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-   -   Type 1 diabetic with high A1C! (https://www.justmommies.com/forums/f106-high-risk-pregnancy/2678024-type-1-diabetic-high-a1c.html)

Just_Jess08 September 10th, 2013 02:19 PM

Type 1 diabetic with high A1C!
Hello. I am a type 1 diabetic and have been since I was 16(25 now) I am about 11weeks and 4 days pregnant now, and couldn't be more worried. I got pregnant in 2010 and miscarried at 7 weeks, I was never in great control on my blood sugars but after that happened I pretty much gave up completely. This past May I ended up in ICU due to dka and had/have a A1C of 13... I have had issues due to my diabetes, when I first got diagnosed I also developed Nuropathy and then two years ago I had cataract surgery on both eyes. Since the minute I found out I was prego I started checking my sugars and trying to watch everything I eat, but it is extremely difficult to control my sugars seeing how I am a brittle diabetic.

I am so worried about losing this baby or it being born with complications due to my negligence. I worry every day and going in to freak out mode when ever I have a slight pain.

Is anyone else on here a type 1? Do you worry as much?

rebeccabaltimore and more September 11th, 2013 06:47 PM

Re: Type 1 diabetic with high A1C!
You need insulin. This is not something you can control with diet alone.

How far along are you? Congenital defects occur in early pregnancy. Also, to your baby, it is not your A1C that matters - it is your blood sugars day to day. A1C is a test to tell your doctor how you are doing overall. The minute your sugars start improving, your baby knows it. Stop worrying about the past, there is nothing you can do. Anxiety isn't good for you or your baby, so try to just take it one meal at a time.

The loss of a pregnancy due to diabetic birth defects is rare. Incredibly rare. I know this, because it happened to me. In February 2009, my son was stillborn. He had no kidneys because I was (essentially) type one diabetic. And I did not know it. I am a Type 2 diabetic, very mild normally, unnoticeable really, but when I become pregnant, my pancreas goes offline. It literally shuts down. And I did not know. Your pancreas may not work well, but it still works. I can answer any question you have about this because I have lived through two pregnancies like this. I'm going to ask you lots of questions so I can try and reassure you. But I want you to look at the two babies in my siggy. The little guy, that's Ethan. He's the baby I lost to the diabetes. Isn't he cute? I was about 5 months pregnant when I had him. The other one is Grant, Grant is three now. He knows he has a big brother named Ethan, up in heaven with God. He also knows that mommy does 'ouchies' on her fingers. Grant is the example of what you get when you work hard at your diabetes, and you can do that.

Brittle diabetes is actually not a medically recognized term anymore, although some doctors may use it. It is not used because it implies that there is no clear cause for the extremely large swings in blood sugar. The good news is that there are a lot of reasons for such swings, reasons a doctor can diagnose and manage! That's always the best thing, when they can address part of the problem. Here is a link for you (What Is ‘Brittle’ Diabetes?). My diabetes isn't treatment resistant, but one of my (many) chronic diseases is, and I can tell you it is a pain in the ***, so I hope you can figure out why your sugars are nuts.

Here are my questions:
What was your diet/exercise/insulin intake/blood sugar monitoring like in the months before you got pregnant?
Was this a planned pregnancy?
If not, what method of birth control were you using, if any?
What is your relationship status with the father? Is he diabetic?
What was your alcohol/drug usage like in the months prior to getting pregnant? (Don't worry, I don't expect you to be a nun, I drink alcohol even though diabetics are told not to)
What diabetic medications have you been on?
What were you on (or supposed to be on) around when you got pregnant?
How many episodes of DKA/other emergency hospitalizations have you had in the last few years?
What kind of doctors do you have? Do you have good, crappy, or no insurance?
Do you have an OB or a high risk OB?
Can you tell me more about your previous pregnancy?

Um, I think that's all I have right now. Anyway, I am going to be your buddy and get you and your baby all taken care of as best as an internet stranger can. When you get scared, or worried, or upset, look at the picture my son Grant and know that for him, surviving my horrific diabetes was actually the EASIEST thing for him. If he got through all of the crap my body threw at him, your baby can too.

Just_Jess08 September 11th, 2013 07:58 PM

Re: Type 1 diabetic with high A1C!
Hey. I am 11 weeks and 4 days.
I do have a large understanding of my diabetes and how important it is to manage it but I guess its as my doc says my mental status that keeps me from taking care of myself(although I am doing much better these days). I know that I can not control this with diet, I have always taken my long acting insulin but its my short acting I gave up on. We do say I am a brittle diabetic cause even the hospital has issues controlling my blood sugar and the "Psychological problems, including depression and stress, are also often associated with brittle diabetes" is a big issue.

My A1C has been high for so long that I can't even feel when I have high blood sugar and when I get down to a normal range I feel very low. My blood sugars where running in the 400-500 range before I found out I was prego, and have been in the 150-250 range since I have started trying to manage it. My pancreas produces no insulin and hasn't since I was 16. I don't have a pump because for some reason Army doctor wouldn't give me one but my new doctor is getting me in to get one. So I have hopes that will be really helpful.

to answer your questions

What was your diet/exercise/insulin intake/blood sugar monitoring like in the months before you got pregnant? for the last two years I haven't been eating well, I never took my meal time insulin, only my long acting, and I NEVER checked my blood sugar. I pretty much gave up on the whole thing, only reason I took my long acting every night is because I would be extremely ill the next day if I didn't. I spent a week in ICU this past may, and in ER several times over last two years due to high blood sugars dehydrating me. Only thing I did do was exercises on a regular basis. I go to gym about 6 days a week.

