TTC with Type 1 Diabetes

jholt87

Wow! It feels strange even to write on a pregnancy message board! First of all, I am not pregnant. We actually haven't even started trying quite yet. Because I am a Type 1 Diabetic (diagnosed one-year ago), pregnancy takes a bit more planning. My blood sugar is under control, and I received the "green-light" from my OBGYN. I am most encouraged by people's real stories of successful pregnancies, and I am interested in the honest difficulties as well. I know "high risk" means a lot of things, but if anyone has any input regarding pregnancy as a T1 Diabetic, I am in that info-gathering stage and would love any input. 

 

Best,

Jordan Holt

Memphis, TN 

JennKosh

Hi, Jordan--congrats on getting the green light! I am a T1 diabetic and spent a year getting my BGs/A1C under control so that I can conceive as well. We got the green light in May of last year and I was surprisingly pregnant in July! I am currently 34 weeks with my first child (boy!) and nearing the end. There are several other T1s on this board as well, so you are not alone. I went on an insulin pump about 2 years ago in order to gain greater freedom (I am on the tubeless Omnipod system) and greater control and last March I also decided to get a continuous glucose monitor (Dexcom), and I cannot express how much easier they have made my life! The Dexcom has made it exceptionally easy to see trends and be on top of insulin changes (of which there will be many!!) during pregnancy.

2 resources you may or may not know of already: one is Cheryl Alkon's book "Balancing Pregnancy with Pre-Existing Diabetes." This is a fantastic book written by a T1 diabetic about what you can expect as a pregnant diabetic (also talks about conception). I have read through this book twice in my pregnancy and it helped to calm a lot of my fears, particularly as I encountered stubborn highs, increased insulin use, increased drs.' appointments, etc. She also has a blog where she talked in detail about her 2 pregnancies. The other resource for support is another blogger, Kerri Sparling's blog, SixUntilMe.com where she also blogs about her pregnancy. The diabetes online community is a great support tool (wwwtudiabetes.com is another great resource; there is a pregnant board there, but it isn't very active).

Feel free to post questions or contact me if you have any questions. I have thankfully had a complication-free pregnancy thus far, so it does not have to be a scary thing. I have consistently seen both my OB and a perinatologist since 13 weeks and now I am currently required to go twice weekly for NSTs (non-stress tests) in addition to visits to my perinatologist. It does become a full-time job, especially at the end to accommodate all of the appointments! I will deliver at 38 weeks as is still the standard for T1 diabetics as our placentas tend to age faster than a non-diabetic. 

Best of luck to you and I hope to see you on the boards soon announcing your pregnancy!  

tig594

Hi, Jordan!

I, too, am an uncontrolled T1 diagnosed 2 years ago while in the ICU on my 40th birthday.  I am not on the pump and don't plan to be anytime soon. 

My SO and I came to the decision that we'd like to try getting pregnant the natural way.  With my age and health issues (I also have hypothyroidism) we were more comfortable not forcing it but letting whatever powers that be kind of make the decision for us, if that makes sense.  It took about 6 months for us to conceive the first time and that resulted in miscarriage by week 6.  Another year later and we got lucky again...but again miscarried by week 8 (there was not enough fluid around the baby that time).  2 months later and we were in business yet again.  I am now 35 weeks pregnant and can't wait to meet our little girl. My pregnancy has been unbelievable easy and the baby is doing very well inside her poor old diabetic momma. 

So, yep, it can be done.  As the PP said, it ends up being a lot of work with all the doctor's appointments and such.  I also saw my OB every 2 weeks (now every week) and now have NST's 2x a week since 34 weeks and have seen my perinatologist about every 30 days for growth scans.  My OB doesn't want to induce me and strongly suggested a c-section due to my age, the fact I'm not having any more kids, and because it will be much easier to manage my sugar during a c-section vs. labor. 

My advice to you is to make sure you surround yourself with a very strong medical team.  If you trust your doctors 100% it will make your pregnancy that much easier.  Also, plan on your insulin needs going way up at some point.  I am currently on at least double what I was originally.  The end result will be worth it. 

