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newmominks

Type 1 & Pregnancy - millions of questions!

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newmominks

I have had type 1 diabetes since I was 2 (almost 28 yrs) and have been in pretty good control. A1c's usually 5.9-6.2. I am on the Paradigm insulin pump with Novalog. I am in the process of getting the CGMS that goes along with it.

 

I am only 7 weeks along, but have tons of pregnancy questions. Anyone on the pump & a CGMS that is pregnant or has been? I'm hoping to learn where to have my pump sites while I grow. Also, I'm having to use the Belly Band since my jeans won't button and struggling to find where to put my pump. Also, I'm extremely naseous all the time and the only thing that really helps is to eat. Any suggestions on other ways to get rid of it? I don't want to gain too much weight too early.

 

Okay, that's probably enough questions for now. Thank you for any help!

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panda1076

Congratulations :) And you have great a1c's--that's wonderful. I am in week 25 now. I use the OmniPod pump. in the beginning, i was more insulin sensitive. Around week 22 I started to see my ratios and basal settings change. I have already tripled my insulin needs, which seems crazy but my CDE warned me over and over this would happen. And supposedly you go back to pre-pregnancy ratios as soon as you deliver. I am down to 1:3 for one of my ratios. It seems unbelievable. (Speaking from someone who 2 years ago was still honeymooning at 1:45 for breakfast!).

 

I wear my pod in the same places I wore it before--abdomen, back of the arms, thighs. I tried my lower back the other which works but I don't like it as much. I was told as long as you can still pinch up fat on your stomach you can put the pump there. At this point, I haven't had to abandon my stomach yet.

 

keep up the great a1c's. I also have similar a1c's, and being someone who has been so careful to stay low in planning for and being pregnant, it's frustrating and upsetting when you see elevated BGs. Just know to be on the lookout for changes starting as early as week 20 and trust your instincts or ask your CDE/Endo for help adjusting your settings. I went through emotional stress when I couldn't adjust my settings to get my BGs back down. But I am getting through it.

 

Good luck!

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Keezheekoni

I'm currently 24w2d. :) This will be my 6th child...

 

I'm using the same pump/CGMS as you are. I noticed that during the first trimester my rates doubled, but almost magically during the beginning of my 2nd trimester they went back to pre-pregnancy rates/ratios. It's in the 3rd trimester that you want to be really careful, because your rates will usually double or triple again, and if it suddenly goes back to "normal", then your placenta is probably starting to degrade.

 

As for morning sickness, the best advice I can give is to eat about 5 saltine crackers before you even think of getting out of bed in the morning. Some people do really well wearing those seasickness bands, but they never worked for me. If you end up with hyperemesis (which is all day/all night sickness, which I had for two of my pregnancies), they can give you Reglan. It's an anti-nausea medication. It works really well, and after the birth it helps build up a small milk supply if you're having issues.

 

As for sites, I still use my abdomen and hips as I'm growing. Like the PP said, as long as you can pinch up, you can put a site there. If you use the clip on your pump, you can clip it to the belly band. I'm now wearing a lot of loose lounge pants these days, and use the waistband to clip it to. I do tend to keep my pump clipped to the back of my pants these days though. :)

 

Definitely keep your A1c where you have it now. If you do that, most OBs/midwives won't have a problem with taking care of you. Otherwise they'll probably force you to see a perinatologist, whose sole purpose in life is to usually make you get all the invasive testing that can cause miscarriages.

 

All the best to you! Congrats!

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newmominks

Thank you for the help! I am now 10 weeks along and should get the CGMS later this week. I really hope that it will help get me thru all the bloodsugar changes during pregnancy. Do you all have really long cords to reach places like your arms or thighs with the insulin pump? Where do you clip on the pump when you use spots like those? My goal is always to make it as un-noticeable as possible. Same goes for my belly! Don't want anyone to know at work until I'm ready to announce!!

 

A1C 3/10/09: 5.7

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panda1076

That's exciting. I hope the CGMS eases your transition when your insulin needs start to change. I thought about borrowing one but I am doing well right now. Maybe as I get further along I will.

