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[IP] Re: Hi then low, and wanting to achieve pregnancy
While the caveat, YMMV, is also true here, your Drs are trying to get your
glucoses tighter because they want the best pregnancy outcome for you. I've
seen several references with these guidelines for the pregnant patient with
IDDM. Speaking from personal experience, I was able to achieve the fasting of
60-90 my endo wanted. As the pregnancy progresses, more insulin is needed.
Every time I started inching upwards of 90, up went the bedtime NPH. (my pre
pump days) In those preHumalog days, I could not achieve the postprandial
glucoses desired nowadays, but my endo wasn't as concerned with it as the
fasting and premeal levels, and as those were good and my HGBA1c was less than
6 (best at 5.5) we were happy.
There is evidence that having the glucose in tight control BEFORE conception
will reduce the somewhat elevated risk of fetal anomalies inherent with
diabetic moms back down to the same level of risk for the rest of the
population. And having the glucoses in control throughout the pregnancy will
reduce a variety of problems for mom and baby, including the typically big
babies we have. (Reduce, not eliminate, my second was (9lb, 3 oz at 37
weeks...and this was with exquisitely tight control!...can you imagine if I'd
been in less control!!??) However, keep in mind even in the best of
circumstances, there will be some up and down swings, unexplained or illness
produced, and you work with your team to keep things in control. In my case,
I faxed copies of glucoses weekly while trying to conceive and every 3 to 4
days in pregnancy.
You might get the impression from this that I am an "always in control" model
diabetic, but I can tell you that I am far from where I'd like to be in
control now, and have been in the past. However, it is amazing what you can
do for 9 months for that baby!!!!
The BEST luck! Linda
Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org