Was this a planned pregnancy? Not a planned pregnancy, was convinced I wouldn't be able to get pregnant again. So no birth control.

What is your relationship status with the father? Is he diabetic? The father is my husband and he is not a diabetic, he is pretty healthy.

What was your alcohol/drug usage like in the months prior to getting pregnant? have never used drugs and not much of a drinker, only time i have really had a drink this year was on my birthday in July. Just makes me feel like crap, so not a fan.

What diabetic medications have you been on? I don't really take medications for diabetes, Im type 1 so only Insulin. I do take gabapentin for my neuropathy and I was on anti depressents.

What were you on (or supposed to be on) around when you got pregnant? just the gabapentin and anti depressants

How many episodes of DKA/other emergency hospitalizations have you had in the last few years? I have been in hospital once this year and about 4 over the last 5 years.

What kind of doctors do you have? Do you have good, crappy, or no insurance? I have a PC and a endocrinologist. And I have good insurance. I have tri-care from my hubby being medically retired from the Army.

Do you have an OB or a high risk OB? yes, I have a new OB here and I have a appt with a hight risk OB on the 28th of October.

Can you tell me more about your previous pregnancy? There isn't much to say, I only made it to 7weeks, didn't even get to my first OB appointment. My blood sugars where just as bad, but I was under more stress as my husband was away for 4 months for training.

rebeccabaltimore and more September 12th, 2013 11:21 AM

Re: Type 1 diabetic with high A1C!
The term brittle means "we don't know why you fluctuate so drastically." You're not brittle, because you do know - stress, anxiety, and depression. I can empathize about the psychological stress. I myself am Bipolar type 1 and have an anxiety disorder. I strenuously suggest you take antidepressants while pregnant because your mental issues are making your blood sugar impossible to manage. There are a TON of antidepressants that are safe for pregnancy. Because I have the 'brittle' version of bipolar, I was on 7 different psych drugs while pregnant, none of which affected my son. You absolutely need antidepressants. Yours is not a case of just being depressed, your mood state (and mine too) are affecting your sugars which are DIRECTLY impacting your baby.

150-250 isn't too bad. 150 is fine actually. Take your short acting (mine is humalog). I know what it feels like to want to just give up. I am dealing with that right now with a new MS drug I am taking, it is making me so, so, so sick and I just want to say f$%K it, to hell with the consequences. I'm actually doing that, for one day. Tomorrow I'm not taking the pills, so I can get a break from the side effects, otherwise I'm worried I'll snap and flush them down the toilet. Anyway, I totally get it, the giving up. I wanted to do that so badly sometimes. But I promised my stillborn son I'd keep it together for the next baby, and that worked out. The day my son was born, I splurged and had a coke :)

You're basically done your first trimester. All congenital defects, if they have occurred, have occurred already. The second and third trimesters are about growing and functioning, anatomical development is usually limited to the first trimester. So you're not going to create a new defect at this point. Now, it's all about helping your baby grow.

Things that are important:
-taking your short acting. You don't want your baby to get all of that post-meal sugar, it can contribute to larger than normal growth
-Keeping hydrated. Sugar ups and downs use up a lot of water. Drink drink drink.
-Checking your ketones. You don't want to be in ketosis while pregnant.
-Staying active. It boosts your metabolism. I was really bad at this.
-Getting enough sleep. It reduces stress levels and depression and makes your body function better.
-Maintaining a good diet. It isn't always easy, I know.
-Don't try to be perfect. It's not possible, and you'll just trip up.
-Get lots of monitoring for your baby. They'll suggest this anyway. If something IS wrong, it helps to know ahead of time.
-Try to do relaxing things.
-remember - babies are tougher than we give them credit for. My son had to survive a lot to get here safely - and he did. You know who does really well after the first week or so of birth? Crack babies. I'm not kidding. Once they detox, they're fine. There were a few in the NICU my son was in (he was in for a little bit) and they were the healthiest babies in there (after my son of course, he was the healthiest by far, and also the nurses' favorite baby).

So take a deep breath. What's done is done, and now you do what we all do - nurture.

Blue Eyes 409 September 13th, 2013 04:27 PM

Re: Type 1 diabetic with high A1C!
I am a type 2 and I am 9 weeks 4 days. I went over two years without meds for my diabeties I went to the Dr 2 months before I got pregnant and got on metformin my a1c was10 and my sugar was staying over 200. By the time I got pregnant my average was about 150 a week. I am now really watching everything that I eat and really doing better with my sugars. My weekly averages have been 137 -136 -111- 106 I am now having more double digit numbers and feeling better but I admit it is hard to watch what I eat and keep my sugar down but it worth it cause baby is doing OK.

I hope that you can get your sugars under control

bigfamily December 18th, 2013 06:29 AM

Re: Type 1 diabetic with high A1C!
I am type 1 diabetic.27yrs old. Diabetic since I was 11. This is my 4th pregnancy. 1 miscarriage. DS-born 3 months early, DD, born @ 36wks but weighed 9lbs 12oz. Very excited!Trying hard to keep BS under tight control. On pump and CGM.

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