 

I can't respond to the question about tubing, since I use the OmniPod--no tubing :)

 

Good luck though!

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jball

I just turned 30, have been diabetic for 24 years and am currently 27 weeks along. I also have the Paradigm pump and have been on the CGMS for about 20 months....in fact I'm just waiting for it to stop working, since the predicted life time is about 18 months. It has definately been one of the best investments we've ever made. My a1c's have been 5.4-5.9 during pregnancy and the CGMS has really given my endocrinologist good input on adjusting my levels. I had a really difficult time with low BS during my first trimester, and the CGMS really helped to avoid potentially bigger problems...now all my co-workers and my husband are very tuned into the different beeps!

 

As for the pump, I've been keeping it in my bra lately, because even with a bella band I've had a difficult time keeping it on my pants (I wear scrub pants to work and am up and down from the floor alot, so I'd hate to give anyone an accidental show). I've found a bra (and since bought four of them) that holds the pump in place really nicely, plus it gives easy access as well. I don't have longer tubing, but I can't say that I've needed it yet, either.

 

A friend had also recommended increasing Folic Acid for the first few months of pregnancy secondary to diabetic's higher risk for children with neural tube defects. After doing some research, my OB also recommended taking 4000 mcg for the first 12-14 weeks of pregnancy as well as while you're trying to get pregnant. Has anyone else heard of this?

 

Does anyone have any experience with breastfeeding? I'm concerned with controlling my bloodsugars, and I'd really like to give it a try. Also, how often post pregnancy were you followed by your doctor who manages your diabetes.

 

Good luck!

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Keezheekoni

Jball, I can answer the breastfeeding questions. :) I'm a breastfeeding advocate and really try to enforce breast is best...

 

While breastfeeding, I recommend having high protein snacks and a bottle/glass of water nearby. When the baby is nursing, you tend to get really thirsty. Since in the early days of nursing they only nurse for about 15 minutes per side, you can usually maintain your bg really well. As they get older, if you nurse on demand like me, then you'll get used to getting up and moving around while nursing, so you can always grab something to nosh on while the kiddo is nursing.

 

If you are "well endowed" like me, then you might also find that until the baby has more head control, you're going to need to use your opposite hand to "prop up" your breast for ease of nursing for the baby. That stops around 2 months of age, and I also recommend using a sling to carry and nurse the baby in. :) My favorite is the Maya Wrap, but there are *many* slings out there. I'm not a fan of front carriers, they make my kiddos' legs go in weird directions...eek.

 

I'd also highly recommend seeking out a La Leche League group in your area. Go before you have the baby, to see other women nursing, and to get an idea of positioning. If you're having the baby in a hospital, definitely ask for a consult with a lactation nurse/consultant before you're discharged. Proper latch and positioning is important. If nursing "hurts" you might have them check the baby for tongue tie. Nursing shouldn't ever hurt, despite what everyone says. It may be uncomfortable at first, but it shouldn't hurt.

 

As for post-pregnancy follow up with the doctor, I see the OB at the 6 week mark, then see my endo at 3 months. From there I follow my normal pattern. :)

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mazea

I'm 10 weeks pregnant and my endocrinologist and OB reccommended that I take 5mg folate before throughout pregnancy. They reccommended it as diabetics can have increased risk of neural tube defects. I've been taking this amount of 5mg however a bit concerned about some unproven studies suggesting large doses of folate it can increase risks of some conditions.

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Fraida

im brand new to this site. i just happened upon it and im so excited! im a type one diabetic since im 19 and im preg with #1- about 24 weeks thank G-d. i had a fairly simple time controlling my sugars in my first trimester- just a lot of lows, but now im having such a hard time with highs- i have started upping my basals and boluses under the direction of my doctor but im so frustrated- its never enough! anyone experiencing the same thing? any advice?

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JennP07

I am new to this site as well. I am 23 yrs old and 7 1/2 weeks pregnant with my first baby. I had a mc about 2 1/2 yrs ago at 4 wks, so am feeling blessed to have made it this far. I have been on a pump for 11 yrs and have not been the role model diabetic. This is all so new to me...I am checking 10+ a day and eating better than ever, I have not had a recent A1c done, but my last one about 2 months ago was 8.4. I have a question for the diabetic mothers already or the one's further along than me, I have gained 2 1/2 lbs already, is that normal? Thanks for the answers and support!

