# Pregnancy with type 1



## Bethdud (Aug 1, 2020)

Can anyone who has had a baby tell me what their hba1c was before they started trying to get pregnant? My nurse has told me that mine needs to be 6.5 and is currently about 8. I'm really struggling and it's really getting me down. If anyone can give me any advice from their own experiences I would be very grateful, thank you x


----------



## Pumper_Sue (Aug 1, 2020)

Hello and welcome to the forum 
Have you seen the pregnancy board? https://forum.diabetes.org.uk/boards/forums/pregnancy.14/  hopefully someone will also see your questions there.


----------



## Inka (Aug 1, 2020)

Hi @Bethdud  

I don’t remember the exact figure but my HbA1C was below 6. It takes a lot of testing, especially after meals to catch post-prandial spikes. It’s a constant thing - minimising highs.

Is there any particular time of day you’re struggling to get good control? Are you on injections or a pump?


----------



## Deleted member 27171 (Aug 1, 2020)

Hi @Bethdud 

Welcome to the forum.

I’ve moved your post to the pregnancy board as those with some relevant experience may be more likely to spot it there


----------



## Bethdud (Aug 1, 2020)

Inka said:


> Hi @Bethdud
> 
> I don’t remember the exact figure but my HbA1C was below 6. It takes a lot of testing, especially after meals to catch post-prandial spikes. It’s a constant thing - minimising highs.
> 
> Is there any particular time of day you’re struggling to get good control? Are you on injections or a pump?


Hi Inka 
I'm on injections, it's mainly when I'm at work that I struggle with my bloods. They can go very high after my breakfast even though I have my insulin about half an hour before I eat and I don't like to do a correction dose because it tends to fall and I start getting hypos then. I'm on my feet walking around all day at work. I'm wondering whether it would be easier to just take more insulin and then keep topping myself up with glucotabs to try and keep my levels more stable! X


----------



## Inka (Aug 1, 2020)

Well, yes, slight ‘eating up’ to the insulin does work. I do that sometimes and I did it in pregnancy. Obviously you need to test lots and be cautious. Do you have a half unit pen for boluses? That way you could give more precise doses and not risk overdoing the insulin. It also means you can correct slight ‘highs’ whereas you might not if you only had a choice of 1 unit.

Work is a pain because it makes it harder to control your environment and plan ahead for blood sugar levels. What time do you eat breakfast? What do you eat? What kind of numbers are you getting before breakfast and after breakfast?

Also, don’t be afraid about moving your bolus a little more in advance. That has the most effect for me. Try 35 mins maybe? 

Have you been offered a pump?


----------



## Bethdud (Aug 2, 2020)

Yes I have a half unit pen and they are much better! At the moment I start work at 3am so I have breakfast about 2.30-2.45am. Yesterday I had ready brek (which I won't be having again) as my sugars went up to 22. Today I had seeded toast and an apple and it went to 11. This morning my bloods were good, 4.6 before breakfast, yesterday was 10.8 before breakfast. 
I was offered a pump a couple of years ago but didn't like the sound of them at the time. Can't remember how they work now!


----------



## Inka (Aug 2, 2020)

Working those hours must make things harder. On the rare occasions I’ve worked nights, I found my blood sugar was rising for no apparent reason and I needed extra insulin. 

Obvious questions but:

 a) have you done a basal test? 
B) are you confident carb-counting and changing your ratios?

I think a pump would make things easier for you, especially with your unsociable hours. Pumps are often described in over-complicated ways but they’re basically simple. A non-diabetic person releases tiny amounts of insulin throughout the day and night to keep their blood sugar in range. If they eat, their pancreas releases a bigger lot of insulin to deal with the food. A pump does the same - tiny amounts of insulin released over 24hrs and tailored to your individual need (you can have different amounts throughout the day and night). This is your basal.

Pumps only use fast-acting insulin (just like our bodies). When you eat, you simply take extra insulin as a bolus (you do this by pressing buttons on the pump, the pump doesn’t do this automatically). You don’t have injections. You get the insulin through a tiny cannula that goes into your skin. You can’t feel it. You then change this cannula every 3 days.

Pumps are very small. I forget I have mine. They also allow you to reduce your basal rate for exercise, increase it for illness, and change it easily for different work shifts or schedules.

Apart from anything else, a pump would make pregnancy *a lot* easier.


----------



## Bethdud (Aug 2, 2020)

I'm not sure what a basal test is I'm afraid 
Yes, I'm fairly confident with carb counting but my nurse said she would arrange an appointment with the dietician for me to go over it again. 
Ah, thank you for that, I thought that was basically how they worked. I have been thinking about them a bit recently, I will bring it up with my nurse next time I speak with her. Anything that makes it easier has got to be worth a go!


----------



## Inka (Aug 2, 2020)

A basal test is just to check your basal insulin is at the correct amount, which you do by not eating and not bolusing. You split the day into segments and test one segment at a time so you don’t have to starve yourself all day. 

