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Successful Pregnancy With Type 1 Diabetes

Type 1 Diabetes And Pregnancy

Type 1 Diabetes And Pregnancy

Pregnancy in women with type 1 diabetes remains a challenge for the patient and healthcare team alike. The scenario box on this page highlights some of the problems in achieving satisfactory pregnancy outcomes in women with diabetes. We discuss in the article the main areas of concern. SCENARIO Julie rang the diabetes specialist nurse having confirmed pregnancy with a home test kit. Her period was two weeks late. Although she recalled being advised about the need for prepregnancy care, she thought her glucose control was good enough (HbA1c concentration 7.9% at last check) and she had been taking a 400 µg tablet of folic acid daily. She had developed type 1 diabetes 16 years before (at age 8) and at her last annual review had no retinopathy or microalbuminuria. She controlled her diabetes with bedtime insulin glargine, plus insulin lispro (a rapid acting analogue) before meals. An urgent appointment for the medical obstetric clinic was arranged, and telephone advice was given to achieve blood glucose levels of 3.5-5.5 mmol/l before meals and 4.0-6.5 mmol/l two hours after meals. HbA1c concentration decreased from 7.7% at presentation to 6.3% within eight weeks and was maintained around this level for the rest of pregnancy. The 19-20 week anomaly scan showed a cardiac abnormality, later confirmed with fetal echocardiography as a ventricular septal defect. Blood pressure increased from 102/66 mm Hg to 124/84 mm Hg. Labour was induced at 38 weeks. Blood glucose concentration was maintained at between 5.5 mmol/l and 7.3 mmol/l through use of intravenous glucose and insulin. After a normal vaginal delivery the 4100 g baby boy had Apgar scores of 7 and 9 at 1 and 5 minutes respectively. The locum neonatal senior house officer was advised by the experienced midwives not to me Continue reading >>

Type 1 Diabetes And Pregnancy

Type 1 Diabetes And Pregnancy

Integrated Diabetes Services’ track record for coaching women with Type 1 diabetes through successful pregnancies is unsurpassed. Our team of Certified Diabetes Educators works to supplement (not replace) the services of your endocrinologist and obstetrician on all aspects of child-bearing: Pre-Pregnancy Counseling Success is 90% in the preparation. It is well-documented that most birth defects occur during the first six weeks of gestation. We work diligently with our clients to achieve the best possible blood sugar control prior to conception. This includes developing/fine-tuning self-management skills, incorporating advanced diabetes care technologies*, as well as taking the necessary preventive health steps to ensure your well-being throughout the pregnancy. * including insulin pumps, continuous glucose monitors and data downloading/analysis software. Diabetic Pregnancy BG Management Tight blood sugar control is essential during the second and third trimesters to prevent fetal macrosomia (excessive growth of the baby) as well as a premature or complicated delivery. Throughout pregnancy, expectant moms with type-1 diabetes see major changes in their insulin requirements – typically decreased needs in the first trimester followed by steadily increasing needs in the second and third trimesters. Through frequent reviews of self-monitoring data, our team will work with you to make the necessary adjustments and keep you on track. Our lifestyle specialists will also coach you on nutrition, physical activity and weight issues, and prepare you for “the big day”. Postpartum Adjustment Challenges to blood sugar control don’t end after delivery. Sudden changes in weight, hormone levels, physical activity and nursing patterns can create a virtual “roller coaster”. W Continue reading >>

