Comments on: The Type 1 diabetes pregnancy update – 34 weeks.

By: Nic

Nic — Sun, 08 Aug 2010 02:32:03 +0000

Louise – that is absolutely AWFUL! I hope you gave that doc a right dressing down for that comment. You must be at about 32 weeks now and I bet you don’t have “raging pre-eclampsia”.

All the best for the next few weeks – you’re almost there!
Nic

By: Louise

Louise — Tue, 27 Jul 2010 17:04:10 +0000

Hi Nicola,
I have just read all your pregnancy articles and thank you so much for sharing, I feel so much better!
I am T1 and have been since the age of five. Currently 30 weeks into my pregnancy.
Today’s trip to the hospital was less than ideal. Whilst trying to work out what the general plan would be I asked when they would book in the induction. The obstetrician scoffed at me and said it was way too early to be thinking like that. She said, and I quote ‘you could get raging pre-eclampsia at 32 weeks and then it would all be over’…. not entirely the information I was looking for.
Do you have any ideas where I could meet other pregnant T1’s? I live in Hamilton, otherwise the Auckland coffee group would be ideal!
Louise x

By: Nic

Nic — Sat, 17 Jul 2010 06:22:05 +0000

Wow, Maria, what a story!! I have always wondered about those ladies who have T1 and have twins AND vomiting – that is a challenge five times harder than a singleton pregnancy with diabetes. Huge congratulations to you and thanks so much for sharing your story. Nic x

By: Maria

Maria — Sat, 17 Jul 2010 00:16:07 +0000

Hi Nicola
I read your article in the Diabetes magazine and it brought back lots of memories. I was diagnosed with gestational diabetes in my first pregnancy which I easily controlled with diet. Matthew will be 16 in December. Two years later I had blood sugars of 40+ and it was confirmed I had Type 1. I found that the gestational diabetes had prepared me for starting injections, blood glucose testing, carbohydrates, diabetes clinic, etc. My next pregnancy was with twins! I live in Warkworth so had to travel down to National Womens Hospital on a regular basis. The best part was having a midwife phone me twice a week to see how I was faring. The worst part was really bad morning sickness – I had to have injections to ease the awful vomiting. I was trying to eat and take iron, folic acid, etc but had no appetite whatsoever. It didn’t come back till after the birth and I was lighter than pre-pregnancy! People were excited for me having twins though I just felt awful! I had really bad hip pain and could barely walk to the letter box. I worked fulltime teaching until 28 weeks then went into labour at 32 weeks. I had a private obstetrician (a good thing as I found with my first pregnancy I saw so many different people) who tried to stop the labour which wasn’t successful. My babies , Alice and Jack, spent a month in NICU/PIN before we went home. They will be 10 next month – life is much easier… Good luck. Maria

By: BeingDiabetic.co.nz | Pregnancy with Type 1 diabetes – the summary.

BeingDiabetic.co.nz | Pregnancy with Type 1 diabetes – the summary. — Mon, 05 Jul 2010 08:34:32 +0000

[...] 7. 34 weeks [...]

By: Nic

Nic — Wed, 11 Nov 2009 19:23:35 +0000

Hi Amy, thanks for your story. You can read what happened in the end here: http://www.beingdiabetic.co.nz/?p=387.

All the best for your current pregnancy!
Nic

By: Amy from Canada

Amy from Canada — Wed, 11 Nov 2009 18:44:14 +0000

Hi Nic,

I’m Type 1 (for 18 some years) too. I live in Canada & have been on an insulin pump since 2000. I just turned 30 years old.

My first pregnancy & weight loss:
My first son was at the 98th percentile. I sneezed & my water broke at 6 weeks early.
Weight didn’t drip off me either during breastfeeding. It wasn’t until I started working out when my son was 8 months that I started to lose weight. (even then, it was incredibly hard to lose weight b/c during workouts/aerobics, my blood sugar would crash & I would have to drink juice, aka more cals & carbs, to get my sugars up). It’s hard work for us diabetics, but unfortunately, there is no alternatives.

Breastfeeding/Low Blood sugar:
For the first time since being diabetic, paramedics were called after I breastfed. My dad thought I looked tired & he took my son out while I napped. But then I became incoherent (my son was 7 months old).

I was vigilant about testing my blood around the clock…but my blood sugar plummeted & I was out of it. Ironically when my husband tested my blood, it had first said I was 4 mmol (though I was out of it & behaving like a 2 year old, from what he & my parents told me). Then it went down to 2.4 mmol in 5 mins. They called the ambulance at that point. When I was 4 mmol, since I was already behaving erratically (& creating a spitting fountain of milk from what they had given me), it is likely that I had already dropped lower & that my body took my sugar stores from my brain & that is why it appeared that my blood sugars were “normal” & that is why I couldnt’ process much mentally (thus behaving so childish).

