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Re: [IP] pregnancy

At 3:21 PM -0800 3/28/99, ce p wrote:
>I would be interested in any information that anyone would like to share
>about pregnancy and the pump.  Particularly - what range is acceptable
>for blood sugars, what happens if you spike high after a meal or are
>high at another time, what sites do you use, how often were you at the
>doctors, and any other info would be greatly appreciated.

Hi Christa,

I have two children, ages 10 and 18 months. My 10-year-old was born while I
was on MDI (NPH & Regular) and my daughter when I was on the pump (Humalog).

I went to perinatologists (high-risk obstetricians) before and during my
daughter's (18-month-old) pregnacy. I highly recommend this. The docs in
this practice and their extremely competent nurse/practioners knew so much
more than my previous ob. I got much better care and much more info
regarding all my questions. They knew (and could tell me) about how insulin
requirements change as the pregnancy progresses, about what complications
(such as pre-eclampsia, which I had with both my kids) are more prevalent
in DM moms--even well-controlled ones.

My doctors wanted me to aim for a fasting BG between 60-90 and
postprandials 140 or below. I knkow that I went above these numbers at
times, I had at least a couple of surprise 200s. My doctors stressed that
the isolated highs were not as important as long-term highs in hurting your
baby. So, it is important to monitor your BGs often so that you can quickly
correct any highs that might occur.

I read a few years back (and I can't remember the exact percentage) that a
certain number--somewhere between 30-60%--of uncontrolled DM pregnancies
result in healthy babies. I don't quote this stat to encourage you to play
Russian roulette with your BGs and, ultimately, your baby's health, but to
let you know that keeping your BGs in the normal range is doable and not
quite the high-wire act over a river of alligators it sometimes seems.

With my 2nd pregnancy, I saw the docs once a month and then every 2 weeks
after about 28 weeks. I saw them about once a week after 30 weeks, but I
was showing some signs of pre-eclampsia, so they were keeping a close eye
on me.

A few important things I learned regarding pregnancy:

- there was *nothing* like a growing embryo or fetus inside me to motivate
me to keep my BGs in the normal range. And because I was so motivated, both
my pregnancies gave me very useful info about staying in control even when
I wasn't pregnant.

- test like crazy in the first 3 months of pregnancy. The growing
(exponentially) amounts of progesterone and other hormones can make your
BGs erratic. You can also be more insulin-resistant due to these hormones.
Plus, if you've got morning sickness (a misnomer, I tended to have it all
day), eating is the best cure, so give insulin when you do.

- For pump sites, I used my stomach the whole time I was pregnant. After a
certain amount of time, I couldn't see the lowest part of my abdomen (!),
but the rest of it was fine. I have a thick enough layer of adipose tissue,
even when it's stretched out 8 months of pregnancy worth. ;-/

I was trying to think of any literature you might want to read. Dr. Lois
Jovanovitch (I think that's her name) has a chapter on pregnancy in her
book, "The Diabetic Woman," but if I hadn't already had one child, I would
have found it really intimidating. Most of the women quoted in that book
talk about how hard pregnancy was for them. One woman decided to adopt a
2nd child, rather than get pregnant again. Your doctor probably has a
pamphlet about DM and pregnancy. Also, the March of Dimes has a good
book/pamphlet, although it's aimed at nurse/practioners, not lay people.
You can order it from the March of Dimes.

As for general pregnancy books, Dr. Glade Curtis's "Your Pregnancy Week by
Week" is wonderful and tells you what's going on each week (how big the
baby is, what organs etc. have grown.)

Both my kids were born 6 weeks early due to pre-elcampsia (it runs in my
family), but both are very healthy! Good luck and enjoy, it's a wonderful
time. :-)

Jenny (Sorry this was so long!)

Jenny Nash
freelance writer and editor
email @ redacted

Insulin Pumpers website http://www.insulin-pumpers.org/
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