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Sobriquet

Newly diagnosed Type 1 and newly pregnant...

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Sobriquet

Hi!

It has been a big month for me - but long story short - I am 39 yrs old, and was diagnosed with Type 1 diabetes three weeks ago (they think the diabetes was kicked off by a miscarriage last year), and now 3 weeks later, I have just found out I am pregnant -we are not entirely sure when this happened - but my doctor now jokes that she can do magic. She also says it is too early in my diabetes for me to be pregnant, but that we will do the best we can. Obviously the long term blood numbers are terrible - h1c? - because i was running around with very high blood sugar for at least a few months (hospital admission had 12.1 - it is now down to 9.6, and i'm working on it.

 

Problem is - I don't know much about being diabetic, and i live in a non-English speaking country - i am learning very fast, but at the moment I am really scared to eat anything - my sugar goes up so fast, my doctor recommended that i eat half a meal, then walk around a little then eat the other half. I have pretty much only eaten vegetables and small amounts of meat since finding out - my only carbs are fruit and yogurt.

 

So here goes:

1. What do diabetics eat? I have read articles recommending low carb diets to help control blood sugar, and i have read others saying that is worst thing you can do. I haven't had enough time to experiment, I only know that potatoes make me spike very quickly, so I am avoiding those. I am trying to restrict myself to a maximum of 40-50g carb per meal, and usually have 20g or less - but this is not easy.

 

2. Is it normal that exercise (just walking to the supermarket and back) has a massive effect 2 hours after eating? I have been told that if i test above 120 i should do something vigorous to bring it down, but then i went from 136 (7.5) to 72 (4.0) just with a stroll to get some coconut chips.

 

3. Coconut chips- suddenly, i cannot live without them. Is this a bad thing? So fattening! Does anyone have any diabetes friendly snack tips? What about eating chick peas slowly through out the day? One specialist said that is ok, i don't have to inject for it, and another said i did.

 

4. I have been told i should be 90 (5.0) in the morning, but I am usually 110-120. What should i be when i go to bed? I don't know how to influence this number - it seems like you have to exercise in your sleep!

 

5. How do you deal with low blood sugar? I have not been able to get above 80 (4.4) this afternoon, I have been drinking juice diluted with water so that it doesn't shoot up...

 

6. Am i being paranoid about the whole spiking thing? My doctor says it's ok, but i should try to control it, but the diabetes consultant lady was very strict about it, and warned me that every high is damaging my child.

 

This is a long post - I am sorry - i would just appreciate any links, advice, recipes or secret diabetes tips!!

 

 

 

 

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jwags

Welcome to our forum. As a type 1 you are probably on 2 types of insulin-basal and fast acting. You should be able to eat more carbs than a type 2 who is not on insulin. What you want to prevent is spiking high and using too much insulin which crashes you low. Most of us cary glucose tablets around with us. You can get them at any pharmacy. It seems like your bgs are pretty good and as long as you keep them that way your baby should be fine. As far as snacks, I am not sure what coconut chips are. I do eat unsweetened coconut and drink unsweet coconut milk with no bg spike. Raw veggies, hummus, guamole, cheese, deli meats make good snacks. You want to stay away from high carb junk food.

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rubidoux

Gosh! Congrats on your pregnancy! I'm on my phone and don't have a lot of time, so I can't address all of your Q's, but I did want to say a couple of things...

 

First, I am sorry that the diabetes educator would put it that way. That's just over the top stressful. All diabetic t1's are going to have spikes and I don't think it's helpful to believe that you're damaging your child every time. The best way to protect your baby, IMO, is to test A LOT, like every hour when you're awake and maybe twice during the night, if things are going pretty well. If your b/s was going crazy at night I'd say more! For a lot of the time I was pregnant I would get up to pee enough that I didn't have to set alarms. I just kept my meter next to the bathroom.

 

Also, if you have any trouble keeping your blood sugar in line, i *highly* suggest going lower in carbs and upping the fat. You do NOT want to be on a low fat diet! And that is so 80's anyway! lol. The thing about eating low carb/high fat is that you're only making small inputs in either direction, small amounts of insulin/small amounts of carb so you're not going to have big spikes. Right now (not preg and wouldn't be doing this if I was) I eat once a day and my blood sugar is basically flat for 22 hours a day and then I eat my meal who's his usually about 10 grams carb, 50 g protein, and a ton of fat and I get a little blip of a rise in blood sugar and do very little insulin to compensate so I almost never go low after eating.