Good luck to you and your hubby!  I hope all goes well when you finally decide to go for it!

kmcd23

T1 here as well. It took us a long time the natural way, and we had actually given up, but shortly after we did, voila! 

My A1C when I found out was in the lower 6's. I started the Omnipod Pump and the Dexcom CGM, and soon, I was in the 5's. Now I'm at 4.9, and I only use the CGM sporadically, but I test 10 times a day with my Omnipod PDA. I *love* that thing.

The only complication I've had was a subchorionic hematoma, but it was most likely unrelated to my diabetes. Keeping tight control of my sugar led to weight loss in the 1st Tri, and very slow weight gain in 2nd Tri. But my docs don't seem concerned.

I'm lucky that I've had a pretty easy time of it. I had some scary lows in 1st Tri, and then some stubborn highs right around the beginning of 2nd Tri, but overall, my insulin increase has been slow and steady and easy to manage.

My sister is T1 too, and had a harder time than I've had with all 3 of her pregnancies, but she still ended up with 3 very healthy happy babies!

 

Good luck! 

Korfhage5512

Hey! I'm a type 1, too I had my daughter on january 1, 2008 and am pregnant again at 5 weeks 2 days. my pregnancy with Roxie was unexpected which made it rough, so its great that you are taking the proper steps to ensure your body and diabetes are ready for a pregnancy. roxie was 11lbs9oz at birth and born at 37w3d! she was in the NiCu for 5 days controlling her blood sugars and my blood sugars in the third trimester were deemed uncontrollable even though my first and second were near perfect. She is the healthiest little 5 y/o girl i know now no health problems at all. so far with this pregnancy my blood sugars are proving to be an issue although they were properly managed before conception. i keep getting highs every single morning, which everyone chalks up to hormones, but it is still frustrating! good luck to you

megstr29

I completely agree with Jenn. Cheryl's book is fantastic! My husband and I conceived the very first month we tried, which was a surprise. I hadn't quite gotten the green light yet, and assumed it would take a few months for it to work. Guess what they tell you in health class is true... So kudos to you for waiting.
I'm 19 weeks and have been seeing a perinatologist, dietician, and diabetic nurse every two weeks since the beginning. Control prepreg makes it easier, but there's a learning curve for everyone. E.g. Cereal never used to be that big of a deal for me, but now it's a guaranteed spike.
The biggest thing for me was to be super crazy about meal timing... Like within 5 minutes of the target time every day. And the medical teams are full of depressing statistics... I understand that we all want a healthy baby in the end, but a few highs aren't going to thwart all of your hard work, so don't let yourself get too worked up. Note the trigger, and move on...
Good luck!

smsakai

Hi! I have been a T1 for 23 years. Animas pump and Dexcom. I was well-controlled for several years before ttc (a1c 6 and below).

I had 2 miscarriages not associated with the T1, and successfully carried my 3rd pregnancy to full term. It was a lot of work, but I never had any complication. My A1c was horribly low for the duration of the pregnancy due to horrendous nausea and vomiting (in the mid 4s), and we did our best to raise it in a healthy way to no avail (also not because of the T1).

I did have a ton of doc appointments (endo, mfm, u/s, non stress tests) especially in the end. I was blessed with a job where I had the summer off, or I could have never been there. 4 appointments a week in the final month!  I was induced at 38 weeks per hospital T1 protocol. I labored for 36 hours, and did not progress (not bc of T1 either). I wore my pump the entire time, and never went above 130.

I delivered via c-sec after I really needed to eat to continue to maintain a good bs. I pulled pump in the OR immediately before cs. I reconnected 30 mins later. I had a totally healthy baby boy, 07/10/12. 7lb 6oz. He had a 9 APGAR score. No nicu, yay! 

I breastfeed, and that is an entirely different world with T1.

It is amazing, and nothing compares. I'm so excited for you!