Mamas with type 1 diabetes - Page 14

[DentedHalo]

Originally Posted by widemouthedfrog

I know that so many people struggle with understanding diabetes and/or try to ignore it, so I do understand the health care provider's perspective. However, it is refreshing when they're able to break out of the "must do it my way" mode into "wow, you're managing ok, here's some leeway to do it your way" mode.

Yup. I unfortunately live in a border town, where the docs often see more DT2 patients than DT1. Poverty is horrendous here, so is lack of even the most basic education - the docs don't have a choice but to force everything on their patients, and "because that's the way we do it" is basically the simplest concept that allows them to keep their patients reasonably healthy. DT1 patients are not that much different, and with all of the above you have the added "bonus" of poverty making for horrible nutrition.

However, there's something to be said for weighing the facts and seeing what's in front of you. If I applied the same lack of flexibility to my own job that my previous endos applied to theirs, I would have been kicked out of my guild a long time ago.

The weight thing you're talking about is diabulimia. I struggled with close-to-anorexia as a young teen, but I like food a lot now. However, I have met people at our clinic who've had it, and boy, it sounds awful. Anorexia is inherently a struggle to exert some control over your life, and I guess people with diabetes find it even more necessary to feel in control of something...since so much of this disease makes you feel like things are beyond your control.

Dang, it even has a name. I was just surprised to hear about this, because I know that diabetes alone can be a royal pain in the a** at times and I didn't think that anyone would want to add anything extra to that. Now that I think of it, it could go both ways - someone with anorexic tendencies would have the perfect tools (diabetes\insulin) at their disposal, and a diabetic could easily get into the mindset of "the less, the better" with the added "bonus" of less injections\controls with the very low levels of carb intake. Thanks for the info, much appreciated!

On a side note, have you ever been checked for hyperthyroid? I believe that this can manifest due to an autoimmune disorder too.

Yup, had thyroid checked - nothing out of line. Being lean is an inheritance form my dad's side of the family - they're all tall and thin. At 5'8" I'm the shortest one in I think 3 generations. I also run and exercise, mostly because of my work. After all the hours of having my rear end glued to my chair, my backbone would crack in half if I didn't get some movement.

How is your marathon training going? I think it's fantastic that you're doing it, and I sorta wish I was able to make that kind of a commitment to something. I bet you're going to ace it!

[widemouthedfrog]

Originally Posted by DentedHalo

How is your marathon training going? I think it's fantastic that you're doing it, and I sorta wish I was able to make that kind of a commitment to something. I bet you're going to ace it!

Marathon training is going pretty well, though I've been tired the last week. Dd is not napping any more. I don't know about acing it, but finishing would be good. That's the kind of running category I'm in.

[emmabird]

new type 1 gal~

hi ladies~
my name is emily.
i was just diagnosed with T1 this march, but am now under control. my first post-dx a1c [now] was 5.6. of course, i'm probably honeymooning a bit, but due to my interests in natural medicine and food therapy, i keep my sugars tightly controlled.
i am not pregnant and have not been ever, but within the next year, my partner and i would like to start our family.
i joined this forum b/c of my concerns with [perhaps] being bullied into induction, c-sxn or iv glucose drips, etc. while i understand that out-of-hospital birth is not really an option for t1 gals, i want to have as natural birth as possible. my internist said something great: "it's not the t1 that puts a woman at risk, it's a t1 woman who doesn't have tight control." this gave me hope that i will be able to plan and have a healthy pregnancy, but also a healthy birth.
i am hoping to just learn and listen from all of you, and hopefully get my questions answered as i move into this next phase of my life over the next year. thank you sisters!
my first question then, is induction always necessary? i've read some articles that said t1's are always induced [slightly] early b/c of the 'placenta maturing a bit fast' due to something about our sugar fluctuations....? i wouldn't want to be!

[fullofgrace]

Hello!

In the interest of limiting FYT to subjects not hosted elsewhere on the board, we have moved your tribe here. You're still a tribe, which means you're still support-only.

