Author Topic: New to site-Type1 & want to conceive  (Read 1094 times)

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Offline cmcs85

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New to site-Type1 & want to conceive
« on: 21 September 2015, 01:43:21 PM »
Hi guys, type 1 for 10yrs and me and my husband would like to get the go ahead to conceive ASAP.  My current HBA1C is 73 & meeting my endo again in 6weeks for uptodate HBA1C...anyone got any experience in trying to lower the hba1c in this time period? I've been preparing for conception ie on the high dose folic acid etc but now working on getting the bloods sugars right.  I'd love to hear from others who share similar story or your experiences? I was told not to carb count by my endo that they don't like people adjusting during preg and so basically eat the same every day & figure out insulin doses around that! Another big question i have is how realistic is it to work during pregnancy etc with frequent testing-this is a big worry of mine that I'm under too much pressure at work and don't have time.  My endos response was that it takes 5seconds to test but she's not the one with diabetes!...I mean testing does take 5secs but its dealing with the result then eg giving correction dose if needed then wondering about going hypo or if testing and hypo, treating it, retesting after 10mins etc! Really sorry if I'm waffling on but to be honest feeling quite overwhelmed.  I took today off work to start planning my meals etc & testing so that I can deal with the 'errors' part of the trial & error process. Would be grateful for any advice x

Offline nytquill17

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Re: New to site-Type1 & want to conceive
« Reply #1 on: 21 September 2015, 02:38:11 PM »
Welcome to the forum!

Hopefully some of our forum mums will be around to share there stories - in the meantime feel free to have a look through other threads in the pregnancy sections ("pregnancy issues" and "small talk") to get an idea of other people's experiences!

I have to say, I have some serious qualms about an endo that says not to carb count and not to adjust during pregnancy. You will see if you read other pregnancy-related threads that it would be pretty much impossible to achieve the kind of tight-range BG targets required in pregnancy without near constant adjusting. Even in a non-pregnant person, if you just ate the same things every day, your BGs would be okay half the time and out of range half the time, because there is so much more to BG control than just food and insulin! In a pregnant woman there are also massive hormone changes to deal with. Plus, just with morning sickness and cravings, I don't think it's humanly possible to eat the same things all the time while pregnant!

Basically what your endo is asking, first of all is impossible, and second of all will not help you achieve good control during pregnancy, in fact quite the opposite. I wonder just how many pregnancies this endo has overseen with this method (can't have been many) and what the outcomes were (can't have been very good) - might be a good question to ask her, actually! Add to that the "it only takes 5 seconds" which suggests a lack of empathy, understanding, and helpfulness when it comes to actually having diabetes in the real world (as opposed to in a textbook or in a hospital!) and I might be in the market for a new endo if I were you. I know they're hard to come by though and you can't always switch up just because you want to. But pregnancy with T1 is enough work without fighting an uphill battle all the way with your medics!

Be aware that even planning in advance, you will still have to go through the "error" part of trial and error. Things don't always go according to plan with diabetes, life, or pregnancy and you will be dealing with all three! However, if you aren't used to carb counting and adjusting your insulin yet, as your endo has steered you away from it, it's a really good idea to get comfortable with it BEFORE you're pregnant and everything goes A over T. If you're not comfortable doing this on your own, there are courses you can take (including online ones) or you might be able to schedule an appointment with, say, a qualified DSN who will be more open to the idea and can show you the ropes. I'm not actually in the UK so someone else will have to give you the info on where to go/who to contact but I know there are resources out there! And of course we will be happy to help in any way we can :)
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline cmcs85

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Re: New to site-Type1 & want to conceive
« Reply #2 on: 21 September 2015, 05:00:05 PM »
Hi nytquill17,

Thank you so much for your reply.  Maybe some extra info I should have added-that endo isn't against adjusting per se...I guess what she actually said was that she wants me to eat the same daily to nail down the same carb content at each meal so I guess by eating the same daily I avoid that as one the the many variables il be accounting for in preg like u said eg hormones etc.

