Help please if you have Type II diabetes

EXL311

So I was diagnosed last week through my OB's office.  I had GD with both kids so I'm not really surprised but thought it wouldn't hit as soon.  I'm in med school so with the stress and all I haven't been great about eating right.  My a1c is 8.6 and I need to schedule an appt to start dealing with it.  My friend who is a doc suggested going straight to an endo rather than going to an IM doc.  DH and I have been trying to get pregnant now for almost two years and it's hard to deal with not knowing how to proceed.   My mom also passed last month and now I have a lot of tests to make up so the next few weeks, not to mention next quarter, are going to be rough.  Any advice anyone can give me on anything would be great.  Any food suggestions?  Thoughts about getting pregnant with diabetes?   It's been an overwhelming time for me recently so it would just help to know I'm not alone in dealing with this.  Thanks.

starskristen79

I am Type II, and wow, you are going through a lot. Just know that things will only get easier with time. My sympathies.

My IM doc sent me to an endo since I was still planning to have kids. The endo will suggest you get your A1C under control before conceiving. It will not take long to get it down if you are willing to work hard. It is not always fun, but very worth it. An 8.6 is not great, but there are much worse numbers out there! For now, I would start cutting your carbs right away, and honestly, I would hope to get put on insulin. It may sound scary, but it is the easiest way to control your sugars, and since it takes some time to figure it out to perfection, you can figure it out before you are pregnant. I was on pills before pregnancy, but my sugars got crazy once I was pregnant, and I hope to not need insulin after, but it is great for now.

Email me if you have any questions.

Rubypercy

I have type II as well and agree with the pp.  You need to get your A1C down before you consider getting pregnant.  A really high A1C means your sugars are out of control and that is really bad for early in the pregnancy (bad for the baby).   Insulin will get it under control quicker - but I found that insulin made me feel like I was gaining weight like crazy when I wasn't pregnant so I switched back to metformin.  I am sorry to hear about your year.  I can relate.  Both my in-laws and my grandmother passed away in 2010.  Here is to healing and a less difficult 2011.  GL. 

EXL311

Thanks to you both.  I'm sure I'll have tons of questions to e-mail you about.  It's hard right now because I have four tests this week starting on Monday so right now it's so hard to even think about what I'm eating or have time to go to the grocery store and figure it out.  I'm doing my best though.  Could you guys give me a quick idea of what go to foods you have for meals?  Also what do you have for snacks?  I feel hungry right now but it seems that most of our snack stuff is all carbs.  When I had GD I would have crackers and cheese or an apple with peanut butter.  We don't have much right now like that so at some point hopefully I can get a list together of stuff for DH to get for me.  I'll definitely call to set up an appointment with an endocrinologist.  I guess if I can't get an appt soon enough then I should probably set up one with an IM doc too just to get started on some meds. 

gigglesks327

I'm sorry you hear you are going through all of this. I was also diagnosised with type 2 diabetes by my ob when I was going through some routine testing before we started TTC. I was put on Metformin and my blood sugars were easily controlled with oral meds. I am also a Dietitian so I had an advantage. A year and a half after being diagnosised my A1C was averaging 5.6-5.8. We got the green light to start trying. A year later still no pregnancy. My husband also has almost no normal morphology sperm so that was an added difficulty. We had made an appt to see the ob in January of this year to get the go ahead to see a fertility specialist. This lit a fire under my butt and I started exercising like crazy in Octobter 2010. On New Years Eve we got a BFP. I attribute it all to the exercise. My blood sugars went crazy as soon as I got pregnant so I was put in insulin at my first ob visit. It has not been easy, but not that bad at all. I've actually lost about 5 pounds since I found out I was pregnant b/c of having to eat on a schedule and cutting out the crap food.

As a professional, the best advice I can give you without knowing your height, weight, etc. is to keep your carbs at breakfast to no more than 45 gm, lunch and supper 45-60, and snacks 15-30 gm. You should be eating 3 meals and 3 snacks a day (eating every 2-3 hours). Start reading food labels and use the number by "total carbohydrates" as the number to count your carbs. Don't get wrapped up in counting net carbs or any of the new trends. You also don't want to go "low carb" because that can have the opposite affect of what you are trying to do. There are several carb counting books out there and even a few apps for smart phone to help with counting carbs and tracking blood sugars.

I hope this was helpful! Let me know if there is anything I can help with.

UK2ME

You are having a rough time of it right now, I'm sorry. 

First things first, stress makes it more difficult to control your blood sugar, so cut yourself some slack.  Remember that you can only do what you can do, and if that means that your focus right now is on grieving the loss of your mother, dealing with med school and looking after your family, so be it.  That's OK.

That being said, I have been working with an endo for about 3 years now, mostly about general Type II issues, and only recently about TTC.  I've found it a lot more effective to go right to the endo with questions rather than my PCP because that's what he does.  I get good answers and no panic.  I was recommended to have an a1c below 7.0 before even thinking about getting pregnant, but I also have to change onto insulin (Byetta is not safe for use during pregnancy) so it's all had to be a very planned affair.  Since your a1c is not horrible, you'll probably find that with the help of an endo and a nutritionist you can get it where it needs to be pretty quickly.

I find a handful of pretzels and peanut butter to be a good snack, or a mini-bag of popcorn.  Both of those are reasonably gentle on my sugars.

Good luck!

EXL311

Thanks again.  This is all very helpful.  I'll call tomorrow to set up an appointment.  One of my problems this morning is that I'm trying to calculate carbs but I can't figure out the tomatoes and green peppers.  For 1 cup chopped green peppers online said like 7 carbs but for 1 cup of sliced green peppers it's only 4 carbs.  So is that because it sliced takes up less of the cup?  Also with tomatoes the carbs are different based on if they are cooked or not.  How does that make a difference if I've already accounted for everything else?

gigglesks327

Most of your non-starchy vegetables you don't need to worry about counting the carbs on. The reason 1 cup of chopped bell pepper has more in it than one cup of sliced is because you can fit more of the chopped in a one cup measure than you can of slice. Also with the tomatoes, being cooked they become more concentrated so do the carbs. So that makes a difference.

With your vegetables, unless they are potatoes, corn, peas, beans,winter squashes (butternut, acron, etc), spaghetti sauce, you don't have to worry about coutning the carbs on those unless you are eating over half of your plate full of them.

Hope this helps!