Author Topic: High Hba1c and pregnant!!!!!  (Read 3149 times)

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Offline to104

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High Hba1c and pregnant!!!!!
« on: 31 October 2011, 08:51:23 PM »
Am new to the site but looking for any info/support thats going. Am type1 diabetic and have been for 22 years, hba1c 5 months ago was 9.2%! advised not to try to concieve but after being on antibiotics/pill, have fallen pregnant. am 5 weeks, and seeing the gp tommorow. Im so over the moon to be pregnant, but am so terrified ill miscarry due to my high hba1c. I have actively been trying for the last 5 months to test more and look after myself. Anyone been in the same situation???

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Re: High Hba1c and pregnant!!!!!
« Reply #1 on: 31 October 2011, 08:57:59 PM »
Hi and welcome to the forum

Sorry I can't advise on pregnancy matters, but perhaps we can help with general tips for getting BGs down?  Can you tell us what insulins/doses you are on, a typical day's diet and the sort of Bgs you see throughout the day relevant to meals?

Some of the ladies who are new mums or are currently preggie will be in to advise soon.  Some had Hba1cs of 7.9 at conception and certainly had healthy children if it's any help.
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 6.0 (or 42) April 2014

2011 Patti Evans

Offline to104

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Re: High Hba1c and pregnant!!!!!
« Reply #2 on: 31 October 2011, 09:08:24 PM »
Hi there, i am on novorapid 3 times a day, im learning to carb count so the doses vary from day to day depending on what i eat, usually 7units breakfast 10 at lunch and 12 at dinner. lantus before bed at 23.
5 months ago was having alot of hypos, usually 5 a week due to the fact id been put on the 4 injections a day routine 5 yrs ago but never given any carb counting education, so was giving myself too much insulin. Am now carb counting and tend to start the day at around 10mmols, 6-7 about lunchtime, 11 around dinner. if i go to bed less then 10mols i tend to go hypo so my lantus was reduced to 22. however i found i was always waking up around 15mmols. So am now back to 23 units. to be honest i think im all over the place due to my shift work, i over eat when i get low which then makes me high for the rest of the day. i feel like im one big mess and although its been 22 years with this im no closer to getting it controlled. Now im terrified and will do whatever it takes to finally sort myself out. Sorry that was alot of info iv blurted out1 :-[

Offline sedge

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Re: High Hba1c and pregnant!!!!!
« Reply #3 on: 31 October 2011, 09:48:43 PM »
Congratulations!

The tricky thing here is your preg hormones won't help one little bit, your BG's will be doing strange things anyway for most of the 9 months you are preg - but from memory with some of the 'well controlled' ones - it was when their BG shot up and there was no other reason, that they went out and bought a preg testing kit.

Are you going to the hospital - who is teaching you to carb-count? - you haven't been left on your own have you?  You should be ref'd straight to the diabetic preg team ......
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

Lipids - 7/09 - TChol 5.3 HDL 1.8 LDL 3.0 Trigs 1.0  Trigs/H 0.56
- 7/10 - T 5.6 H 1.9 L 3.3 T 0.9  Trigs/H 0.47
- 2/11 - T 5.3 H 2.1 L 1.46 T 0.6  Trigs/H 0.29
- TChol 01/13 - 4.5

BP - Losartan 20mg

TSH - 7/10 5.1, 2/11 8.7  2/12 5.7 11/12 3.9 01/13 6.1  Thyroxine 50mg

Offline mand

  • Type 1 for 9 years & PCOS
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Re: High Hba1c and pregnant!!!!!
« Reply #4 on: 31 October 2011, 10:04:30 PM »
Hi congratulations on the pregnancy  :)  It might be worth asking about spilting your lantus I always had night hypos so mine was split and it works alot better it's not perfect but better than before. My Doctor has said the only way for me to fix background issues would be to go on a pump which I'm thinking about after I've had the baby. You could also test at 3am to see whats happening in the night. Just off thoses readings you gave me it looks like your lunch time ratio might need upping if your going from a 6-7 upto 11 by tea time if you have the right ratio you should be back at 6-7. Are you writing your readings down? I would start writing them down and looking for patterns over a few days so you can change ratios and background if you see the same thing happening but your diabetes team will help you with this.
It is very hard to control diabetes in the first 3 months of pregnancy and you will have high's and low's for no reason due to crazy hormones. All you can do is try your best :)
 
Type 1 for 10 years & PCOS
HBA1C Nov 10 7.1 / March 11 6.9 / May 11 6.6 / June 11 6.4 / July 11 6.1 / Sept 11 5.8 / Oct 11 5.8 / Nov 11 6.1 11 / Jan 12 5.9 / May 12 6.5 / Sept 12 7.1 / Feb 13 7.3 / July 13 7.1 / Oct 13 6.7
Metformin
Novo rapid on Animas vibe pump since feb 2013
Dafne Graduate

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Re: High Hba1c and pregnant!!!!!
« Reply #5 on: 31 October 2011, 10:09:02 PM »
I agree with both Mand and Jenny Sedge.  Lantus is a weird beast and not easy on 1 injection a day to cover all aspects of basal requierments.  Please go and talk to your team. 
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 6.0 (or 42) April 2014