I will have a look through the other threads like u said & would def love to hear from others too.  It seems like frequent testing is the key to maintaining good control & I'm freaking out over that as I don't know how I can fit that into my working day!! I'm also on a statin for familial hyper cholesterolaemia just to add to the fun!...ive been told to come off it 3months before conception, wonder is anyone else on same situation or dealt with that too?like I said-overwhelmed  :-\
 Thanks again for your advice x

Offline Pattidevans

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Re: New to site-Type1 & want to conceive
« Reply #3 on: 21 September 2015, 06:23:04 PM »
Hi and welcome to the forum.  Firstly I think you should have been given the help and information which would have enabled you to control your diabetes long before any mention of pregnancy.  I am saddened and horrified that T1s are not educated in a manner which gives them tight control.  Given the lack of help/advice you seem to have had up to the present I really suggest that you take matters into your own hands and get that info that will help you.  I highly recommend 2 books that will help, the first is "Think like a Pancreas" by Gary Scheiner and the 2nd is "Using Insulin" by John Walsh.  My personal opinion is that the first is more easily "readable".


The first thing, before even thinking about carb counting is to ensure your basal is correct and that can be tested by you yourself easily.  It's explained in the books but also http://www.diabetes-support.org.uk/info/?page_id=120 about half way down the Page.  That's the start of good control and I know I was never given this information by any health care professional.


Secondly I am absolutely horrified that a young woman of childbearing age has been put onto statins which are known to be teratogenic I.e. They cause foetuses to be deformed.  They shouldn't even have been offered to you if you might even accidentally have become pregnant.


Sorry cmcs85, I am just so indignant and angry on your behalf.  I do not mean to lecture or put you off the forum and please feel most welcome and ask lots of questions!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Dollyrocker

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Re: New to site-Type1 & want to conceive
« Reply #4 on: 21 September 2015, 09:34:42 PM »
Eating the same meal/carb amount will NOT help during pregnancy, my ratios went from 1:15 to 1:6 as I got nearer my due date, not carb counting or adjusting constantly is just bonkers and incredibly dangerous for both you and your baby, I would seek a second opinion if you can or do some reading up yourself, this book, though American, is excellent http://www.amazon.co.uk/372/dp/1932603328/ref=asap_bc?ie=UTF8

73 is a bit high still, you really want to be in the mid to high 40s before trying, high a1cs can leave you vulnerable to miscarriage and doesn't give you the best starting point, the first few months is pretty much just firefighting the highs and lows but if you start off on a good number it's not such a big deal.



7/2014 7.2 (55) / 4/2015 7.3 (56) 1/2016 7.0 (53)
pumping with a shitty Accu Chek Insight

Offline Liam

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Re: New to site-Type1 & want to conceive
« Reply #5 on: 21 September 2015, 10:34:58 PM »
I'd suggest seeing your diabetic nurse too. I know at least at my clinic one of the two 'does the diabetic pregnancies', if you can meet with the one that deal with that type of thing she (or he of course lol) might be able to help you more. Glad to see dolly has replied, always helpful to hear from the horses mouth. 
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline cmcs85

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Re: New to site-Type1 & want to conceive
« Reply #6 on: 21 September 2015, 11:11:40 PM »
Hi Patti/Dolly/Liam many thanks for your replies-really grateful for any response /feedback ...

Patti I've just downloaded 'think like a pancreas' on your advice and starting to read it! I've also set my alarms for tonight to nail down the basal readings.

Dolly-thanks - good to hear from someone that's been through it-I actually have that book but I've only read as far as the planning stage-was going to read through it when I would be at the corresponding stages so that it's more relevant! Just wondering personally do you have any tips on getting hba1c down pre conception?

Liam thanks for your reply -I actually have an appt with the dsn prior to my next endo & she does specialise in pre preg care but couldn't get appt before October unfortunately.

Offline Pattidevans

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Re: New to site-Type1 & want to conceive
« Reply #7 on: 21 September 2015, 11:36:30 PM »
Quote
Do you have any tips on getting Hba1c down pre pregnancy


Well seriously, it's exactly the same advice any of us T1s would share because we need tight control all the time.  So ask away, but as I said, start with getting your basal right.  None of us need to be trying to get preggie, we just need to be on top of our condition.


Personally I find limiting carbs helps no end.  My highest Hba1c has been 43 I think, last one was 41.  I also do exercise a lot.  Only walking not gym or anything.

Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Dollyrocker

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Re: New to site-Type1 & want to conceive
« Reply #8 on: 22 September 2015, 01:14:39 PM »
Yes, limiting carbs does help, the less insulin you take, the more predictable the results also, if you are on MDI, you should perhaps start to make noises about getting a, your struggles with higher a1cs and planned pregnancy will go in your favour and you will find it way easier to get through the pregnancy. Alternatively, they might be able to set you up with a CGM sensor for a week or so you can see what times/doses need the most attention, they can do that without you having a pump, they just download the results once the sensor runs out.