 

Sadly, it took me many years to figure out how to control my blood sugar and you have to do it right off the bat, but the key to that is lots and lots of testing and record keeping. Also, you need to pick up Think Like a Pancreas or Using Insulin so you can learn how to make your own adjustments. Doctors are not as good at it as we are. ;)

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Bountyman

Hi!

It has been a big month for me - but long story short - I am 39 yrs old, and was diagnosed with Type 1 diabetes three weeks ago (they think the diabetes was kicked off by a miscarriage last year), and now 3 weeks later, I have just found out I am pregnant -we are not entirely sure when this happened - but my doctor now jokes that she can do magic. She also says it is too early in my diabetes for me to be pregnant, but that we will do the best we can. Obviously the long term blood numbers are terrible - h1c? - because i was running around with very high blood sugar for at least a few months (hospital admission had 12.1 - it is now down to 9.6, and i'm working on it.

 

Problem is - I don't know much about being diabetic, and i live in a non-English speaking country - i am learning very fast, but at the moment I am really scared to eat anything - my sugar goes up so fast, my doctor recommended that i eat half a meal, then walk around a little then eat the other half. I have pretty much only eaten vegetables and small amounts of meat since finding out - my only carbs are fruit and yogurt.

 

So here goes:

1. What do diabetics eat? I have read articles recommending low carb diets to help control blood sugar, and i have read others saying that is worst thing you can do. I haven't had enough time to experiment, I only know that potatoes make me spike very quickly, so I am avoiding those. I am trying to restrict myself to a maximum of 40-50g carb per meal, and usually have 20g or less - but this is not easy.

 

2. Is it normal that exercise (just walking to the supermarket and back) has a massive effect 2 hours after eating? I have been told that if i test above 120 i should do something vigorous to bring it down, but then i went from 136 (7.5) to 72 (4.0) just with a stroll to get some coconut chips.

 

3. Coconut chips- suddenly, i cannot live without them. Is this a bad thing? So fattening! Does anyone have any diabetes friendly snack tips? What about eating chick peas slowly through out the day? One specialist said that is ok, i don't have to inject for it, and another said i did.

 

4. I have been told i should be 90 (5.0) in the morning, but I am usually 110-120. What should i be when i go to bed? I don't know how to influence this number - it seems like you have to exercise in your sleep!

 

5. How do you deal with low blood sugar? I have not been able to get above 80 (4.4) this afternoon, I have been drinking juice diluted with water so that it doesn't shoot up...

 

6. Am i being paranoid about the whole spiking thing? My doctor says it's ok, but i should try to control it, but the diabetes consultant lady was very strict about it, and warned me that every high is damaging my child.

 

Hey! I thought you said long story short!

 

Welcome to the Forum... :)

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k_dub

Hi Sobriquet:

 

I'm Kelly.  I'm a Type 1 and I just gave birth to my first child (a son) on 1//4/14.

 

So where are you located?

Can you tell us about your insulin regimen now?  What insulins are you on?  Do you do multiple daily injections?  Pump?

You may want to check in with your doctor about going on a pump (in many places you are more likely to be approved for a pump if you are currently pregnant or trying to conceive).  You may also want to ask about a continuous glucose monitor.  Or an all-in-one pump/CGM system.

 

When I was pregnant, I typically ate pretty low carb.  I tried to keep my A1c under 6%.

Do you know what your A1c was at diagnosis?

You want to do the best you can to avoid spikes in your BG.  And if you do spike, you want to try to lessen the duration that your BG is high as much as possible.

HIgh BGs and BG fluctuation can be harmful to your little one.  Be vigilant, but don't stress yourself too much.  Just do your best.  

 

You might want to read THIS book chapter.  I found it to be helpful and a reason why I choose to low carb.

You will need to test often to determine what works for you in terms of exercise and diet.  We are all different.  

 

Glad that you are here.  Get into the forums and read all that you can.  Educate yourself.

 

A book that I would also highly recommend for any pregnant Type 1 mama is a book titled, "Balancing Pregnancy with Pre-Existing Diabetes.  You can find it here.  

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Sobriquet

Hi Everyone! Thanks for writing back - I did write a bit much - but once i started, i couldn't stop!

Firstly - I am in Germany - here they call it basis/bolus or intensive insulin therapy, which sounds like what you said - I am on Humulin basal and normal (my doctor says that is the only insulin that is proven pregnancy safe?)

Once in the morning (8am), and once at night (11-12). I have noticed that i have an unexplained spike in the late afternoon - doctor mentioned possibly injecting an additional small dose of basal insulin in the afternoon but did not mention a time - would 4pm work given the working time of the insulin?