2011 Patti Evans

Offline Winni

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Re: High Hba1c and pregnant!!!!!
« Reply #6 on: 31 October 2011, 10:12:34 PM »
Hi,

Congratulations on your pregnancy. It sounds like your hba1c won't be as high as it was. It's no good worrying now, you can only do your best.
Tbh, I'd ask for a bit of a review of your insulins. I never got on with lantus, I could never get it right. And if you're waking up at 10, then really the dose is right, but you're going to bed too high. Does that seem right?  If you go to bed at 10 and wake around 10, then the dose of lantus is ok, but you might need to ake a tiny correction first. A lot of us found that lantus didn't last 24 hours, so would often go high before the next injection as it start to wear off. That was my biggest argument for trying levermir. I promise you it helped me a 1000%. Everything kind if fell into place and I was on lantus for over 5 years-worst control of my life.

I'm now on a pump. Best decision ever. If you are carb counting and with your pregnancy and hba1c, they'd throw one at you ;-). If you hate it, you can always go back.

Don't let the gp and diabetes team scare you. If they are any good at their job, they'll be looking at ways to support you. There are hundreds of stories of type 1 women having successful healthy pregnancies with high hb1cs.

Good luck, let us know how you get on.

And my bs went sky high the stage you're at. Just keep throwing insulin at it. Not the most medically correct solution, but personally, I'd much prefer to be chasing the hypostyle than highs at this stage x x x
Type 1 (20 years and counting)

Insulin pump (medtronic paradigm) with apidra and now cgm!

Last hba1c 5.8!

Offline Clare

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Re: High Hba1c and pregnant!!!!!
« Reply #7 on: 01 November 2011, 11:17:49 AM »
Hi, congrats, agree with what everyone else says, also add that it'd be a good idea to set alarms for 3am or there abouts to test then, check that you aren't going hypo then bouncing back by the morning. I got pretty good control on lantus but i did find levemir easier, took 5 days to see if a change to my lantus dose had any effect, it was immediate with the levemir. Doing the night time tests I found that I was going hypo a lot more during the night than I realised and ended up taking way less by the time I got pregnant for the first time and it all went haywire.

Best of luck, keep us posted!
Clare

Offline hayley

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Re: High Hba1c and pregnant!!!!!
« Reply #8 on: 01 November 2011, 02:09:57 PM »
to104- pls dont panic as Winni said it is likely to be lower now, i conceived twice on 7.8 for which some would scream that is too high but had one healthy baby and one on the bay, i also have been diabetes 20 odd years and took me til only a few years ago to become better and i am not an expert. do as the girls say and talk to your diabetes upport team, you have a fabuous incentive to 'be better' now. that will take effort from you and maybe laying off the carbs abit for abit but you will soon feel brighter for having a better result, oh and nearly forgot- congrats on the baby it will change your live forever for the better (you will just have abit less energy!) :)
Type 1 Diabetic for 20plus years on novorapid and levimir, hba1c Jan 09- 7.8, April 09- 7.3 July 09-7.2,Nov 09-7.8, Jan 10-8.1, Apr 10 -8.4. Nov 10-8.2, jan 11-7.9, March 11- 8.2, July 11 7.7, Nov 11 7.1 I have also been on dafne and eat what i want when i want

Offline Venomous

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Re: High Hba1c and pregnant!!!!!
« Reply #9 on: 01 November 2011, 09:25:27 PM »
Congratulations on the pregnancy :)
T2 and PCOS.

Levemir and Novorapid started Feb 2012 after hba1c of 90.

Offline kezzie

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Re: High Hba1c and pregnant!!!!!
« Reply #10 on: 01 November 2011, 10:21:06 PM »
Hi congratulations on your pregnancy

I concieved with a hba1c of 8, but it wasn't planned.but really tryed to tighten my control as soon as i found out and  managed to get it down to 6.5 & have now got a healthy little boy.
As for using lantus, i really struggled with it whilst being pregnant as from around 20 weeks my insulin requirements began to increase & as you probably know it takes a few days for increase/decrease in Lantus to take effect, so by the time it takes to work,your requirements have changed again & constantly correcting it with nova!! It was so annoying!! I agree to test in the night as I used to have hypos i could set my alarm by them as they were same time every night!
Best of luck : )
Type 1 diabetes since 2007
Levemir 20units Evening 5units morning
Novo rapid
I have also done dafne

Offline Gemma

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Re: High Hba1c and pregnant!!!!!
« Reply #11 on: 01 November 2011, 10:56:49 PM »
Hello and congratulations to104!

I agree with the others re. lantus. I couldn't manage with it as, if I took too much before bed I would hypo before morning, but what I was taking wasn't enough to last me through the day. I ended up on levimir and take 8u - am, 5u - pm...so my needs are obviously much less during the night.

I am 17 weeks preg and hba1c was 7% at conception. It is now 6.1 so you will manage to bring it down - it just takes a lot of testing, recording, adjusting and so on - as the others have said.