7/2014 7.2 (55) / 4/2015 7.3 (56) 1/2016 7.0 (53)
pumping with a shitty Accu Chek Insight

Offline Dollyrocker

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Re: New to site-Type1 & want to conceive
« Reply #9 on: 22 September 2015, 01:15:09 PM »
Glad to see dolly has replied, always helpful to hear from the horses mouth. 

Neigh! ;)


7/2014 7.2 (55) / 4/2015 7.3 (56) 1/2016 7.0 (53)
pumping with a shitty Accu Chek Insight

Offline Pattidevans

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Re: New to site-Type1 & want to conceive
« Reply #10 on: 22 September 2015, 06:08:35 PM »
Lol!  Sorry Dolly didn't mean to suggest you resembled a horse.


Did you mean making noises about getting a pump?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline cmcs85

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Re: New to site-Type1 & want to conceive
« Reply #11 on: 22 September 2015, 07:53:40 PM »
Unfortunately pumps not an option because of waiting lists so going to stick with MDI for pregnancy.

Doing basal testing last night - BSL pre bed(4hrs after last NR dose) was 11 & took my usual lantus dose of 22u.  At 1am it was 9.3,at 3am it was 5, at 6.30am it was 4.3, at 9.30am it was 6.7 (didn't have breakfast) and at 11.30am pre breakfast was 7mmol.

I know pre bed out of range but wondering if my basal is too high as my levels came down...and NR should have been out of my system.  Anybody any thoughts? Will be repeating same tonight...

Offline Venomous

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Re: New to site-Type1 & want to conceive
« Reply #12 on: 22 September 2015, 08:27:18 PM »
I'm T2, but I totally understand the work related anxieties. I have always cut down my work load during pregnancy (you'll have frequent check ups as well as all that monitoring to do, we had weekly check ups from week 8 onwards at the hospital but I think it depends on your health history) but if work is such a stress for you maybe it's time to consider part time hours even before pregnancy :) Up to you!

Good luck, I hope you get your dreams soon :)
T2 and PCOS. Just had large serous adenofibroma removed with ovary and fallopian tube. Bp is now normal!

Novorapid, levemir, trulicity, metformin.

Offline sedge

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Re: New to site-Type1 & want to conceive
« Reply #13 on: 22 September 2015, 11:00:43 PM »
Is your basal Lantus?  if so it peaks after about 4 to 5 hours or so.  Do the rest of the 24 hour basal testing and report back, because this might be solved by simply bringing the timing of you basal jab forward to earlier in the evening, so the peak coincides with the natural peak in your BG.  But we don't know when that is - yet!
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline gemsa

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Re: New to site-Type1 & want to conceive
« Reply #14 on: 21 October 2015, 08:44:45 PM »
Hi cmcs, you've had some great advice so far, hopefully I can add some more.

Yes you will need to test your bloods more, and depending how dedicated to the cause you are it may interfere with your work. I carried my test kit with me to all meetings and had it set to beep on reminders for testing one hour after a meal, 20min after a hypo or 2hour after a hyper. My colleagues were very understanding about this and never criticised, which I was very lucky/grateful for. I had in the back of my mind though that should they complain I was protected by both pregnancy/maternity legislation and disability legislation. I also spent about 1 1/2 - 2hrs a fortnight out of the office on diabetes antenatal appointments, plus of course the usual midwife ones. But of course, again you are protected legally for this.

I'd say carb counting is more essential during pregnancy - the body becomes far more sensitive and I found just 3g of carbs would make a difference for me. Plus, I don't know if your endo has been pregnant or been around pregnant women before but eating the same thing throughout pregnancy is highly unlikely what with morning sickness, heartburn/indigestion, cravings and changes in tiredness/sleeping patterns throughout the 9 months! However, the good news is its getting easier and easier to carb count due to improvements in food labeling and more restaurants giving nutritional information.

Good luck
T1 diagnosed 1985, DAFNE Oct 2012 (HBA 9.2%), started pumping April 2013.
HBAs: Feb 2013 8.6%, Jan 2014 7.4%, June 2014 5.9%, Jan 2015 7.5%
Healthy baby delivered Nov 2014 predicted 97th+centile but actually 50th centile.