Pregnancy And Type 1 Diabetes

Pregnancy And Type 1 Diabetes

As if managing type 1 diabetes wasn’t complicated enough, adding pregnancy to the daily challenge can be immense, but many women today have shown that it can be done safely and happily. The challenges for a woman with type 1 in pregnancy are the result of constant changes in hormones and the demand on the mother’s body of the growing fetus, which means that insulin needs for optimal blood sugars are constantly changing. Women with type 1 diabetes are advised to not get pregnant until their A1C is below 7 percent, for both the sake of their baby’s health as well as their own. Higher-than-normal blood sugars during pregnancy can lead to a variety of complications, and most commonly, macrosomia, which is when the baby is born significantly overweight from the increased supply of glucose in the mother’s bloodstream. Despite the challenges, many women have succeeded in the meeting the demands of diabetes management during pregnancy and successfully given birth to healthy and happy babies, with happy and healthy mothers. Jennifer Smith shares her story and advice for maintaining optimal blood sugars during pregnancy thanks to diabetes technology and her own diligence. (Her own A1C is generally between 5.8 to 6 percent, even during pregnancy.) Jen Jacobs shares her pregnancy story at A Sweet Life and the joyful challenge of trying to find the best place for his insulin pump. Kerri Sparling shares her story of once being told she could never have children 25 years ago to giving birth to her beautiful daughter just a couple years ago. Gina Capone shares a powerful story of how pregnancy with diabetes saved her life at DiabetesMine. Gina Capone shared another aspect of her pregnancy at the JDRF’s blog. Diabetes Forecast shares multiple experiences from women with type 1 Continue reading >>

Type 1 Or Type 2 Diabetes And Pregnancy

Type 1 Or Type 2 Diabetes And Pregnancy

Problems of Diabetes in Pregnancy Blood sugar that is not well controlled in a pregnant woman with Type 1 or Type 2 diabetes could lead to problems for the woman and the baby: Birth Defects The organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant. Blood sugar that is not in control can affect those organs while they are being formed and cause serious birth defects in the developing baby, such as those of the brain, spine, and heart. Download Chart[PDF – 167KB] An Extra Large Baby Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery. C- Section (Cesarean Section) A C-section is a surgery to deliver the baby through the mother’s belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth. High Blood Pressure (Preeclampsia) When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesn’t go away, she might have preeclampsia. It is a serious problem that needs to be watched closely and managed by her doctor. High blood pressure can cause harm to both the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleed in the brain that ca Continue reading >>

Pregnancy If You Have Diabetes

Pregnancy If You Have Diabetes

If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>

I Was Pregnant With Type 1 Diabetes

I Was Pregnant With Type 1 Diabetes

According to experts, of the nearly one in 10 women with diabetes in the U.S., about five percent have type 1 diabetes (an inability to produce the insulin needed to process the food we eat). Moms with diabetes can deliver healthy babies, but they need to take extra precautions during pregnancy to avoid potential complications. These women endure more than most during their nine months, from constant monitoring of blood glucose levels to a seemingly endless succession of prodding-and-poking doctors. What to Expect reached out to our community members who struggled with type 1 diabetes during pregnancy to find out how these moms fared. Continue reading >>

Type 1 Pregnancy Risks And How To Minimize Them

Type 1 Pregnancy Risks And How To Minimize Them

There’s a lot to consider when trying to get pregnant or being pregnant as a Type 1 woman. There’s of course, the maternal desire to do everything you can for your unborn child so that he or she may have the best life possible. An ideal pregnancy is a full-term and uneventful one, the outcome a healthy, happy baby. Having Type 1 diabetes doesn’t mean you can’t have that; it just means that you have to be more vigilant, more prepared because of the heightened risks involved. But you’re a Type 1, so you already know how to do that. In fact, you’ve been doing it ever since “D-day,” so take a deep breath and trust yourself. All pregnancies have the chance for complications, but having Type 1 makes you more susceptible to specific ones. Here are the most important things to do in order to lower those risks: Pregnancy Advice for lowering risks for complications 1. Keep your blood glucose levels in range The most important thing you can do as a Type 1 mother-to-be is to try and get your blood glucose levels in a healthy range. Check your number and check often. This will decrease the chance of excessive sugars being given to your baby. Excessive sugars for your baby may cause them to grow quickly as if being “over fed” (Macrosomia) or can do harm to the early development of organs (fully developed by week seven). This is not just vital for your baby’s health during pregnancy but also before conception. Doctors recommend having your blood glucose levels in range three to six months before you become pregnant. Target blood glucose range pre-pregnancy (NIH) – 80-110 mg/dl before eating 100-155 mg/dl 1-2 hours after eating Target blood glucose range during pregnancy (NIH) – 60-99 mg/dl before eating 100-129 mg/dl 1-2 hours after eating Be sure to set goal Continue reading >>

