Planning for a Baby...Advice Needed

Hello...

I have been married almost a year and would love to have a baby. What advice can other mums with type 1 give to me? I haven't started trying as only got diagnosed a month ago and my last HBA1C was 104 so i know this needs to come down?

What is a healthy HBA1C to start trying for a baby?

What do my BGL need to be? At the moment i have managed to stabilise my blood sugar levels so its going from approx 4.5-11, most days it stays around 6-8 since i've started taking insulin.

Any advice would be massively appreciated xx

I was told hba1c of around 43 and target bs levels are between 4 and 7.5 (including the post parandial test).
Your diabetes team should arrange preconception clinic appointments, rather than just the standard diabetes clinic, as there are other drugs you should take....high dose (5mg) folic acid (prescription only) and vitamin D are the 2 I was told.

Wow, that must be a big shock. Being male, I have absolutely no experience of being diabetic and pregnant, however, I would like to give some advice anyway.

1) If you can, try and get a good handle on diabetes before you start trying for a baby. Even leaving things for 6 months will give you much more experience than you currently have. You will want to have that experience and knowledge when you are pregnant and your BGs aren't responding in the way that you want them to.

2) HbA1c is a very blunt tool in determining your management of diabetes. For example, having lots of hypos can lead to a low HbA1c, but having lots of hypos is not good management. Rather than aiming for a specific HbA1c, try for steady blood sugars within the 4-8 mmol/L range without too many spikes and troughs. This is quite difficult to achieve though - after 4 years of being type 1, I'm still struggling to do that. If you do that however, a good HbA1c will naturally follow.

3) Don't be hard on yourself when you have highs and lows. We all get these (and mentally beat ourselves up over it before realising that really, we are doing a pretty good job of managing a difficult condition).

4) I've been finding for myself, that reducing the number of carbs I eat, is helping a lot in terms of managing the spikes and troughs. Less carbs, mean less insulin and so there is less chance of hypos. I'm not advocating an extreme low-carb diet (which would be dangerous during pregnancy), but I recommend finding out what the recommended range of daily carbs is for a pregnant mother, and trying to stick to that as much as possible. (I do understand about pregnancy cravings though! ) I also find that aiming to eat protein every meal is helping me cut out snacks as I feel full in between meal times. Having adequate protein will also be important when you are pregnant.

5) You are probably still in the honeymoon period where your pancreas still produces some insulin ( and could be for 18 months or so). That may or may not be an advantage while pregnant, but is something to discuss with your medical team when talking about preparing for pregnancy. It can make your BGs a little more unpredictable because your doses of insulin may coincide with your pancreas sending out some insulin and leading to a hypo.

All the best with it. I was diagnosed at my daughter's 6 week check-up, so for me fatherhood and diabetes started only 6 weeks apart. I've met a lot of type 1 mums in the last 4 years who have delivered healthy babies, (some whose children are now in their twenties), so I'm confident that with the care and support that you will get while pregnant, you will be fine.

My honeymoon period was straight after giving birth to my son, and that was the best part of the whole pregnancy. I wish I have that again

Thats really useful. Thanks for your responses

Hi lffat, you've had some really good responses so far to give you an idea.

To reiterate Warwicks point 1 - pregnancy really makes your hormones etc change which really makes your blood sugar and insulin requirements change. If you want a smooth pregnancy (and by this I don't mean a complication free one, although that would help too, but a low-stress not worrying about your bloods every couple of hours one) then you need to really understand the different sort of tweaks that can be done and what reactions to look out for etc.

Speak to your Diabetes team at the hospital, as VickyP said most offer a pre-conception clinic where you'll be seen more regularly and they'll help prepare you in advance of it happening. They will be able to offer advice as to how soon after diagnosis is a good idea for you taking into account the likelihood of the honeymoon phase. I found it took me 15 months after doing DAFNE to get my bloods good enough - the length of time will vary for individuals of course.

In an ideal world you need to be taking the 5mg folic acid dose a minimum of 3 months before conception to ensure there is enough in your system - so it would be good to wait that long at least. It does you no harm to take for a much longer period if your bloods don't get good enough as quickly as you thought, or you don't fall pregnancy as quickly as you'd expect so don't worry on that front.

But whatever happens, as sometimes 'accidents' do happen, if you find yourself pregnant and your bloods aren't where you'd want them to be - don't feel like a naughty schoolgirl and hide from the medical team, get yourself into the antenatal diabetes clinic within the week and you can start working together to make things better. My consultant always joked she asked patients to tell her the result of the pregnancy test before they tell their husband! The early days are very important both for baby's development, but also for you (increase of hypos + reduced symptoms can lead to a stressful period that may knock you under more than morning sickness) and so get all the help you are offered as it will have an impact. They don't want to criticise you, they want to get a healthy baby and healthy mum out of it at the end.

Iffat said:
Hello...

I have been married almost a year and would love to have a baby. What advice can other mums with type 1 give to me? I haven't started trying as only got diagnosed a month ago and my last HBA1C was 104 so i know this needs to come down?

What is a healthy HBA1C to start trying for a baby?

What do my BGL need to be? At the moment i have managed to stabilise my blood sugar levels so its going from approx 4.5-11, most days it stays around 6-8 since i've started taking insulin.

Any advice would be massively appreciated xx