The one thing I would say is you may need to increase your novo in order to avoid post meal spikes, but this means you will have to do lots of testing after meals to avoid/catch hypos. However, the lower your carbs are the less this will happen (I really struggled to lower carbs in 1st trimester due to nausea - so I was ploughing the insulin in then looking out for lows afterwards :)) Also - try to train yourself not to over-treat the hypos - I find the more prepared I am, the less likely this will happen. Make sure you have glucose tabs and a biscuit to hand to stop you reaching for everything in site :) you will need to test and record to see how much you need to eat to bring bg back up.

Good luck with everything...please speak to your diabetic team and then come back here with any questions, queries, worries etc - this site is wonderful for advice and reassurance.

G x
Type 1 - novorapid and levemir

HbA1c: Feb 08 - 7.8%, Dec 08 - 7.1%,  Sept 09 - 9%, Mar 10 - 8.7%, Jul 10 - 7.5%, Mar 11 - 7.0%, Aug 11 - 7.0%, Sept 11 - 6.4%, Oct 11 - 6.1%, Nov 11 - 6.0%, Dec 11 - 6.1%, Jan 12 - 6.3%, Feb 12 - 6.5%

Offline sedge

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Re: High Hba1c and pregnant!!!!!
« Reply #12 on: 01 November 2011, 11:59:32 PM »
Quote
and take 8u - am, 5u - pm...so my needs are obviously much less during the night.

HoHoHo!!! bet you you don't! - that's exactly what I thought too! - unpregnant LOL - I took 15u Levemir in the morning and 5u at night.
 
It didn't make sense really; your body repairs itself during the night - esp your brain - and therefore that is why many note they need MORE insulin at night than in the day.  So - did that mean mine had packed in doing that - or wot?  LOL
 
However on the pump I have found that surprise surprise, overall I need just as much at night as I do in the day.  The Levemir didn't run out after 12 hours-ish at all.  It evidently carried on - then I propped it back up with another 5u .....
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

Lipids - 7/09 - TChol 5.3 HDL 1.8 LDL 3.0 Trigs 1.0  Trigs/H 0.56
- 7/10 - T 5.6 H 1.9 L 3.3 T 0.9  Trigs/H 0.47
- 2/11 - T 5.3 H 2.1 L 1.46 T 0.6  Trigs/H 0.29
- TChol 01/13 - 4.5

BP - Losartan 20mg

TSH - 7/10 5.1, 2/11 8.7  2/12 5.7 11/12 3.9 01/13 6.1  Thyroxine 50mg

Offline to104

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Re: High Hba1c and pregnant!!!!!
« Reply #13 on: 23 December 2011, 08:06:34 PM »
Thank you all so much for your responses, Wow i never imagined a place with so much support and helpful advice! So iv made it to the first crucial stage of 12 weeks and 3 scans in and all is good with baby and couldnt be happier. HBA1C is now 7.5 which i know isnt great but for me thats a big improvement. Really knuckling down with the carb counting, bms and correction doses and have definitely taken the advice of not over eating when i get low, thats made a massive difference in itself alone!

So now i am having 6u for breakfast and 9u for lunch and 11 for dinner, lantus was cut down from original 24 to 18 units.
I cant really explain it but i just dont feel like the lantus is right, this week iv had more highs then ever, even when not eating my bms have been in the low teens, ill give myself a correction dose yet a couple of hours later the reading is just the same if not higher. Saw the diabetic nurse today who said to cut my lantus to 16 units to cut out overnight hypos but to leave my novrapid the same. I just dont understand that. I feel that the more they lower the lantus the higher i run in the day, i think the odd hypo im getting at night is probably only where im over correcting my bms with extra doses during the day, the nurse didnt seem to listen to that. Any one else had a similar problem?

Some days i feel like the novorapid doesnt work as well as it used to, usually 1unit brings me down by 3mmols but some days doesnt bring my bms down at all (only since they changed my lantus from 22 to  18units). They say resistance to insulin doesnt start until 20 weeks so its too early for that. im convinced my lantus dose isnt right but im no proffessional and am only going by what i feel, crazy i know!

Offline sedge

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Re: High Hba1c and pregnant!!!!!
« Reply #14 on: 23 December 2011, 10:02:51 PM »
Well - you can 'test' to see if your Lantus is OK or not - see  http://www.diabetes-support.org.uk/info/?page_id=120

But I don't know how advisable this might be whilst preg.

And you say you have X amount with one meal and Y amount with another - do you not carb count, or do you mean you eat fixed amounts of carbs at those meals? - unless you get both your Lantus and your fast-acting insulin right, you are fighting quite a bit of a losing battle really.

Have you been on a carb-counting course?
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

Lipids - 7/09 - TChol 5.3 HDL 1.8 LDL 3.0 Trigs 1.0  Trigs/H 0.56
- 7/10 - T 5.6 H 1.9 L 3.3 T 0.9  Trigs/H 0.47
- 2/11 - T 5.3 H 2.1 L 1.46 T 0.6  Trigs/H 0.29
- TChol 01/13 - 4.5

BP - Losartan 20mg

TSH - 7/10 5.1, 2/11 8.7  2/12 5.7 11/12 3.9 01/13 6.1  Thyroxine 50mg