Pregnancy In Women With Type 1 Or Type 2 Diabetes

Pregnancy In Women With Type 1 Or Type 2 Diabetes

Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life. Blood glucose (sugar) control is a daily challenge for people with diabetes. Hormonal changes during pregnancy make diabetes even more challenging. The majority of women who properly control their diabetes before and during pregnancy have successful pregnancies, and give birth to beautiful, healthy babies. Risks and potential complications Women with diabetes have a higher risk of miscarriage and of having a baby with birth defects (heart and kidney defects, for example). This risk significantly increases if blood glucose (sugar) control is not optimal, especially at conception and during the first 3 months of pregnancy, when the baby's organs are forming. If your blood glucose (sugar) levels are poorly controlled, you should avoid becoming pregnant until your healthcare team has helped you improve your blood sugar control. Risks for the mother: Miscarriage Rapidly worsening retinopathy (damage to the retina caused by diabetes) Rapidly worsening nephropathy (kidney damage caused by diabetes) and kidney failure A more difficult vaginal delivery (because of the baby’s weight) requiring special maneuvers by the obstetrician or the use of forceps or suction Caesarean delivery Gestational hypertension and pre-eclampsia (a pregnancy complication characterized by high blood pressure and significant swelling) Excess amniotic fluid, which can cause premature labour Risks for the baby: Defects (especially if the diabetes is poorly controlled in the first 3 months of pregnancy) of the heart, kidneys, urogenital tract, brain, spinal cord and backbone Higher-than-average birth weight (more than 4 kg or 9 lbs.) or, convers Continue reading >>

Pregnant With Type 1

Pregnant With Type 1

Just wondering if anyone with type 1 can share their pregnancy stories with me. Just found out i'm 5 weeks, and very stressed as i hadn't been very good with my testing, injections etc. This is crazy. I literally took 2 tests last night, both positive. I am very stressed as well bc my diabetes care and A1C levels are not in the range they need to be in, especially considering what they should be in prior to pregnancy. I am totally freaking out. I do want to congratulate you though!! In the grand scheme of things this is a true blessing beginning in our lives and we both will get better with our care and our blood sugar control. There are plenty of healthy diabetic pregnancies, births and babies. I am in a way relieved to read someone is sharing the almost identical situation as I am. Please reach out if you need anything.. I would love to be able to communicate during this process with someone who can relate to what I am going thru. BTW I am estimated to be around 4 or 5 weeks as well. Best wishes to you!! Congratulations on your pregnancy! I have technically had two, successful, pregnancies while type 1. I say that because I was thought to have gestational diabetes during one pregnancy only to find out four months post partum that it was type one diabetes, not gestational. The one insulin dependant pregnancy I had went very smoothly. I was at a good A1C before getting pregnant, but I did struggle during the first trimester with high blood sugar, then low blood sugar during the second trimester, then high again during the third. It felt like I was failing miserably, but my A1C was consistent about 5.4 throughout the pregnancy. I was on MDI during the first trimester, but when I started having lows during the second I was able to get on the MiniMed Paradigm Pump and tha Continue reading >>

My Successful Twin Pregnancy As A Type 1 Diabetic

My Successful Twin Pregnancy As A Type 1 Diabetic

My successful twin pregnancy as a type 1 diabetic Recently in history, Type 1 diabetes and pregnancy did not mix. However, now that we have insulin pumps and better insulin and meters, healthy pregnancies in type 1 diabetic women are a norm. Yes, pregnancy as a type 1 diabetic does carry extra risks. Obviously the risk level changes depending on the person as well. But, I can tell you personally that it CAN be done. I have had diabetes for 15 years this November. I am 26 years old. I got married a year ago and last October I became pregnant (After being told I may never conceive due to endometriosis). I was so pleasantly surprised! Then terror struck me. I thought of all that could go wrong either with me or my baby. I was told by an obstetrician that my pregnancy was considered very high risk even though I was in good health. So of course that freaked me out. My first month pregnant was easy because I didnt know I was pregnant and didnt notice any symptoms.During thesecond month I worried my tail off but, still didnt feel much. I noticed I was outgrowing my clothes very rapidly though and starting to feel a little nauseated. I had an ultrasound at two anda half months to see how things were progressing and discovered alongside my mom that I would be having twins! I called my husband and informed him wed have to sell his nice truck because our family would not be fitting in it. Well, now my pregnancy was even more high risk than previously believed. I am a spiritual person and thought to myself, wellmaybe this is Gods way of telling me that he knows I am capable of doing this and to just trust him. And so Itried. I had to somehow eat an extra 600 calories a day and check my blood glucose more often and still manage my busy work routine. All this on what they affectiona Continue reading >>

