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[IP] Re: insulin-pumpers-digest V7 #537


 DO NOT listen to the OB staff for advice on your insulin doses! Have your
endo/CDE continue to manage your diabetes during your pregnancy. They can
communicate with your OBs, but the diabetes specialists need to call the shots.
When I was pregnant I had to have my endo call my OB to explain to him that I
could not follow the OB's advice (keep A1C's at 5.0, etc.) without risk of
severe lows. Most OBs are used to dealing with gestational diabetes and it is
more stable and easier to control than Type 1. They just don't know enough about
dealing with Type 1 to micromanage it. Also, the whole point of a pump is so you
can eat your meals whenever you want to, not being tied to a fixed schedule. As
long as your basals and bolus to carb ratios are correct (and they will need
adjusting at various stages of a pregnancy), you should be able to continue
being flexible with your schedule. When I was pregnant I saw my endo far more
than usual, as often as once a week during the last month!
  or so.
 So be prepared for more work and more doctor visits, but it can be done! 

Pam dx'd 1989, pumping 10 yrs.

<Well, I am thinking about taking the plunge -- into motherhood that is 
after today, I am not so sure I can do it. I met with the "OB/GYN 
Care Coordinators" for preconception counseling today. So, one of them 
told me I
have to follow my meal plan exactly and that I have to eat my meals 
every 4
hours. The other one upped my basal (which I thought was too high in 
the first
place- my CDE had lowered it after lunch as I was bottoming out), which 
resulted in 2 lows since lunch. I pretty sure that I overcompensated 
with the
second one as I ate some candy (which was wrong as I was told to only 
glu-gross tablets or juice --yea, I carry juice with me all day) then
immediately ate dinner and am feeling a little high. I know that the 
better care
you take of yourself and your diabetes, the less chance your baby will 
problems but this is the REAL WORLD-- I work a full time job and some 
days there
is no possible way to eat dinner at 4 pm. Incidently, my s!
 econd low
  occurred between 4:30 and 5 pm as I was trying to make dinner. 
Anyway... I am
interested in what other pregnant pumpers are doing / have done about 
the whole
food / meal issue. I feel way out of control now. I know I am going to 
go low
again as my basal is still up.

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