Type 1 diabetic 8 weeks blood sugar levels

Mrsmichemiche

I'm about 8 weeks along (baby #1!!!!!) and have been a t1d for over 10 years. I 've always had great control (5.9A1c's) but this 1st trimester is recking havok on my normalcy. I am not yet high risk- my endo seems to think I can manage without one but he wants my blood sugars to NEVER be higher than 120 and wants me to aim for 60-80 before and after meals.....is this pretty normal or does he just have ridiculous standards for me....:( managing my diabetes has never been this hard (except for maybe when I was first diagnosed) I'm getting a little discouraged....any t1d mom to be's or already mom's have any advice?

Abfisher

I am not a Type I DM, but I am a nurse. I think that those target sugars are a little bit too strict. In the hospital, we treat any fingersticks that are <80 as hypoglycemia. You've kept your hemA1c so low, I think you'll do great. The 60-80 just seems unreasonable for a Type I DM, especially one that is pregnant. I would think that as long as your giving yourself the right coverage and not getting significantly higher than usual, then it would be fine. I would not recommend getting lower than 80, especially while pregnant. I would think that aiming for 80-90 preprandial, and no greater than 100, would be appropriate, but then again, I am no endo lol.

Here is a piece of an article that I read. They reviewed patients with gestational diabetes, which is different, but it offers some actual guidelines in managing blood sugars. "In order to prevent all these complications, the fourth international workshop-conference on gestational diabetes mellitus recommended maintaining the capillary blood glucose values of pre-prandial glucose <95 mg/dl, 1-h post-prandial glucose <140 mg/dl, and 2-h post-prandial glucose <120 mg/dl in order to reduce the risk of excessive fetal growth. American College of Obstetricians and Gynecologist (ACOG) guidelines are the same except that the 1-h post-prandial glucose value is considered acceptable at either 130 or 140 mg/dl. Jovanovic–Peterson et al. suggest guidelines that are a little stricter: fasting glucose <90 mg/dl and 1-h post-prandial glucose <120 mg/dl (Parikh et. al, 2007)." I would definitely follow-up with your OB on those numbers, or get a second opinion. Have you had an appt with your OB yet? I would probably go with their recommendations over your endo, depending on how experienced your endo is with pregnant women. 

Reference
Parikh, Rakesh M., Joshi, Shashank R., Menon, Padmavathy S., & Shah, Nalini S. (2007). Intensive glycemic control in diabetic pregnancy with intrauterine growth restriction is detrimental to fetus. Medical Hypotheses, 69(1), 203-205.

Runrinrin

^ I was going to say the exact thing. I'm also a nurse

KeitaiKT

I'm a type I and granted, only 5 weeks in (last A1C was 5.2). But my MFM diabetes NP told me that around week 8 you are higher risk for hypoglycemia (risk is week 7-12). Overall it is definitely to be expected that your blood sugars are super crazy in early pregnancy. If you are on the brittle side anyway, I would be super careful about aiming for such low pre and post-prandial glucose levels. I was told to aim for 90, and to go no higher than 140. Tight control is great, but the other side of the coin is the danger of hypoglycemia. Of course, I'm sure you are very aware of that already!