Pregnancy And Type 1 Diabetes

Pregnancy And Type 1 Diabetes

When you are pregnant, your ideal scenario is to not gain too much weight, pass each milestone without worry, and have a safe, fast delivery that results in a healthy baby. When you have Type 1 diabetes, however, the ideal pregnancy may seem unattainable. Lisa Pink, a new mother, was able to manage her pregnancy along with her diabetes to have a healthy baby girl. She summed up her experience: “It’s a lot of work. However, it’s also worth it when you hold your healthy, perfect baby!” Before conception Lisa learned she had Type 1 diabetes when she was 25 years old. She didn’t think about pregnancy and starting a family until she reached her mid-30s. Lisa didn’t know any mothers with Type 1 diabetes, but two of her friends knew of women who had managed their diabetes throughout successful pregnancies. Encouraged, Lisa went to her doctor a year before she and her husband began trying to become pregnant, which is highly recommended. A woman with Type 1 diabetes should attain healthy blood glucose levels before conception. This is important for the baby’s health during pregnancy but also before conception. The National Institutes of Health recommends that a woman with Type 1 diabetes have blood glucose levels in the target range of 80 to 110 mg/dl before eating and 100 to 155 mg/dl one to two hours after eating for three to six months before becoming pregnant. During pregnancy, the recommended target blood glucose range is 60 to 99 mg/dl before eating and 100 to 129 mg/dl one to two hours after eating. Safe sugar Meeting these target ranges will help decrease the chance of too much sugar being passed to your baby. Too much sugar may cause a fetus to grow too quickly or possibly harm the early development of organs. Having a large baby was one of Lisa’s concer Continue reading >>

How To Get Pregnant With Type 1 Diabetes (all The Lifestyle Tips)

How To Get Pregnant With Type 1 Diabetes (all The Lifestyle Tips)

Who recognizes the name Lyrehca from the blog Managing the Sweetness Within, chronicling one woman's efforts to get and stay pregnant while dealing with her lifelong type 1 diabetes? Yes, you guessed it: Lyrehca is coming out of the closet as herself, Cheryl Alkon, now-author of the forthcoming book Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. Today, Lyrehca (er, Cheryl) shares a brief version of her story, and some don't-miss tips on diabetes and pregnancy. A Guest Post by Cheryl Alkon, D-blogger and Author When I first thought about trying to get pregnant, almost five years ago, I did everything I was supposed to do: I stepped up visits to my endocrinologist for pre-pregnancy consults I worked to get my blood sugar numbers into the tight ranges recommended for pregnancy I saw my eye doctor to check my eyes for any longterm damage from diabetes and learned how pregnancy might affect them I ate better and took prenatal vitamins I also looked everywhere for books and websites about the subject and I soon met with the maternal-fetal medicine specialist who worked with my endocrinologist at my hospital's diabetes and pregnancy program. Despite excellent blood sugars, an overall good bill of health, and extensive knowledge about the topic, I left the specialist's office in tears. Why? The doc, also known as a high-risk obstetrician, spent our appointment telling me all the terrible things that could happen in a pregnancy complicated by diabetes. Yes, tight blood sugars were necessary. Without them, the chances of having a pregnancy colored by complications, both for me and for the unborn baby, were high. The visit was a long list of all the potential things that could go wrong, from the pregnancy itself, to actually giving birth, to the health Continue reading >>

