# Preconception advice



## ECB (Jan 25, 2017)

Hi, 
I'm new to the forum, T1 for 12 years,  35yrs old and hoping for my first baby.
I'm currently at the preconception stage with a hbA1c of 56. My target as advised by my diabetes nurse is 53. 
I'm really struggling to keep my BG within the target range:
 <7.8 1 hour after eating 
 <5.8 2 hours after eating. 
I use novorapid and have had to adjust my ratios dramatically to achieve the target. I can get my BG down to <7.8 at 1 hour but then I usually hypo very soon after (sometimes within the following 15 mins). I've tried splitting my meals and eating more carbs 1 hour after I first eat, but I still seem to hypo.  I'm also trying to eat low GI food but I'm having hypos more then once and day and feel like I'm eating constantly! I feel like I've lost all control of my blood glucose.  Really need my next hbA1c to be within range so I can start trying for a baby. 
Can anyone offer any suggestions on how to keep to target? Any advice would be appreciated,
Thanks 
Xx


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## grovesy (Jan 25, 2017)

Welcome.


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## trophywench (Jan 25, 2017)

Hiya

I didn't know they had brought these tight pre and post meal limits in at the preconception stage now - they only used to apply once you were actually pregnant  - so I'll keep quiet and learn the up to date way, with you!


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## PhoebeC (Jan 25, 2017)

Okay so what if its higher than 7.8 after an hour, what is it like after 2 hours? maybe its just taking longer.

Is it every mealtime?

I've always had no worries between breakfast and lunch but hypo on the way home sometimes so I know i have to watch my levels at lunchtime, or have a snack.


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## Northerner (Jan 26, 2017)

ECB said:


> Hi,
> I'm new to the forum, T1 for 12 years,  35yrs old and hoping for my first baby.
> I'm currently at the preconception stage with a hbA1c of 56. My target as advised by my diabetes nurse is 53.
> I'm really struggling to keep my BG within the target range:
> ...


Hi ECB, welcome to the forum  I wonder if adjusting the timing of your novorapid injections would help? It may be that your insulin is peaking before your food is digesting properly, so you drop low, then perhaps go high later? If you can stretch to it, I wonder if a Freestyle Libre would be helpful so you could get more information of what is going on? Lots of our members use them and have discovered all sorts about the patterns of their blood glucose - if you've not heard of it, it's a sort of CGM (Continuous Glucose Monitor), but cheaper than a full CGM. Still not cheap, but perhaps for a short term use it would be helpful.Also, what slow-acting insulin do you use? Have you done a basal test to see if the dose needs adjusting - might be too high if you are struggling against hypos.

Good luck!


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## ECB (Jan 29, 2017)

grovesy said:


> Welcome.


Thank you


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## ECB (Jan 29, 2017)

Hi


PhoebeC said:


> Okay so what if its higher than 7.8 after an hour, what is it like after 2 hours? maybe its just taking longer.
> 
> Is it every mealtime?
> 
> I've always had no worries between breakfast and lunch but hypo on the way home sometimes so I know i have to watch my levels at lunchtime, or have a snack.



Hi phoebe,
Thanks for your response. Yeah I think the insulin is maybe working faster than the food. If my BG more like 10 at 1 hour after food my levels are within range at 2 hours. I see a significant drop in blood glucose levels at 1-1.5 hours after eating. I have noticed a late rise in BG on occasion, after 2-3 hours, but I have often had to treat a hypo before that.


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## ECB (Jan 29, 2017)

Hi Northener,
Thank you for responding. I am currently using the freestyle libre which is a great help. I don't think my basal dose is too high as my overnight levels are usually very stable. If I take less I notice a gradual rise in BG overnight. I am wondering if my insulin is peaking before food but not too sure how to address that?! It doesn't seem correct to delay insulin injections, does anyone do that? 
Carbs are not my friend so I'm thinking that cutting down massively on carbs is the only way forward?!


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## trophywench (Jan 29, 2017)

Dunno about massively - but certainly being dead careful what you have would probably help - especially if you assure yourself upfront that it isn't forever, only until .....

And you'll probably end up finding it was habit forming not to eat high amounts of the blasted things - except when you need to medically cos of hypos - and eat less of them generally for the rest of your life!  That can and does happen and does nobody any harm, in the finish, all in all !


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## PhoebeC (Feb 9, 2017)

I never take my insulin ahead unless I'm eating something really carby and fatty. It makes me hypo if I take it before I eat. I've found during is best but that's not practical.
It just never worked for me.
We didn't plan but I was very lucky with my HbA1c back then and my team weren't to concerned with that. Saying that I had an horrendous pregnancy from the start to end so maybe planning would have helped. 
I heard a brilliant thing on BBC radio saying all women should have a year of super healthy lifestyle before getting pregnant, that all pregnancies and babies would be healthier if everyone prepared with the right weight, diet, lifestyle, sleep pattern and so on. It was very interesting and makes so much sense!


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## grovesy (Feb 9, 2017)

PhoebeC said:


> I never take my insulin ahead unless I'm eating something really carby and fatty. It makes me hypo if I take it before I eat. I've found during is best but that's not practical.
> It just never worked for me.
> We didn't plan but I was very lucky with my HbA1c back then and my team weren't to concerned with that. Saying that I had an horrendous pregnancy from the start to end so maybe planning would have helped.
> I heard a brilliant thing on BBC radio saying all women should have a year of super healthy lifestyle before getting pregnant, that all pregnancies and babies would be healthier if everyone prepared with the right weight, diet, lifestyle, sleep pattern and so on. It was very interesting and makes so much sense!


This is not new I went on a study day back in the mid 80's that was trying to promote preconceptual care for everyone.Though especially thoose with pre existing medical conditions.


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## Medusa (Feb 10, 2017)

Hi and welcome, I know how hard these targets are to reach. How are you getting on now?


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## PhoebeC (Feb 10, 2017)

grovesy said:


> This is not new I went on a study day back in the mid 80's that was trying to promote preconceptual care for everyone.Though especially thoose with pre existing medical conditions.


Maybe it's not new for diabetic or other conditions but most other people come off the pill the start trying the next day, keep drinking, eat junk and don't prepare. Witnessed this so many times sadly :/ x


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## Ditto (Feb 10, 2017)

Hello and welcome.


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