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katetana

Early Pregnancy Highs???

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katetana

Ok...so I need some advice. I'll start with a little background on myself. I've been a type 1 for 6 years and have been pumping for 4 years. I've always been in pretty good control. My highest A1c ever was 7.3 and that was several years ago. Three months ago, it was 6.3. I know that's pretty good but I really want it to be under 6. I'll find out my current A1c next week when I go to my Endo. I'm a little worried though. For the past week or two, my blood sugar has spiked to over 200 almost every time I eat something with carbs in it. I'm able to bring it back down within an hour or two but it's still freaking me out. I just found out that I'm 4 weeks pregnant yesterday (totally planned) and I'm afraid I'm doing damage to my baby with having so many highs. I tweaked my bolus ratios today from 1:15 to 1:13 so I'm hoping that will help. Of course, everything I've read about diabetes and pregnancy says that the first trimester is supposed to be filled with lows not highs. I'm trying not too stress out too much, but I'd really like some advice/experiences from others on what they ate during pregnancy and how they dealt with the uncontrollable blood sugar swings. Any other experience/knowledge of what to expect is greatly appreciated. I see my Endo in a week and then I'll have my first prenatal visit the week after so I would really like to get this under control before then. Thanks!

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aiah23
Ok...so I need some advice. I'll start with a little background on myself. I've been a type 1 for 6 years and have been pumping for 4 years. I've always been in pretty good control. My highest A1c ever was 7.3 and that was several years ago. Three months ago, it was 6.3. I know that's pretty good but I really want it to be under 6. I'll find out my current A1c next week when I go to my Endo. I'm a little worried though. For the past week or two, my blood sugar has spiked to over 200 almost every time I eat something with carbs in it. I'm able to bring it back down within an hour or two but it's still freaking me out. I just found out that I'm 4 weeks pregnant yesterday (totally planned) and I'm afraid I'm doing damage to my baby with having so many highs. I tweaked my bolus ratios today from 1:15 to 1:13 so I'm hoping that will help. Of course, everything I've read about diabetes and pregnancy says that the first trimester is supposed to be filled with lows not highs. I'm trying not too stress out too much, but I'd really like some advice/experiences from others on what they ate during pregnancy and how they dealt with the uncontrollable blood sugar swings. Any other experience/knowledge of what to expect is greatly appreciated. I see my Endo in a week and then I'll have my first prenatal visit the week after so I would really like to get this under control before then. Thanks!

 

I noticed some spikes like that as well then around 6 weeks my blood sugar really plummetted (and i'd started low carbing at that point to avoid the highs). Had to reduce insulin, basal and bolus, and bring back the carbs. Relax, you'll be fine, Iknow it's scary when you see those numbers but if you're bringing them back into range pretty quickly you'll be okay. I'd go so far as to say go to 1:10 for now but check at the 2 hr mark after every meal or snack...

Fawn

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Steal

It sounds like you are in great control and I too had a goal to get my A1C in the 5's. I got mine down from 6.5 (in my first pregnancy) to 5.2 and then kept it in the mid 5's for the second pregnancy. You can do it and it will be able to happen. You probably are experiencing some peeks from your changing hormones. I had the same experience and most of us on here have had some random highs in the very beginning. If you are on top of them, your baby will do just fine. I was super diligent during my first pregnancy and ate hardly any carbs and really worked to keep my numbers in check. I kept my numbers in control during my second pregnancy, but allowed myself a bit more carbs in the first two trimesters. Just stay on top of it, there will be lots and lots of changes and it might come back down.

 

Keep us posted and I am here. Feel free to write me.

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katetana

So I just got back from my Endo. It went a lot better than I expected. My current A1c was 6.2. I was very happy about that and am now working my butt off to get that even lower. :) I go back in a month. I asked how often I would be seeing him in the next year and he said possibly 2 times a month! I was expecting more like every 6 or so weeks. How often did you guys see your Endo? And how often with your OBGYN?

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diaboki

Now that I'm pregnant, my endo wants me to see him once a month. I have no idea about the ob/gyn yet. I'm still seeing my RE (I did IVF). I think I see him for the first 10 weeks or so and then "graduate" to the OB. My first ultrasound is on Friday, when I'll be exactly 6 weeks!

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aiah23

When pregnant, I saw my endo monthly, my perinatologist monthly (until around 28 weeks then weekly, then at 32 weeks biweekly), and my OB monthly until I was around 32 weeks, then it was once every 2 weeks, then at 35 weeks on it was weekly. You'll feel like you spend most of your time at the doc's office or waiting to enter it and that's normal. Oh yeah, I saw my diabetes educator monthly, then every 2 weeks once I hit 30 weeks.