I’m going to tag @everydayupsanddowns because I’m sure there’s a link that explains better than me!


----------



## everydayupsanddowns (Aug 2, 2020)

Inka said:


> I’m going to tag @everydayupsanddowns because I’m sure there’s a link that explains better than me!



This is one of the links we often point people towards, co-written by our own @trophywench 






						Basal insulins « Diabetes Support Information Exchange
					






					www.diabetes-support.org.uk


----------



## Bethdud (Aug 2, 2020)

Inka said:


> A basal test is just to check your basal insulin is at the correct amount, which you do by not eating and not bolusing. You split the day into segments and test one segment at a time so you don’t have to starve yourself all day.
> 
> I’m going to tag @everydayupsanddowns because I’m sure there’s a link that explains better than me!


It's alotto take in but sounds good so think I will give it a try, I have a week off work soon so I think it's probably best to do it then. Thank you for all your help!


----------



## everydayupsanddowns (Aug 2, 2020)

Bethdud said:


> It's alotto take in but sounds good so think I will give it a try, I have a week off work soon so I think it's probably best to do it then. Thank you for all your help!



For what it’s worth, that simple technique was a real ‘lightbulb moment’ for me when I discovered it about 10 years ago.

My basal wasn’t out that much... but I’d never realised how often my basal needs changed, and how when my basal dose is out by a unit or two how much havoc it creates with meals and corrections... and how many rapid units are required or hypos  need to be dodged!

Made a lot of my ‘diabetes randomness’ make a lot more sense!


----------



## trophywench (Aug 2, 2020)

It is a lot to take in - but not actually all that complicated once you make your mind up and get down to it although I 100% agree it's a PITA when it needs to be done and 100% also say I've been needing to for more than quite a while and yet still haven't.  

It's all very well writing down what we SHOULD be doing for the best, but there's a very old adage that says it all - The spirit is willing, but the flesh is weak.


----------



## Bwallace (Aug 20, 2020)

Hey! Im currently 30 weeks pregnant and made sure my HBA1C was around 5.6 (its now 5.7)... My only struggle with sugar levels is at breakfast... I wake up and my sugars naturally rise! Even when i inject for my breakfast an hour before i eat (also now injecting a ratio of 5:1!!) i still have a spike and go up to a reading of around 12 but after that most of the day I'm better. I have the libre sensor in my arm so constant testing is sooo much easier!


----------



## PhoebeC (Aug 21, 2020)

It’s 


Bwallace said:


> Hey! Im currently 30 weeks pregnant and made sure my HBA1C was around 5.6 (its now 5.7)... My only struggle with sugar levels is at breakfast... I wake up and my sugars naturally rise! Even when i inject for my breakfast an hour before i eat (also now injecting a ratio of 5:1!!) i still have a spike and go up to a reading of around 12 but after that most of the day I'm better. I have the libre sensor in my arm so constant testing is sooo much easier!


Sounds like you are doing well, I wouldn’t worry too much about the spike of 12.
What are you having for breakfast? Maybe lower the carbs you are eating x


----------



## Bwallace (Aug 21, 2020)

PhoebeC said:


> It’s
> 
> Sounds like you are doing well, I wouldn’t worry too much about the spike of 12.
> What are you having for breakfast? Maybe lower the carbs you are eating x


Well i was having cereal but all cereals are so high in sugar! So I've changed it now to have more eggs bread etc so hopefully thatll work! X


----------



## PhoebeC (Aug 21, 2020)

Bwallace said:


> Well i was having cereal but all cereals are so high in sugar! So I've changed it now to have more eggs bread etc so hopefully thatll work! X


I would cut out the bread a few days and just see if it makes a difference. Add in some sausages, bacon or grilled tomatoes etc in its place x


----------



## Inka (Aug 21, 2020)

Bwallace said:


> Hey! Im currently 30 weeks pregnant and made sure my HBA1C was around 5.6 (its now 5.7)... My only struggle with sugar levels is at breakfast... I wake up and my sugars naturally rise! Even when i inject for my breakfast an hour before i eat (also now injecting a ratio of 5:1!!) i still have a spike and go up to a reading of around 12 but after that most of the day I'm better. I have the libre sensor in my arm so constant testing is sooo much easier!



I had to bolus an hour before breakfast too! Weird, isn’t it? I’ve got a pump so that helped with Dawn Phenomenon but the ‘waking rise’ is harder to sort, IMO. When I was pregnant (and even now sometimes), I bolused a small amount of insulin when I woke up. This helped stop the rise which, for me, was my body helpfully (not!) pushing out some glucose to start the day.

As @PhoebeC says, experimenting with different breakfasts helps too. But it sounds like you’re doing really well. The insulin resistance in late pregnancy is something to behold!


----------



## PhoebeC (Aug 21, 2020)

Yeah just increase it as you need to because the resistance will increase quickly and I think daily by the end. 
your nearly there now just keep it up x


----------



## Bwallace (Aug 22, 2020)

Thanks both!  everything is so new to me being my first pregnancy! Will do my best x


----------