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mazea

Jen I look at this graph sometimes to make sure I'm putting on the right amount of weight in pregnancy. I think however it would vary from person to person.:)

Maternal Weight Gain during Pregnancy

 

According to the table I should have put on about 6.5 pounds at a minimum at 15 weeks and I have put on 6.5 pounds.

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mazea
Posted · Hidden
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Jen I look at this graph sometimes to make sure I'm putting on the right amount of weight in pregnancy. I think however it would vary from person to person.:)

 

I've put on 6.5pounds so far so that is kind of right? I'm 14 1/2 weeks.

 

Actually I don't. understand the graph properly and think I am reading it wrong.

 

Maternal Weight Gain during Pregnancy

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angel007

Hi,

Im 31 weeks type 1 for 13 yrs..been on a pump for almost 9 yrs. My first 2 months I gained 10 lbs. I believe it was the increase of insulin. The next 3 months I mantained good blood sugars and a stable weight. Like yourself I wasn't a diabetic roll model either. My pre pregnancy a1c was 7.3, my first pregnancy a1c was 5.9..I was pretty excited considering I have never gotten under 7. After about 20 weeks I really had to crank up my pump..and my recent a1c was 6.3 really frusterating but I guess when the hormones increase up..up..up goes the pump..good luck and stay positive...congrats!!!

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22type1

Hey newmominks, it's good to see someone else who is going through pregnancy on the paradigm. I am 22, and I am in a surprise pregnancy with my fiance who is 25 and just joined the nuclear engineering program in the navy this week. He should be shippping to bootcamp when I am about 7 months. We wanted to get married just before he shipped, but now I don't know how it will all happen. I just graduated with a four-year degree this month, and I'm living with my parents. When he gets out of bootcamp in February I will go to live with him on base in Charleston. We haven't told anyone else yet. We just found out today. I guess I'm a few weeks, not very far at all. I'm trying very hard to be strong about everything, and I just feel so lucky to have found a man who is my best friend and my unfailing love and who has committed to a plan which will provide for our family. Right now what I need is technical and emotional support. In our minds this was still for years to come. On the bright side, I think that having a pregnancy early will allow my body to heal so that I can live out the days after in a more healthy way than I otherwise might have. I love children, and I'm ready for a child, but I wanted those first few years alone with my husband. All advice is welcome. I hope your pregnancy is going well, newmominks, and I hope we can talk soon. I'm so scared, and I'm just doing everything to make this work. I'm riding my bike a few miles every day, and my hemoglobin A1c is 6.7. I'll be looking for a job tomorrow just to save up some money until we can be married. I'm very afraid of the timing. Will I be huge when I get married? Will I show Ehren his child for the first time at his bootcamp graduation in South Carolina? Will the first years of our marriage be over-stressed? Will I be able to control my diabetes so that the baby's safe? Will I collapse under the pressure? I need help right now, so please talk to me and let me know how your pregnancy is going and what you have done to make it a good one. I can't wait to hear from you. I need a diabetic friend to help me through.

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rames77

Hey there. congrats on the pregnancy. I am also a Type 1 on a pump. my prepreggy A1C was 7.7.. During 1st trimester it was 6.. from then on it has been 6.4. it is very frustrating. just prepare yourself. i am currenly 37 weeks preggers and i am recieving approx 180 units of novolog daily. prepregnancy i was only taking 45 units daily. just remember that CONSTANT contact with your doc/midwife/nurses is VERY important. report your BG 2 times weekly... if you have ANY concerns or questions CALL them! that is what they are there for. I am a nurse and i know just enough about being pregnant to make me crazy ( i am a cancer nurse.. i know nothing about being preggers) dont be scared to utilize your resources! remember also, your diabetes control isnt for you for the next few months.. it is for the bundle of joy in ya.... stay health to the best of your ability.

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