diabetic pregnancy and life update

I was asked to post an update so here it goes!

I started posting here at 19, while a sophomore in college. I was using a medtronic 522 pump and the medtronic sof sensor at that time. I am now 23, married, and in my second year of medical school. I'm a MD/PhD student so have about 4 years to go after this one (at which point I will have been in school for 25 years!). I am currently using a medtronic 523 pump and dexcom G5. I switched back to the medtronic pump for my pregnancy because I found it the most reliable in terms of not stopping insulin delivery for occlusions or random alarms.

I'm now 29 weeks pregnant. Overall it has been extremely manageable in terms of diabetes but less so in terms of my somewhat newly dx'd hypothyroidism which has been proving quite difficult to find the correct dose for. My pre pregnancy A1C was 5.5 and during pregnancy it has been around 5.1-5.3. My personal goal is under 5.5 and my doctor's goal is under 6. I'm using about 3x as much insulin at this point as I was before pregnancy but overall with basal adjustments every few days I am able to maintain an average of around 105. I do expect my insulin usage to continue to rise though-- I am quickly depleting my stock of insulin. I use dexcom clarity on a daily basis and that along with the dexcom has probably been the most helpful pregnancy tool for me. Currently I have urine tests, blood tests, and an ultrasound every 2 weeks but that will soon increase to weekly. Fortunately, the outpatient clinics are attached to the medical school campus so it is very convenient and I live a 10 minute walk from the hospital so overall I am very lucky in terms of managing all the testing. Pre pregnancy, I did set up a pregnancy planning appointment with a high risk OB (which I ended up showing up already pregnant to) but they really had minimal concerns regarding my diabetes after seeing my blood work and significantly more concerns that I am an Ashkenazi Jew (my husband is not) with a family history of tay sachs. So I ended up with quite a few genetic counseling appointments early on and had CVS at 10 weeks and my diabetes kind of took the back seat for my first trimester. I think that is it in terms of pregnancy. I will most likely have a scheduled C-section around 38 weeks unless something changes before then and we are very excited to meet our baby boy!

If I could do this over, I would have set up a medical team in advance of my pregnancy. We were expecting much more difficulty due to my past medical history so thought we would have more time but I ended up having tons of issues getting appointments with the various specialists at the correct time. Also, I would have stocked up on pump supplies and insulin ahead of time because I really have run through what I thought was a huge back up supply.

 

Thank you for sharing. Sounds busy but so happy that you and your baby are doing well. Enjoy the last couple of months and would love another update after the birth.
Ali

 

Congratulations, Meg!

 

Thanks for sharing your experience, Meg! I've always wondered what diabetes would be like to manage during pregnancy. I wish you well over the next 10 weeks! Pregnancy can be hard but it is also so amazing. Don't forget about the amazing.

 

Thanks so much for sharing this. You are doing great! :cwds:

 

Thanks everyone!

 

Congrats! Have you ordered the T1D pregnancy book by Ginger Vieira and Jennifer Smith? https://www.kickstarter.com/projects/1194457185/pregnancy-with-type-1-diabetes-your-month-to-month

 

Thank you for the info. I have a friend with T1D who wanted to get pregnant. She had been around 6.8 at the time and they told her to try to get down to 6, and she got so stressed out by it that she ended up in the 7s despite her best efforts, although she is one who does not change her pump settings on her own, but waits until her regular endo appt. to do it.

I have a few questions maybe for later if that is OK, but just one for now. How many segments do you have to divide the night time up into to get your basal rates right? Can you run one basal rate all night or do you chop it up into 2, 3 or 4 hour segments? Is that different during pregnancy than before?

Thank you very much.

 

I'm happy to answer any questions. That said, I think everyone has different experiences during pregnancy and thus far I feel like I have had a relatively easy time managing my blood sugars. I currently have 4 basal segments from 12 to 8 AM in 2 hour segments. I need more basal in the early morning than any other time. I had a similar number of basal segments before pregnancy but before pregnancy I needed more insulin in the evenings and now I need more from around 2 AM to 6 AM (about 2x as much as any other time) to avoid spiking to the 160s-180s.

 

Thanks for a look into the life of an expectant mom with T1d. Best of luck to you on this new adventure! Can't wait to see pics.

 

Well, we have a very healthy baby boy. His name is Benjamin, he was born Monday in the early morning, and he was 7 lbs. exactly. His BGs were slightly low initially but he had a bottle of formula (which they let my husband give) and then was fine. He is doing extremely well and we left the hospital on Wednesday evening. I'm struggling to a certain degree with pain and the adjustment of going from studying/being in the hospital 14 hours a day to just hanging out at home but we are so love with our baby boy. In terms of my blood sugars, it is a bit of a disaster (OK, that's an understatement) but I imagine it will get better. It doesn't help that I'm loading up on carbs and goodies I didn't eat for 9 months (I had Chipotle for lunch and even got extra rice on my burrito and it was amazing ). It is a bit of a carb high, nursing low and then repeat rollercoaster. But our son is totally worth it :cwds:

 

What an adorable little face! Congratulations to you guys!!

 

He's darling! Congratulations!

 

He's so adorable! Congratulations and hope you can bounce back soon. All the best!

 

Wonderful news! Thanks for sharing, and congratulations! :cwds:

 

Congratulations, Meg! Beautiful baby!

 

Congrats!

 

What wonderful news! Enjoy every second...it goes by so quickly!

 

Congratulations! He's a beautiful baby!

 

Well done, Meg! Best wishes to you and your family.