I’m DM1 planning to get pregnant! I’m 26y and I have been on insulin pump for 6 months now (actually since my bf and I decided we wanted to have a baby). I’m pretty confident about using the pump, and I’m not really afraid of my DM1 because I have had it for 15 years now! My doctor doesn’t know yet that I want to get pregnant, I have an appointment this Monday . I’m preparing myself to this meeting and I have a question I would like to ask here. I read that controlling HbA1c in pregnancy works differently, like different targets?? And it doesn’t make sense to me! Can anybody explain this to me please? Any advice is welcome!
Good that you are taking care and looking for advice for planning to get pregnant! HbA1c is normally lower in the early pregnancy and there’s a further decrease in late pregnancy. You will find different recommendations as to which value is considered normal, but they normally vary between 4,5-5,7% in early pregnancy to 4,4-5,6% in late pregnancy. But the good thing is you are asking for advice before you get pregnant and it is recommended to get pregnant (ideally) if you have HbA1c lower than 6,5% and some people say even 6,1%. But during the pregnancy your doctor/nurse will actually want your daily test more than your HbA1c to guide your therapy [????]. The pre meal and post meal recommended values are around 90mg/dl pre meal and 120mg/dl post meal, but this you will also have to discuss with your doctor. Another important point is to have your eyes checked before you get pregnant so if necessary you get treatment before the pregnancy. Also very important is to take folic acid. Keep in mind that in pregnancy is very important to have a strict glycemic control. Good control is important for mother and for the fetus.
I was living a nightmare when I got pregnant and diagnosed with lower hemoglobin A1C levels believing that this is something that you can't control. So, basically, I can tell that I am the same, T1 since 2005 & on a pump under a year. When I and my hubby were considering having a baby, I measure it and my hba1c is at 7.7 & I've to get it down. I was consulting my doctor all the time about this because I was really scared that I can have some baby problems. Also, he told me that the unborn fetus was 4.56 times more likely to die among women who had diabetes before getting pregnant than it was among women without diabetes. That is why you need to control it and I don't think that I was bored with this constant doctors visits at all.
That is wonderful that you are considering adding a new family member to your clan! You should be fine when you go in to discuss this with your doctor. Nowadays, type 1 diabetic women can safely carry a baby with the new technology, additionally, insulin pumps. You already have one so you are set in that respect. It should not be much different as far as diet goes other than eating an additional 300 calories a day for the baby. Your doctor will anticipate that your body may have additional insulin needs, so the pump will be a great tool in helping you through that part of your diabetic planning.