March 02, 2003
permalink blood sugars and first trimester angst

It's strange how even the title 'blood sugars' can bring on a twinge of guilt for me. My HbA1C at conception was 6.0. And the one before that, at the end of last year, was 6.1. So I couldn't really have asked for better than that.

But it's strange, when I ponder my blood sugar control, I find it hard not to focus on all the readings that have been too high. The ones that caught me by complete surprise eg. hormones right at the start pushing me up to 14, 15 and 16 briefly. The times after eating out where the blood sugar has risen to 14 or 17 a couple of hours after a meal that I swore I had overinsulinised for, if anything! Very frustrating and upsetting to think, oh I really shouldn't be eating out at the moment. How selfish of me. I could damage my baby's developing organs. It wouldn't have been that hard to eat a meal at home. Maybe I've eaten dinner or lunch out around eight times since becoming pregnant. Often it's been good for me. Catching up with a friend. Or it's just been too inconvenient getting home again to eat. Then you can say to yourself, well you should have planned your day around being home or taken your food with you. And on and on it goes.

Well, I guess I thought that suddenly when pregnant, perhaps I would snap into regimentation. Certainly my control according to the doctors is 'fabulous' and I have 'nothing to worry about' with my endocrinologist saying recently these amazingly unfamiliar words: 'I'd actually like you to back off a bit with your control'. But this doesn't stop me from feeling guilty for the high readings. For allowing myself to retain some spontaneity.

I've been told by the educator/midwife that it's the overall control that matters. Not the occassional high. However it's impossible to ignore the risk of congenital malformations that occur in conjunction with blood sugars being too high. You just hope so much that you aren't doing any damage to your unborn child. I think the psychological wrestling matches that women with type one diabetes who are pregnant have to go through are very tough. So fingers crossed!

Oh yeah, and I didn't mention the 'ideal levels' we are all told about for pregnancy. Less than 5.0 fasting. Less than 7.0 (or 8.0 depending on which reference you use) 2 hours after meals. Less than 5.5 premeal. I know it only says ideal, and certainly many of my readings are inside this ideal range. But it's an impossible thing to expect to achieve and it can make you feel extremely anxious.

One woman who I find very helpful, a diabetes educator who helped me get started on the pump and has a fair bit of experience with pregnancy and diabetes, said if you can get your levels between 4.5 and 7.5, 75% of the time, that's what we're aiming for.

The insulin pump I wear (have done for 2 years now) is what enables me to get my sugars good enough for pregnancy and I can't recommend it enough. It's the thing overall that allows me to maintain my spontaneity. In short it allows me to stay sane while achieving once only dreamed about HbA1C's.

Posted by patton at March 02, 2003 07:37 AM
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