# First preconception clinic next week =/



## amyh_101 (Mar 10, 2012)

Hi all 

New on here today, hopefully will be sticking around! 
i have been diabetic for 8 years now and we are now thinking of starting a family.
Before xmas my HBA1c was 10, Awful i know and only have myself to blame. sooo from then on i have been trying and trying to get it down. Things are going fairly well apart from breakfast! It seems to spike to 12 after i eat, then doesnt start dropping until 2 hours after...yet before lunch its down to about 5!

Has anyone else had problems with post meals? What are the goals during pregnancy?

I have my first preconception clinic next week but i know if i dont get this sorted my HBA1c is NEVER going to be good enough!

Also, any of you trying to get your HBA1c lower for pregnancy, how long is it taking you? When i spoke to my nurse recently i was told "you have a long way to go", not what i wanted to hear


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## trophywench (Mar 10, 2012)

Mealtime targets in preg are 3.5 to 5.0 before eating. No more than 7.8  by 2 hours later.

The reason for this is that higher BGs than these are harmful to the baby, hypos aren't as long as they aren't the 'call an ambulance, she's lost consciousness' kind.


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## everydayupsanddowns (Mar 11, 2012)

Hi Amy

Good luck with your push to reduce A1c pre-pregnancy. From what I've read a rapid reduction in A1c can actually put the body (esp micro-vascular system eyes etc) under quite a lot of stress. Not sure how much of a hurry you are in, but going slowly/steadily might be better than a sudden crash. 

As to breakfast levels... It's a tricky time for many. Some people's livers decide to 'help out' just before/after rising with a little boost of stored glucose. Have you tried leaving a little time between injecting and eating breakfast to give the insulin a bit of a head start over the food? It can also be worth experimenting with different breakfasts to find a reliably slowish release one for you (everyone is different, and alleged low GI choices may not be so for you)


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## Medusa (Mar 11, 2012)

Good luck, tight control is important during and pre pregnancy, hopefully you will get all the info you require at the clinic, if not be sure to ask anything you are unsure of, i remember having to keep my levels no higher than 5 pre meal and no higher than 6.5 post meal, you should find that the diabetes team will be very supportive, make sure you start taking folic acid too


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## Nic (Mar 11, 2012)

Hi Amy

Welcome! Although I do feel like an impostor as I haven't posted on here for a very long time but have been reading the pregnancy forum with interest the last few months. Sure you will get lots advice from the regulars on here!!

Just wanted to say that I also found post breakfast blood sugars really tricky and still do (I have been type 1 since 1998, currently 24wks+2 with my first and on a pump) It was the one time of day I have found the hardest. In the first few months of my pregnancy it was very difficult to even eat breakfast never mind trying to stick to the lower GI options such as porridge or granary toast - somedays it just had to be Weetabix or Special K! 

One of my Consultants said recently that there is debate that if your BG does come down to target post-meal after two hours then that is okay. Obviously everyone wants to try and get as good control as possible but I have been reassured by his advice and try not to get too hung up on particular readings but concentrate on my overall control in general.

Regarding your hba1c, some people might argue that mine could have been better when I conceived - it was 7.0%. I gradually got that down from 7.8%-8.2% probably over a year or so, perhaps longer. I just kept chipping away at it. But then a few months after i was pregnant it came down to 6.5% but last week was 6.8%. If you are keeping close (or even close-ish) to the recommended targets then it will come down, I promise and you will have the incentive of a baby growing inside you!

Without this sounding like a plug...you might want to have a look at my blog as I have been writing about my pregnancy for the last few months, you might find some of the posts useful and hopefully reassuring! Good luck!

Nic
http://www.duffysdiabetes.blogspot.com/


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## Babysaurus (Mar 12, 2012)

Hi Amy, I am 26 weeks with my first and I too have always found post breakfast readings tricky. Mine can shoot up then in a way that it will at no other time! My DSN said it may be that Type 1's have strong insulin resistance in the morning as a lot of her patients have it (not all pregnant ones - when you are pregnant it can be worse as you have resistance all day). 
Good luck with trying to get your HBA1C down. Hope it doesn't take too long!


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## RuthieG (Mar 12, 2012)

Hi

I echo what has been said. Since I have been pregnant (20 weeks) my post breakfast has been the time of day when I have struggled (pre conception i wasn't testing post meals). Mine were a little like yours - an hour after meals they were high (sometimes really high) and then another hour later I was having a massive dip and hypos at about 2.2. It is really tough at that time of day for some reason. 

The levels my consultant has given are - fasting (premeal) 3.5-6 and one hour post meal 7.8 or lower. He has now said the 3.5 might be too low as I was hypoing left, right and centre - but you get the idea.

I have recently gone on a pump which has helped beypnd belief with thsi time of day - I don't know if thsi is an option for you but if it is I would highly recommend exploring this. 

My HbA1c wasn't too bad before and I don't know about whether a sudden drop is bad but that does seem to make sense I think. Check with a doc though.

All the best and good luck


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## Monkey (Mar 12, 2012)

I can only echo what everyone else has said really. 

With breakfast, one thing that really helps me is to inject about 30mins before I actually eat - that extra bit of time seem to mean my post-breakfast readings are usually ok. I do still have a tendency to have late morning hypos, but I'm dealing with that by snacking mid-morn. Not ideal, but I know from being pregnant previously that snacking becomes a lot more normal!

I also split my lantus dose, so have a larger dose about 9.30pm and a smaller amount about 8am. First started that as suggested by my consultant in pregnancy, and have stuck with it because it works.

Good luck - it might seem hard work, but is well worth the effort!


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