Birth Weight:
My son was 7 lb 7oz (6 weeks early) via C-section (we were trying for natural, but his heartrate went high & they wanted to get him out). Just found out that my current baby (in utero) (I’m 34 weeks preggers now) is also at the 98th percentile. Therefore, they have scheduled me for a c-section at 38 weeks again (due to the expected large size).

Insulin Pump:
With my first son, my pump was turned off for 12 hours post-op. I can’t remember what we had adjusted it to afterwards (but I’ll let you know). What did you do? Your baby must be born now (& approx 1.5 months old by now?)

Delivery:
I threw up right after my surgery. I can tell you this now since you have been through it yourself…but I wanted to die. Surgery went fine…but after I threw up (several times after just being stitched up), caused me agony all night long. How did yours go? Did you have a C?

Size:
How big was your baby? I’m hoping my current babe doesn’t grow any larger than the 98th percentile.

HbA1C:
Mine have consistently been 6.1 up to 6.5 mmol (& they are tested every month).
I test all the time (10 to 20x daily) & try my best to keep everything perfect, but I keep getting higher than optimal levels after breakfast, in particular (& peaks at other random times too).
I have been chronically increasing both my basal & bolus rates at breakkie, but it’s still not perfect. My endocrinologist said I have been doing a great job. Hoewver, I feel like my OB-GYN, whom I like very much, feels like I haven’t been doing a superb job on my sugar control. I feel the guilt/worry of her opinion because I do test ALL the time and try my very best to keep my sugars kosher & don’t want to be the cause of my gargantuan baby (& particularly because I don’t know what else I can make my sugars even better). But once we found out that my new baby was at the 98the percentile, I felt that she felt like it was my fault (& that I wasn’t doing enough). …Oye the worries/stresses of being a diabetic mom.

I’d love to hear how everything went for you during your birth (& the size of your baby).

All the best!
Amy

By: Sarah

Sarah — Tue, 29 Sep 2009 22:47:54 +0000

Hi Nic – I don’t get low blood sugars breastfeeding so don’t count on that. And throughout labour the midwives took my BGs and adjusted the drip accordingly – it worked really well, and I stayed between 5 and 6 mmol/L. I hear that if you progress quickly enough, you can bypass the insulin dextrose drip. I was trussed up like Jesus (hehe) for my first and third births, but for my second it all went really quickly – I didn’t need sinto, and they just occasionally waved the heart rate monitor over me. Mainly the midwives looked after me, but the OBs popped in and broke waters, inserted drips etc. They seemed to work well together – no tension evident. I had pain relief for birth 1 & 2 but my third birth I did drug free. Re the OB – you can request continuity while you’re at the clinic but I think it’s pot luck on the D-day. The OBs at the diabetes clinic don’t seem to actually deliver babies! But all the midwives/OBs I encountered at National Women’s seemed very competent and kind.

By: Nic

Nic — Tue, 29 Sep 2009 18:38:07 +0000

Hi Emma – having baby in Auckland (National Womens). As I’ve said before I have complete faith in the team around me which is a really great position to be… I was just a bit down after the last appointment as I didn’t feel I got as much info out of it as I had hoped. I take part of the blame for this and will def go in armed with my list of questions next time! Funny about your Mum’s “Jesus on the cross” comment. I was talking to my mum yesterday and realised how lucky we are today with all our options… no matter what their health (Mum’s was excellent, no pregnancy issues or other complications) they ended up strapping up your legs into the stirrups for delivery – yuk!!

Cheryl – your comments are so useful and informative, thank you very much. For non-U.S readers, 70-110 is 4.4-6.9 mmol/l. Great advice on keeping tight control over BGs during labour – might give that job to my husband to monitor. I’m pretty sure I’m on your database for people to email when the book comes out, but if not please add me as I’d love to buy your book.

Thanks people – what a great community we have here on the blog!

Nic

By: Lyrehca

Lyrehca — Tue, 29 Sep 2009 15:12:01 +0000

Just thought of another point–have your endocrinologist ADJUST your insulin doses immediately after giving birth, and particularly if you are going super low with breast feeding. You will definitely need much less insulin upon giving birth, and with breastfeeding, your excess weight, and other issues, it will likely be a different dose than what you took when pre-pregnancy.