# Pre- Pregancy



## Tina chick (Aug 22, 2012)

I have type 1 diabetes which is controlled by a insulin pump, Currently my Hba1c is 10.6 which is far to high i am currently trying very hard to get this down and was wondering what the ideal HB1ac is for pregnancy and if there is any things to consider or tips of things i need to do before trying to get pregnant


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## Monkey (Aug 22, 2012)

Tina chick said:


> I have type 1 diabetes which is controlled by a insulin pump, Currently my Hba1c is 10.6 which is far to high i am currently trying very hard to get this down and was wondering what the ideal HB1ac is for pregnancy and if there is any things to consider or tips of things i need to do before trying to get pregnant



Hello, and welcome over here! 

Does your clinic run a pre-conception clinic? In experience, asking your DSN for a referral to that is the best thing you can do to get lots of support. 

Ideal hba1c is under 6.1%, but lots of folk on here (me included) were given the go-ahead to start trying once under 7%. My DSN was very much of the opinion that it might take a while to get pregnant, so a balancing act!

You need high dose folic acid (only on presctiption - it's 5mg rather than the 400mcg stuff from the shelf) taken for at least 3 months (or is it 6 now?) pre-conception, plus things like your eyes, kidney function, and standard bloods need to be checked and management plans agreed if there are problems. Also, they'll need to look at any other meds you're on to check what ok in pregnancy and not.

There's lots of us who've been thro the slog and can offer a hand to hold if it helps.


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## chattygirl197811 (Aug 22, 2012)

I think Monkeys pretty much covered it. Once you see pre-pregnancy diabetes nurse they should be able to help you get it down. Its not easy I know but worth it. I had to get mine down from 9 to 6.8 or below and I just achieved it. Now I'm pregnant I'm averaging 6.7 which I hope is ok Id like to get it down a bit more if poss but what I'm saying is dont be deterred, seek help I'm sure you can do it. x


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## Tina chick (Aug 22, 2012)

Thanks for the advice I will mention it to the diabetes nurse next time I go. How  long did it take for you to get everything under control and get the go ahead


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## chattygirl197811 (Aug 23, 2012)

Took me about 6 months but that was just me personally. Good luck x


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## hyper-Suze (Aug 23, 2012)

Tina chick said:


> Thanks for the advice I will mention it to the diabetes nurse next time I go. How  long did it take for you to get everything under control and get the go ahead



Took me 3 years but I did have a really high HBA, 10+ along with psychological issues around my control/manipulation so I  had a lot of work to do, a lot of proving to my team I was serious. I wanted a pump, had to learn to carb count and addressed my eating/insulin issues with counseling. 

Anyway, pre pump got my hba from 12 to 8. In the 6months of being told to try, I got my pump, and my hba was at a respectable 7.5 and has fallen ever since(I do believe that the maternal instinct also kicks in once finding out your pregnant and a desire to reign in control takes over!)

Also a bit of info to add.. to get a better HBA, try working to the pregnancy blood glucose ranges. Check with a professional first but the ranges are to have stable levels between 3.5-5.5 and a level 2hrs after eating of no  higher than 7 (or 7.5?) ....it sounds almost impossible BUT I thought I'd never ever manage it and it has been relatively easy. 

Are you on a pump or on MDI?


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## Tina chick (Aug 27, 2012)

I'm on a pump been on  a pump about 5 years


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## hyper-Suze (Aug 27, 2012)

Tina chick said:


> I'm on a pump been on  a pump about 5 years



Oh wow, sorry! I presumed with a hba of 10 that you'd be on mdi? 
Sorry to jump the gun there! Are your pump team not concerned and helping you with the high hba? 

Well we're all here to offer help and support so hope you ask away!


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## Tina chick (Aug 27, 2012)

At my hospital appointment which only seem to  happen once a year there just up my ratio and say i just need to try and get it down my gp is concerned as i will be doing long term damage.  I often feel I'm left alone to look after me and my diabetes. My boyfriend has really been helping removing temptations etc for me so I can get it down


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## Monkey (Aug 28, 2012)

Tina chick said:


> At my hospital appointment which only seem to  happen once a year there just up my ratio and say i just need to try and get it down my gp is concerned as i will be doing long term damage.  I often feel I'm left alone to look after me and my diabetes. My boyfriend has really been helping removing temptations etc for me so I can get it down



Definitely pre-conception care, then - call your DSN. They saw me every 6-8 weeks, and I could call whenever needed. It didn't take me long - asked for referral in August, was seen firstly in October, and got go-ahead at end of December. Fell pregnant in April/May. BUT, I'd done it before, knew what the targets were, we were hoping to start trying early 2012, so I'd done lots of work beforehand.

Targets are 7.8 1hour after meals, 7.1 2hours after, fasting is 5.5 or under I think. BUT, you'll find your team will fiddle with that according to what you can realistically manage whilst doing the best for you and baby.


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## hyper-Suze (Aug 28, 2012)

Tina chick said:


> At my hospital appointment which only seem to  happen once a year there just up my ratio and say i just need to try and get it down my gp is concerned as i will be doing long term damage.  I often feel I'm left alone to look after me and my diabetes. My boyfriend has really been helping removing temptations etc for me so I can get it down



Heya, that sounds very much like my care prior to pump and it was frustrating as the team were saying exactly the same 'try to get it down' and I'd leave feeling so unmotivated and think 'BUT HOW?' followed by 'whats the point'.

Did your pump clinic give you any training on how to adjust your basal rates or your bolus ratio? I think as Monkey has said, ask your pre pregnancy clinic for help and they (if there is no-one within the team trained on pumps) should seek for a pump consultant to come onboard. I think you may need to revisit basal testing, something deffo best before getting pregnant due to the 7-8hours without food ( 
There is a really informative link in the Pumping section (I think its the first post by Pumper Sue) about basal testing and by doing it different times of the day may highlight which areas you can get your bg's down. I can't remember the percetage to adjust the rates by but someone in the pumping section would know, EverydayUpsAndDowns is very knowledgable.

Do you find you have a lot of hypos? Reason I ask is,  I was,  and this was causing me to over compensate the hypo treatment as well as the liver dumping glucose so I was then having swinging highs and my bg chart looked like a rollercoaster. I think it may have been Trophy Wench who told me a pearl of advice...get rid of the hypos and you'll soon get rid of the highs. And it is soooo true! 

Not sure if any of that is of help but as said, the basal testing is something you can do to evaluate your results but push push push your pump team to get their butts into gear and work for you!!


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