to get pregnant until it was under 6.5, but I'm not getting any younger so I finally decided just to go for it. When I found out I was pregnant in September I started testing like a maniac, 8-10 times a day, and now 3 months later it's down to 6.5. I think that result is due in part to the frequent lows I've experienced during my first trimester, but overall just testing frequently has had a huge impact on my control. I think frequent testing is the best thing you can do, both to learn how specific foods impact your glucose levels and to combat highs when they happen. The fact that I have to get up and pee during the night has acted as a natural alarm clock to help me monitor my levels overnight - I highly recommend keeping your glucose monitor in the bathroom overnight so you can pee, test, bolus if necesssary, and get back to sleep!

I won't know for sure whether there's anything wrong until the 16-week scan, but for now all is going well.

#14
DiabeticNurse

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Thinking it would take months to get pregnant, as my gyn told me I have PCOS (Polycystic Ovarian Syndrome) a year ago, I decided to start trying to get pregnant with the intention of seeing my endocrinologist, getting put on the continuous glucose monitor, etc. Unfortunately, literally the first time we tried, I got pregnant. I didn't think I would get pregnant and was drinking alcohol and caffeine and not keeping tight blood glucose control. By the time I took the test 5 days ago, I have been estimated to be 5 weeks pregnant. Ever since I found out, I have been testing every 2 to 4 hours, including waking myself up. I am doing EVERYTHING I possibly can now including working on getting the continuous glucose monitor, and exercising, but I am extremely worried that the first month may have been damaging. I don't know what my A1C is, but I will know soon as I had my blood drawn 2 days ago.
I think this blog is great and I will keep reading and sharing my experience as it progresses





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