 

Fawn

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Steal
So I just got back from my Endo. It went a lot better than I expected. My current A1c was 6.2. I was very happy about that and am now working my butt off to get that even lower. :) I go back in a month. I asked how often I would be seeing him in the next year and he said possibly 2 times a month! I was expecting more like every 6 or so weeks. How often did you guys see your Endo? And how often with your OBGYN?

 

Where I went (Kaiser), they use a Perinatology department and you see your endo and obgyn at the same appointment or sometimes they are the same person. But, in general, while pregnant they have you go a ton! My second time around, I was trusted and I would just email my endo, every so often and let him know that I was just fine. I would go to the obgyn every 3ish weeks. As the pregnancy went on, this increased and near the end I was going in 2 times a week. I was in great control, but they have you go in for NSTs (non-stress tests, fetal monitoring) twice a week and then you still have your other appointments.

 

As annoying as it can be sometimes, it is good to know what is going on. I would say that the best appointments are the ultrasounds or anything else where you can see or hear your little one.

 

Good luck. We are here.

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katetana

How did you guys get set up with a Perinatologist? Did your OBGYN refer you? and when did you start seeing them? I just ask b/c it has never been mentioned to me in any preconception appts.

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Steal

Perinatology is automatic with my provider when you have an "high risk" condition. So, it is something that they do as soon as it is confirmed that I am pregnant. Some providers don't have this department, so it just might be something to check. Alternatively, I would find out if there is an obg that might be specialized in diabetics and see if you might be able to see that person, even if they don't call it perinatology. You could also see if your endo will let you converse over email to reduce some of those appointments, as long as the A1Cs are all in order, I don't see why they wouldn't agree.

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aiah23
How did you guys get set up with a Perinatologist? Did your OBGYN refer you? and when did you start seeing them? I just ask b/c it has never been mentioned to me in any preconception appts.

 

Steph answered this beautifully but my preconception appt was with a perinatologist, recommended to me by my diabetes educator at the time. These docs are also called maternal and fetal specialists under some insurance plans. Type 1s are always considered high risk pregnancies so you get shuttled to one of these and spend more time there than your ob (unless you have a high risk ob).

 

Fawn

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Brookie

I totally had high's week 4-6 or 7, then then I started to drop. It's totally normal:) Just the hormones a changin'!! Congrats!!

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katetana

I had a preconception appt with a maternal fetal medicine doctor back in february. I guess I'll find out from my OB if that particular doctor will be a part of my future.

 

I have noticed that i'm a lot more resistant to insulin in the mornings. I could eat the same thing for breakfast and lunch and go high in the morning but be fine in the afternoon. I'm just over 6 weeks now so I'm hoping that things get moving back towards normal soon cause the food aversions and slight morning sickness are starting to hit. I have already limited what I eat so much that I don't know what I would do if I started not liking the things that I can eat.

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e||ement

I had BIGTIME insulin resistance in the mornings. By around 6 months preg, I was bolusing Humalog roughly 45 mins before eating to catch the spike.

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katetana

Well I had my first appt with my OB today. Everything went pretty well....just went over history and blood work and such. I have my ultrasound scheduled for 2 weeks from today. It looks like I'll be seeing my OB every 2 weeks from now on....I'm hoping I can stretch it out to every 3 weeks though.

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clashann

Glad everything went well for you :) here in the UK, if you are diabetic, it is standard that you see your obs every 2 weeks until 30 weeks, then weely until 35 weeks and then twice a week from 35 weeks until induction which is usually at 38 weeks :)

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diaboki
Glad everything went well for you :) here in the UK, if you are diabetic, it is standard that you see your obs every 2 weeks until 30 weeks, then weely until 35 weeks and then twice a week from 35 weeks until induction which is usually at 38 weeks :)

 

There's that induction thing again. I refuse to be induced unless it is absolutely medically necessary. I will fight for it, get a new doctor, do whatever I need to do. Unless I need it.

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katetana

i asked my dr about the whole induction thing today cause i was curious. he said that he won't let me go a day past my due date but as long as everything is going well and everyone is healthy then he will take me to 39-40 weeks. i was happy to hear that since i'd rather go into labor naturally than be induced.

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Steal

Happy for all of you and hope all goes well without induction. I was insistent about keeping my pump on, but never thought about questioning induction. It was a policy for my doctor to not have us go beyond 39. I am sure that if you continue to keep all of your numbers in line and if all is going well with the pregnancy that you will be able to make this happen.