 

Pump use is rare here, insurance companies only rarely cover it, so that's a no for now.

My A1c at diagnosis was 12.1. In three weeks i have got it down to 9.3 - so even though the numbers are still terrifying, the direction is good. I am scared about what i damage i have already done.

 

I am very happy to hear about the low carb, (and the high fat part!) diet. I pretty much lived on vegetables and cheese anyway.

Thanks for the book recommendations - i have ordered them already! (nerd splurge)

 

One last question - is there such a thing as a general BG level? I know the 'below 90, no higher than 120' numbers - but i often find that i am low at the moment but i don't know what to aim for. - 90? 100? I am exhausted after spending most of today around 75, but i couldn't work out how to get to a safe level without shooting off the chart...

I'm going to stop now, or it will be another novel.

thanks again!!

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rubidoux

About lows...  first, I'll tell you that lows are generally worse during pregnancy.  I was more prone to them and had them all the time and they were worse in terms of symptoms.  The only time I ever got aggressive during a low was during my first pregnancy when I threw a HUGE glass of orange juice across the room at my husband!  lol  Poor guy!  Also, the first trimester was by far the worst for me in terms of lows, so you may be almost out of the woods.  But, my advice in treating them is to find some candy that's mostly sugar, no fat (I use skittles, not sure if you've got them there) that is one gram of carb per piece.  When you realize you're low, test so you know where you're starting and then eat maybe 10 carbs worth of the candy.  Then check your blood sugar in an hour (if you feel ok, if you're a shaking, sweating heap, then take more as needed!).  I think most people probably aim for about 100, maybe 90.  Then next time adjust the number of candies based on what info you get.  Remember, though, that if you are having a low and your bolus insulin is still active, that's gonna require a different amount of correction than if you're low w no active bolus.  So, there are a lot of factors to pay attention to, but you will eventually get a good feel for it.  

 

Do you know if what you're calling "normal" is what we call "R"?  Or could it be NPH?  My gut says that normal is R, but I haven't heard of anyone using it as a basal except through a pump because it does peak.  NPH is flatter and I do think people used to use it twice a day for basal, though it does peak too but to a lesser extent.  Either way, I doubt there are many of us here who have too much experience with it, but maybe some of the old timers.  I don't think those insulins have been used here much since the early 90's or so.

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KelliMax

When I was injecting insulin (I am on a pump and glucose monitor now- 12 weeks pregnant) I would inject for each meal and have one injection for long acting.  Really it wasn't a big deal to try to be so low carb... the main thing was just to take the right amount of insulin for the carbs I was eating- while pregnant I really am trying to not have a big spike after a meal so I take my insulin a head of my meal by about 20-30 minutes.  

I am sure you will realize you will get a lot of insulin resistance later so its important to stay on top of your insulin to carb ratio.   

"Balancing pregnancy with Preexisting Diabetes" is a wonderful and super helpful book.... I have reread it many times.  

 

Food tips- Carbs can affect you differently throughout the day... the time I really try to avoid carbs is my latenight snack.  

    Spaghetti squash makes and amazing substitute for spaghetti- dont over do it though.   Cauliflower can be mashed to be similar to potatoes but you have to spice them up a bit.   Pickles are a wonderful snack. "Carb Smart" ice cream chocolate bars, Sugar free chocolate pudding is good.  Sugar free hot chocolate with milk.   Obviously try not to eat too much sugar free.   If you do eat deli meat make sure you heat it up to steaming first, Doctors say it might contain bacteria that is harmful to the baby.  

If you want to eat carbs just make sure you know how many... food with a label is helpful.  I know having protein with carbs helps keep it more level.  

 

Spikes are inevitable... Don't beat yourself up- thats easy to do.  Obviously trying to keep lower sugar numbers to 100 is better, but you will spike, you're a diabetic now, don't freak out.  Your average blood sugar is what is more important.  Try try try to get to 6% a1C!  I know its super hard.... Testing often is best, like 10 times or more a day if you to not have a CGM.  

 

I was diagnosed just 2 years ago at 25... it was rough figuring out the whole insulin to carb thing, I am sure it is much harder being pregnant.  Definitely read that book and always ask tons of questions.   Do your research, the internet is filled with resources and this forum is super helpful.  

Good luck girl!

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Sobriquet

Thanks everyone - I feel so much better!

The book Balancing Pregnancy arrived today - I'll be doing some serious homework tonight!

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