Thursday, December 22, 2005

It Started Nearly A Year Ago

I married Mr. Lyrehca just over a year ago and we figured that since we were both approaching 35, we should think seriously about the baby thing. He, frankly, was more into it than I was, but intellectually I knew my eggs were getting older and heck, the diabetes wouldn't make things easy.

So we met with a high risk doc who works in tandem with my excellent endocrinologist. The endo focuses on pregnant diabetics, so I figured I was in good hands.

I've heard about those diabetichicks who are like, "I know my sugars weren't where they were supposed to be, but it just happened and now I'm pregnant," or those who aren't aware that super-tight blood sugar control is the best for a growing fetus. Or women who say, "I had a baby years as a T1 mom ago before we knew about such tight A1cs and the baby was born healthy."

I'm not one of those.

Instead, I'm a researcher who finds out the tiniest detail about something before it actually happens. I'd had a fairly hard-core endo when I lived in a different state back in my single days, and she too focused on pregnant type one patients. Her thought was that the A1c should be 6 or below before trying to conceive.

For those non-Ds following along, an A1c of 4-6 is a healthy non-diabetic range. It's generally considered that an A1c below 7 is a good place for a diabetic to consider trying to conceive, or TTC. My current endo says the 7 cutoff is what she recommends.

A year or so ago, my A1cs were actually around 6.3 or so, which may sound great, but for some odd reason, my A1cs have always been in that range, EVEN WHEN MY DAILY METER READINGS (WITH TEN OR SO TESTS A DAY) had much higher averages. So I never really thought my control was as good as my docs thought it was.

The recommended blood sugars for someone trying to get or remain pregnant go like this:

Pre-meals, 70-90
One hour post meal, 140
Two hours post meal, 120

Since I've had readings bounce from 40-400 in a day (thankfully, not that often), and I was seeing averages on the meter from 160 to 180, the idea of remaining around 100 all the time seemed impossible to me.

When Mr. Lyrehca and I first heard about this, I actually teared up and got, as we say, "klempy," which my husband, being more gooey about the baby idea than I was, thought I was crying tears of joy and getting verklempt.

But really, I was freaked out.

I mean, it's one thing for me to have a 200 and feel crappy. I've been doing this schtick for a long time and I know that I'm not going to die tomorrow if my blood sugar is 200 all day, particularly if I'm bolusing what I can to get myself back to normal. Besides, in the most frank possible way, I'm only hurting myself.

But having a baby depending on me for everything, growing inside me, and basically choking in a sugar brine because I can't get my blood to go down, makes me feel horrific and terrified that the kid is doomed from the start.

When I pointed this out to both my doctor and my husband, they had some calming words.

My endo said, and I think about this daily, that it's the average blood sugars that are most beneficial to a growing fetus, and that one high blood sugar once in awhile isn't going to harm the fetus in the way I think it will. It's the average A1C that's important.

She also, at my urging, also does fructosamine tests now, which measure your average blood sugar over the past two to three weeks, rather than the past two to three months an A1C tests. And while she saw how my fructosamines were more in line with my meter readings than my A1Cs were, she also pointed out that my averages, overall, weren't as high as I thought they were.

It's been said before, and I agree, that being a T1 is a never-ending battle for compliance. Sure, my A1C may be under 7, but there's the non-diabetic range that's lower. I may have a week of terrific blood sugar numbers, but that doesn't mean I'll have them next week, or even the next day. It's an ongoing struggle for control, and even when my A1Cs drop in the non-diabetic range, I'm still having a ton of lows and the occaisonal high.

My husband says he'll help me however he can when it comes to keeping certain foods or Diet Coke out of the house so it'll be easier for me to eat right and keep my sugars tight. He says he'll do whatever he can.

But as terrific as he is, and as great as my endo is, and as healthy as all those kids of diabetic moms have turned out to be, and as supportive as all you fellow D people are out there, I'm still doing this on my own. Still doing it all to try to have a healthy baby grow inside me and be born the healthiest that kid can be.

And that still scares the (*)*%^& out of me.


Kerri. said...

I've never been one of those "ah, the miracle of birth!" and so on types of people, but I want to have a child more than anything else in this world, so your journey into this unfamiliar territory will be closely followed by me and my two decades as a Type One diabetic.

Best of luck to you and please keep posting.

Erica said...

I can totally relate to your fears - being that I'm fairly newly Type 1 and very newly pregnant. It's a (*#&$* scary ride.

Good luck!

Anonymous said...

I know I commented before on this topic, but you really can do it. The little baby you'll be growing provides a ton of motivation. I was testing 12-15x/day while pregnant. It's all about frequent checking ... you catch the highs quickly and deal with them just as quickly. You do your best.

It's the hardest thing I've ever done ... but I did it. Please please send a message to The moderator sometimes takes a while to subscribe people, but there are a ton of women there who are planning to get pregnant, are pregnant or who have had their babies -- and are working on the next one. There will be women there who will go through a pregnancy right along with you.

It's very hard. And tremendously scary. But it can definitely be done.

Meredith (who really needs to not be anonymous)
T1 22 yrs
Pump nearly 4 yrs (got on it because I wanted a baby)
Mama to Elizabeth 2.5 and William 10 mos

Lyrehca said...

Thanks, everyone, for your encouragement! Meredith, I've actually been lurking on positivediabeticpregnancy and another group, pregnantpumpers, for more than a year. They are helpful to read.... but the whole thing still seems overwhelming.


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