 

One of the things that I learned about myself through my two pregnancies was that there is so much feeling and emotion associated with the birth. I wish that I would have really looked at all of the different scenarios that could occur and try to work through my own feelings about them before going to the hospital. I was induced at 37.5 weeks with my first daughter and I was dead-set against using any pain meds. I put so much pressure on myself about it. I went for 35 hours and my body would not dilate beyond 7. I continued to refuse an epidural, but eventually I realized that while I had one plan, that plan was not what would work for me. I had an epidural and it was good that I did, as 8 hours later I has still not dilated any more and needed a c-section. My little one was face up. My only reason for sharing is that I had my plan in my head and it was the only way I could see delivery going. I put so much pressure on myself and was so emotional when I had to admit that my plan wasn't working out. I just wish that I would have worked through as much of these possible feelings before and told myself that no matter what ends up happening, as long as we are all happy and healthy, it will be okay. My second daughter was born 13 months later (38.5) as a scheduled c-section. While this was never what I imagined for my birth experiences, all turned out well and we are all happy and healthy.

 

I share this, not to make you doubt yourself, but rather so that you can think about all the possibilities (hopefully you will never need them). All is going well and you will get there, I just found the second time around so, so, so much easier, because I had already dealt with all of my feelings with the first birth.

 

I hope this helps and isn't too much info.

 

Happy and healthy deliveries!

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aiah23
Happy for all of you and hope all goes well without induction. I was insistent about keeping my pump on, but never thought about questioning induction. It was a policy for my doctor to not have us go beyond 39. I am sure that if you continue to keep all of your numbers in line and if all is going well with the pregnancy that you will be able to make this happen.

 

One of the things that I learned about myself through my two pregnancies was that there is so much feeling and emotion associated with the birth. I wish that I would have really looked at all of the different scenarios that could occur and try to work through my own feelings about them before going to the hospital. I was induced at 37.5 weeks with my first daughter and I was dead-set against using any pain meds. I put so much pressure on myself about it. I went for 35 hours and my body would not dilate beyond 7. I continued to refuse an epidural, but eventually I realized that while I had one plan, that plan was not what would work for me. I had an epidural and it was good that I did, as 8 hours later I has still not dilated any more and needed a c-section. My little one was face up. My only reason for sharing is that I had my plan in my head and it was the only way I could see delivery going. I put so much pressure on myself and was so emotional when I had to admit that my plan wasn't working out. I just wish that I would have worked through as much of these possible feelings before and told myself that no matter what ends up happening, as long as we are all happy and healthy, it will be okay. My second daughter was born 13 months later (38.5) as a scheduled c-section. While this was never what I imagined for my birth experiences, all turned out well and we are all happy and healthy.

 

I share this, not to make you doubt yourself, but rather so that you can think about all the possibilities (hopefully you will never need them). All is going well and you will get there, I just found the second time around so, so, so much easier, because I had already dealt with all of my feelings with the first birth.

 

I hope this helps and isn't too much info.

 

Happy and healthy deliveries!

 

Steph, couldn't have said this any better myself. We started an induction but after almost 24 hrs I was only at 2 cm. The baby wasn't doing well either, vitals kept dropping so every other hour they pumped a liter of fluids into me and made me wear an O2 mask. Doc was worried baby wouldn't do well once we started pitocin and recommended we consider an elective c-section (he was worried that we'd need an emergency one if we continued the induction). We chose an elective one and i broke down in tears b/c that was not what I wanted for the birth experience. Was good we did what we did, he had to spend a week in the NICU, not related to complications with diabetes but severely different blood types resulting in a low platelet count and worsened jaundice. I got to see a lot of other NICU babies who were in there with severe damages and problems whose mothers refused c-sections and the babies almost died. I'm not saying I'm pro c-section; I'm merely saying that sometimes it is what's best for the baby to be as healthy as possible. My baby got to go home at 1 week post birth, most of those babies were in the NICU for 3-6+ months :(

 

Fawn

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clashann

I am open to all possibilities. Naturally I would rather go into labour myself as I was induced nearly 2 years ago, it went well but was much more painful than my natural delivery. I understand why the doctors need to induce and trust their judgement, I would much rather induction than risk my babies health waiting to go into labour and the placenta failing beforehand. I didn't have an epidural during my last induction but I think I will be asking for one this time around just incase there are any complications and an emergency c section is required.......I've decided I'm going to do whatever it takes to get my little girl into this world safely and the best person to give me advice on that is my very experienced obs :)

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Steal

Sounds like a plan and it seems like you are working hard and gathering all the information you need. Good luck with your delivery and happy thoughts to you, Clashann.

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Steal
i asked my dr about the whole induction thing today cause i was curious. he said that he won't let me go a day past my due date but as long as everything is going well and everyone is healthy then he will take me to 39-40 weeks. i was happy to hear that since i'd rather go into labor naturally than be induced.

 

I know that a few other Type I's had mentioned this desire on here before. I would love to hear that it all works out for you. Much luck and can't wait for you to meet your little one.

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Steal
There's that induction thing again. I refuse to be induced unless it is absolutely medically necessary. I will fight for it, get a new doctor, do whatever I need to do. Unless I need it.

 

I don't know if your situation is any different with you being Type 2. I hope that it can work out great and that you have no need for induction. Happy, happy pregnancy and delivery.

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