High-Risk Pregnancy
MrsL2B
member
Type 2 DM / AMA Intro
MrsL2B
member
Any T2Ds in here? I know it's not all that common for us "younger" women. Actually, I'm young for T2D, but older for pregnancy. I'm 37 and on my first pregnancy at 7 weeks. I was diagnosed with diabetes five years ago, and have kept my numbers in a reasonable range (fasting is usually 100-120 and a1c is usually around 6.0) with a very restricted diet, regular exercise, and a little metformin.
My OB is switching me to glyburide and setting up a consult with a MFM. I'm hoping the change in medication helps me lower my numbers to a range more acceptable for pregnancy. I'm also trying to just move around more throughout the day, since I'm not especially insulin resistant and I tend to suck up glucose just walking around. The area where I'm having trouble is with not overeating, especially when on days when I'm stuck at my desk. I'm starving almost all the time, and large volumes of food definitely make my BS spike. And apparently I quickly get sick of eating the same few foods over and over. I'm not used to having to come up with more safe food ideas, since I also have gastroparesis and usually don't have to eat much to feel stuffed. And of course, I also don't want to gain too much weight.
Sorry if this was a little lengthy. Any words of wisdom out there?
My OB is switching me to glyburide and setting up a consult with a MFM. I'm hoping the change in medication helps me lower my numbers to a range more acceptable for pregnancy. I'm also trying to just move around more throughout the day, since I'm not especially insulin resistant and I tend to suck up glucose just walking around. The area where I'm having trouble is with not overeating, especially when on days when I'm stuck at my desk. I'm starving almost all the time, and large volumes of food definitely make my BS spike. And apparently I quickly get sick of eating the same few foods over and over. I'm not used to having to come up with more safe food ideas, since I also have gastroparesis and usually don't have to eat much to feel stuffed. And of course, I also don't want to gain too much weight.
Sorry if this was a little lengthy. Any words of wisdom out there?
This discussion has been closed.
Re: Type 2 DM / AMA Intro
I'm another T2, very young for a dx (I'm 26 now, was dx'd with my last pg when I was 24) and hypothyroid. When not pregnant I'm on 1000mg metformin 2x a day and have been consistent with an a1c of ~6. I am assuming you see an endochronologist? If so, my advice would be to try to see if your endo can work with your ob and consult an MFM for scans and to keep an eye on the baby. I say this because in my experience MFMs treat GD VERY differently than a T2 would need to be treated.
I will be honest, it is very likely you will be on insulin. Do no be afraid! I promise, it is not bad!
I'm almost 35 weeks in my second pregnancy; DD1 is now a happy, healthy and mischievous little almost 2 year old.
I played continuous catch up last go, this time around my a1c has been 4.8-5.2 at my highest and I have felt so very in control. The main difference I've seen is that with GD, they tend to be very rigid with insulin, usually 3-4 injections/day and no more. My old schedule and the one I've seen on here for GD is as follows: NPH (long lasting insulin) and regular (fast acting) in the morning before breakfast, Regular before dinner and NPH before bed. I had no flexibility, even when this was just not working for me, thus the having to play catch up until the week I was induced. This time around I am on an insulin pump (which is not the norm as far as I know for T2, but my endo is T1 and likes the control it gives and I have to agree with him), but before starting the pump I was using an insulin pen and doing a few extra injections. While this means playing pin cushion much more, I never felt out of control. On the contrary, I was doing 4+ injections/day to keep all of my numbers under control; this would normally be a correction shot before breakfast + carb count for breakfast itself, 1 before lunch (and after if I'm not in range), 1 before dinner (and after if needed) and one dose of long acting before bed. It sounds like a lot, but it really wasn't too bad and I really liked having this control. I am a recovered needle-phobe, so believe me when I tell you its not so bad!
The MFMs I've met seem to think very lowly of a GD woman's ability to understand diabetes control, endos know that you are dealing with something you'll need to control for life and like to give you that control. The way they treat you because of this mindset is worlds apart. Last pregnancy I felt like the dumbest piece of dirt who just got ignored. This time I feel empowered.
While I'm not terribly insulin resistant when not pregnant, when I am pregnant I become incredibly so. This is not unusual from what I have heard. A woman who uses the same endo/ob team as me was on nearly 300 units of insulin a day when she is normally just on oral meds. For me, I'm averaging from 30-38 units per day, which is a major improvement from last pg where I was on 100+ units/day but still not in control.
Can you meet with a nutritionist about meal planning and food ideas? I find that a lot of MFMs have great nutritionists on staff who are very helpful. In the meantime, how about veggie snacks? Kale chips, carrot sticks, celery sticks. Berries work really well for some people. Throw some nuts into the mix for protein. Light and fit yogurts (I especially like the greek ones!).
Sorry this got long, I know there aren't a lot of T2 ladies at this point around here that I've seen and I have gathered a lot of info during this journey. I'm happy to share my experiences and answer questions that I can! Please feel free to PM me any time!
So far I'm doing ok on glyburide, seeing much lower numbers than I ever have. But I worry about staying on it long-term, since apparently it stops working eventually and it may be associated with a higher risk of heart disease. I told my OB I'd prefer to jump straight to insulin, but she thought that would be too much work for me. I'd be far more likely to be super obsessive about it, and I don't think I'd be very compliant with a rigid regimen like you described because I'd want to be able to adjust as necessary. I definitely understand the need to be in control!