If you have any questions about the move, please do not discuss it on the boards. Rather, contact an administrator (in green) via Private Message or start a thread in Questions and Suggestions where one of the administrators will answer you.

Thanks, and happy posting!

[~pi]

Welcome, Emily!

Originally Posted by emmabird

my first question then, is induction always necessary? i've read some articles that said t1's are always induced [slightly] early b/c of the 'placenta maturing a bit fast' due to something about our sugar fluctuations....? i wouldn't want to be!

It depends a little bit on where you are, what sort of HCPs you have, and your relationship with them.

In general, yes, T1's are induced earlier than non-diabetics, mostly due to concerns about stillbirth. For a long time, 'early' meant 37-38 weeks. It was seen as a tricky balance because T1 is associated with both an increased risk of stillbirth and an increased risk of delayed lung maturity.

I have noticed a slow shift in attitudes going on as more and more women are maintaining very tight control throughout pregnancy. Tight control generally means less chance of complications. It is becoming more common now to delay induction until 39 or 40 weeks or, in rare cases, beyond. It used to be that people got freaked out as insulin needs fell towards the end of pregnancy, thinking that it was a sign of placental deterioration. There seems to be somewhat less panic about it now.

It would be pretty unusual to find medical practitioners who would support going beyond 40 weeks (though a few do) but it is, ultimately, your decision. My opinion is that it is a highly personal thing. You really have to decide what is important to you.

I struggled a lot with the induction issue. I had 'negotiated' to go to 40 weeks assuming all looked good, but I started getting pressure at 35 weeks despite having really gorgeous control. I had originally thought to perhaps push the 40 weeks if I had to, but in the end, I gave in to the pressure and was induced the day I hit 40 weeks.

I had no caregivers who were explicitly supportive of going beyond 40 weeks, and I was not prepared to take what I saw as complete responsibility for any negative outcomes. I realized some time afterwards that I already shouldered that responsibility whether I realized it or not, and that I needn't have looked externally for approval of my decisions. If I were in the same situation today, I don't know if I would make quite the same decision, but on the bright side, I really learned a lot about myself through the whole experience.

[widemouthedfrog]

welcome, Emily!
I developed type 1 during pregnancy, so needless to say...my control wasn't the best during pregnancy. My HCPs had a policy of inducing any people with diabetes around 38 weeks. Luckily for dd, she came at 37.5 weeks. And really quickly, too, so I basically arrived at the hospital and out she came. No need for any drips or anything.

I was really torn between the options. Knowing that my control hadn't been great, and knowing that lung maturity could be an issue vs wanting to make sure that the placenta wasn't deteriorating.....

My insulin needs started dropping quite early and quite rapidly. I recall that this happened ~7 weeks prior to my due date, ~4 weeks before dd was born. The placenta causes insulin resistance, which is why they are concerned that dropping insulin needs may = declining placenta.

As far as I know, they can't check the placenta's health. They did do two late-term ultrasounds on me to make sure that dd was still growing well, plus lots of kick counts and non-stress tests. I was ok with all of these at the time because I was quite overwhelmed with all of the new diabetes stuff.

I think that they can check lung maturity, can't they? Though this might have involved an amnio sort of procedure, and I don't think that I was willing to go there.

Good luck with all of your choices! I am not sure what I would do if I had to do it over again. Most likely I would once again count on our family history of having babies three weeks early.

ETA: If I did do it again, I would be picky about my choice in care providers. The people I had for dd's birth were the only ones around here would would take me...because my doctor at the time did not deliver babies. They knew very little about type 1 and pregnancy, because they didn't deal with a lot of high risk pregnancies. If I did it again, I would make sure that I had an endo I trusted and a doctor I trusted, and I would work on educating them and discussing things with them before I even became pregnant.

[iamlsh]

Hey all I have recently found this site, and then subsequently this thread. I am a type 1 diabetic of 17 years, pregnant with my third. My husband and I are considering home birth. Does anyone here have any experience with this?