Pregnancy With Type 1 Diabetes

Pregnancy With Type 1 Diabetes

Forty five years ago when I was diagnosed with type 1 diabetes I was clearly told I couldn’t have children. I didn’t. Today, thankfully that advice is no longer given. And while a woman with Type 1 diabetes needs to take precautions, she can absolutely, and safely, have a healthy baby. I sat down for an interview with Ginger Vieira, co-author,with Jennifer Smith, of the recent book, Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management. What will people find in the book? As much information as you possibly need to understand why your blood sugars fluctuate during pregnancy and how to adjust your insulin management to keep your blood sugars as close to non-diabetic levels as possible. Also the book covers preparing for pregnancy, months one through nine of your pregnancy, delivery, and postpartum, including the challenges of breastfeeding for a woman with type 1 diabetes. My co-author Jenny is also my diabetes pregnancy coach. As a certified diabetes educator, woman with type 1 diabetes and mother, she knows this journey inside and out. What makes pregnancy for a woman with type 1 diabetes challenging? Let’s face it, a normal day with type 1 diabetes is challenging, balancing an autonomic system your body ought to balance on its own. And we’re only given insulin to do the job, while a non-diabetic body uses several different hormones to balance blood sugar. Add pregnancy to that mix and you add the insane pressure of, “Every decision you make impacts the human life growing inside of you!!!” And now you have to balance your blood sugars with constantly shifting pregnancy hormones. Plus those hormones impact your insulin needs in ways that are constantly changing and evolving. Also, there is never a break. Even when you’re sleepi Continue reading >>

Unplanned Pregnancy Type 1 With High Sugars

Unplanned Pregnancy Type 1 With High Sugars

unplanned pregnancy type 1 with high sugars D.D. Family T1 since 1982, pumping with Animas on 10/20/08 I had an unplanned pregnancy, my numbers where all over as well. My daughter is now 7. Pregnancy is a strange thing, we are at higher risk for lots of things however they can happen to anyone at anytime. Lossing a child is difficult but aborting is as well. I had one and still think about it to this day. There is no mistaking it was the right thing for me to do but as a mom I can't help but think what that child whould have been and how it would have effect my daughters and my life. It is normal to worry and question things. We can't prepare for what is to happen as we never know what that is. Take life one step and one day at a time and try to make the best decision based on what you have to work with at the time. Good luck and Congrats. Regardless of our situation we are living with diabetes and this is our life. I had a hba1c of 16 when I found out I was pregnant!!!! And now I have a healthy gorgeous 9 yr old daughter!!! Before that pregnancy I did miscarry but lots of non diabetics experience this and then after I had my daughter I got pregnant again ( I was always on contraception) and I was advised by everyone under the son that I must terminate the pregnancy...long story... me and baby would most probably not survive and now I had a 1yr old daughter to consider....In the end I felt pressured into doing it, I made the biggest mistake of my life. It haunts me to this day and I wish I had gone through with it because when I was pregnant with Abi my daughter I was warned of all these horrible things that would happen and she is very healthy..I do add though that she was born at 25 wks...so a very prem baby. Try and get the best control you can for yourself now..tha Continue reading >>

Having A Healthy Pregnancy With Type 1 Diabetes

Having A Healthy Pregnancy With Type 1 Diabetes

Kerri Sparling was 7 years old when she was diagnosed with type 1 diabetes. She grew up believing that she'd never be able to have children of her own. But by the time she became an adult, significant technological advances in managing the illness gave her hope. With two decades of blood sugar control under her belt, Sparling eventually looked around for models of a healthy pregnancy with type 1 diabetes. Aside from Julia Robert’s character in the movie Steel Magnolia, she didn’t find much. Roberts’ character had type 1 diabetes and successfully carried a child to term, only to die soon after from diabetes complications. “It wasn’t a positive image,” Sparling said. Undaunted by the Hollywood dramatization, Sparling did her own research and, in preparation for pregnancy and with the help of her endocrinologist, worked for more than a year to get her A1C — a standard test to find out average blood sugar levels over several months — below seven. Sparling, now 34, has a 3-year-old daughter and confirms that while type 1 diabetes and pregnancy might be a challenging mix, a healthy pregnancy and a healthy baby are both possible. That said, pregnancy demanded a lot more insulin than she was used to taking, and she had to spend the last month of her pregnancy in the hospital with pre-eclampsia (high blood pressure in pregnancy) before her 6-pound, 13-ounce baby girl was delivered by Caesarean section. “Pregnancy has a definitive end,” Sparling said. “I felt I could make it through to the end of that. But diabetes goes on and on.” Like Sparling, other diabetic women can get pregnant. But without proper monitoring and extra precautions, the chronic illness puts both the mother and the baby at risk for various complications. Here are some of the important m Continue reading >>

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