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[IP] pregnancy experiences



> Date: Mon, 26 Jan 1998 22:29:53 -0800
> From: Ruth Elowitz <email @ redacted>

> I live in the Bay Area too, have been diabetic since I was 11, have been
> on a pump since 16, and my husband and I are researching getting
> pregnant.  Would love to hear some of the specifics of how it really
> works and what you needed to do before hand. 

[Note: I read the digest, so replying is a little tricky, and it's often a
day or so before I see posts, more over weekends; I've stopped working
weekends since I now have my daughter around all day. :-)]

I assume you already know how to get pregnant. :-)

How does pregnancy and type I work? First, the best resource I've found is
called "Clinical Managment of Pregnancy Complicated by Diabetes", edited by
Lois Jovanovic-Peterson and published by the ADA. It's aimed at clinicians,
but is quite readable. 

As far as managing went, well, I did it the "wrong" way and got pregnant
first, then worried about my blood sugars. In other words, I didn't do
anything. :-) The goal is to run A1C's no more than 0.5 over the high end
of the normal range for your lab, for at least 3 months before you get
pregnant. My doctor thinks that will be sufficient for the next time. 

I would also make sure that I had an endo who had had lots of pregnant
patients on pumps before, and an OB who had had type I patients before and
believed in vaginal delivery at full-term. (That is, unless there were
significant reasons not to, like pre-eclampsia or retinopathy. But I'm
lucky and have no complications so far.) Where in the Bay Area are you? My
doctors are in Palo Alto and San Carlos if you need a recommendation. 

Once pregnant, I had to keep my 1 hour post-prandial blood sugars under
130, and fasting in the 60-90 range. (Non-diabetic blood sugars run lower
in pregnant women.) I had to exercise at least 4 times a week (but I do
that by default). And I had to eat much more carefully, and pay much more
attention to what I was eating, and the protein:carb ratio (I was aiming
for 1:2 at all meals and snacks). Oh, and keep meticulous blood sugar and
food diaries. My basal rates and bolus ratios changed every few days to few
weeks, first down and then up and up.  All-in-all, it was a lot of work. I
ended up going on disability leave from work at 5 months so that I'd have
time to manage the diabetes correctly. I saw my endo every 2 weeks, my ob
every 3 weeks, and a nutritionist as needed (every few weeks at first, but
only once in the 2nd and 3rd trimesters).

I'm happy to answer more specific questions; just ask. 

Janet
email @ redacted