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Paulllywaullly

T2 and planning pregnancy

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Paulllywaullly

Hello! I am new to this forum and am seeking some advice. I am now 29 years old and I had an endocrinologist that I loved, but we moved away from her. I hadn't gotten around to finding a good rated one near my new home when I needed medication so I scheduled an appointment with a family doctor just so I could get a prescription refill. When I met with this Dr, she said she handles diabetic patients and was confident that she could help me get off of insulin to manage my diabetics with orals medication only. I decided I'd give her a shot and moved forward to get blood work done. My A1c was 6.4%. She started me on Januvia. 

 

Fast forward a month later, life started moving pieces around and my husband and I decided to try and get pregnant sooner than we initially planned. I informed the doctor and she said she takes care of diabetic pregnant women and no need for an endocrinologist. She replaced the Januvia with Glipizide and told me we'd hold of on getting me off insulin until after birth. 

 

I started reading Balancing Pregnancy with Pre-existing Diabetes by Cheryl Alkon. With the book along with other resources, I feel my blood sugars need to be tighter. I started testing at least 8 times a day (fasting, before meals, 1 & 2 hours after, bedtime). The book mentioned CGMs. My fasting sugars were always on the higher end, so I thought this would help to see what was going on at night. I updated my Dr and asked her thoughts on CGMs. 

 

First, she didn't seem to differentiate between CGMs and BGMs. I had to explicitly explain the difference to her.

Second, she then said CGMs were only needed if type 1 or type 2 uncontrolled on insulin pumps. She did not address my interest in tracking my nighttime levels nor did she seem concerned. She said such devices were not needed for me and would cause unnecessary anxiety. 

Third, she told me that A1c doesn't matter when it comes to pregnancy and to not worry about it, when I asked her if I was a risk to try to conceive at 6.4.

 

As this is my first time trying to get pregnant, I really want to make sure that I am doing everything I can to have a healthy pregnancy and healthy child. I have also been a bit jaded when it comes to Dr's as I've had way more failed experiences than positive ones. I tend to be more critical on Dr's now.

 

The advice I'm looking for is 1. Anyone used glipizide while pregnant? And 2. What Healthcare professionals did you see during your pregnancy?

 

Long post and appreciate you taking the time to read & offer feedback! 

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Kit

Hi Paullywaully, welcome to the group.

 

I can't help with your pregnancy questions.  I've no kids myself and am at the age that its just not going to happen.  :)

 

I am not familiar with the book you reference, but from what I understand, good diabetes control is important for pregnancy.

 

As for your doctor's response, sadly more doctors than not tend to have a very relaxed attitude about control and aren't that keen on really helping us to good control.  I think they don't know how to deal with it with someone saying I want better control instead of those who are complaining that everything is too strict.

 

If you don't mind me asking, can you give more details on what all meds you are on?  What kind of insulin are you taking and when do you take it?  With some details, we may be able to give some suggestions.  Also, what does your diet currently look like?  Your physical activity?  All of these are important factors in the overall picture of diabetes control.

 

If your morning numbers are higher than the rest of the day, its likely due to dawn phenomena.  Basically the body releases stored glucose in the early morning hours in order to generate energy to get moving for the day.  For non diabetics, this is a non issue as their bodies can easily handle this burst of glucose into the system.  For diabetics, it can be a struggle.

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Paulllywaullly

Currently, I am on 30 units of ER insulin daily (15 morning/15 evening), 2000mg of Metformin (500 morning/1500 evening), 10mg of Glipizide daily (5 morning/5evening). I also take Synthroid for hypothyroidism. Then there's a bunch of supplements I take. 

 

I think my diet is good in terms of what I eat. My struggle has always been with how much I eat. But I've really been working on portion control since we decided to get pregnant and I'm seeing positive results already (better levels after meals and weight loss). No more alcohol has really helped. 

 

My exercise is definitely an area to improve upon. We moved 5 months ago and now I have an hour commute going into work and am 1.5hr commute coming home. I've let that be an excuse not to work out ever since. But that, I've also been focused on fixing, especially since we decided to get pregnant. I'm setting incremental goals for myself, starting with working out at least 2-3 times per week.

 

 

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