Some questions about pregnancy

[Pin-Cushion]

Hi all,

I'm wondering if anyone can help me.

I am 34, and I don't have children. I was diagnosed with T1 at 25, my dad is also T1, and his mother had coeliac disease.
I decided, not too long after diagnosis that I wouldn't have children, I didn't want to risk passing diabetes on to another generation. This was a very personal and difficult decision, and I would never ever judge anyone who did have children, diabetes or not. My own experience of diabetes has not always been good, my dad's diabetes has never been well controlled and I had some pretty horrific experiences with it growing up (finding him collapsed from hypos, near death from several DKA and more) and my own diagnosis was handled terribly and left me with a fair few mental scars, although my actual control and handle on this illness is fairly good these days!

However, the last few months, my yearning to have children has increased, after discussion with my husband, he is keen to have children too, but equally he is concerned for my health, and that of any future children. I'm going to book an appointment with my DSN, but this will take several months in my area, as they have cut the diabetes funding recently!

What do people think about the chances of passing on diabetes, and are there any tests that can be done to determine the risk? I have been told by some that there is the same risk of a child of mine getting diabetes as there is a non-diabetic woman, but by others that the risk is exponentially higher.

Also, are there increased risks to myself, above the normal pregnancy related risks? I'm aware of my age too.

I know about having to take Folic Acid for several months, and having my diabetes under strict control (well as much as you can!) my HbA1c is currently 54. I was told many years ago, at first diagnosis that C-Section was recommended to all women with diabetes, but I'm not sure if that still holds true?

I'm sorry to write such a long post, there is no one else I can currently speak to about this, so I thought you wonderful lot may be able to offer some pearls of wisdom.

Thank you for reading, if you've come this far!
Pin-Cushion x

 

[merrymunky]

Hello. I am type 2 rather than type 1 but am currently 19 weeks pregnant.

I have no idea about the risks of your child developing diabetes but I do know about the risks of pregnancy with diabetes since I’m living it right now.

I am older than you at 39. It took my husband and I ten years to conceive our first baby as I was experiencing weight related fertility issues to the point my cycles had pretty much vanished though no explanation was ever found by doctors other than blaming my weight. (They were correct...more on that later). My son was conceived by some sort of miracle lucky shot last year but sadly at out 16 week routine midwife appointment it was discovered that he had passed away in the womb. I was induced and he was delivered two days later. He had many physical problems that were discovered at post mortem but with no clear cause.

However, as part of the routine testing they ran on me while I was in to deliver him they discovered my hba1c was in the 60s. I had a repeat test 12 weeks later and it was 75, I was diagnosed with type 2 diabetes. The only likely cause for all my son’s problems was the fact I had been living with undiagnosed and uncontrolled diabetes as it can lead to deformity, miscarriage and stillbirth. In my case? Check! I was absolutely devastated all over again.

Since then I have managed to get the diabetes under control and have lost a remarkable amount of weight. Since January (my son was born in November 18) my cycles returned completely like clockwork which enabled me to conceive again. Sadly I had another miscarriage in August at just 6 weeks but it was nothing to do with the diabetes. It just wasn’t meant to be, as devastating as it was all over again.

We conceived the baby I am currently carrying within a month. Three pregnancies in a year after team years of nothing is an absolute miracle but I put it down to the weight loss, metformin and the fact my body had been through a birth process and suddenly remembered what to do!

With diabetic pregnancies you are induced at 38 weeks. I don’t think a c section is performed as routine. However they induce early as a result of the risk of a higher birth weight baby and extra risks. I was told I would likely be given an epidural in labour so that if the need arises for an emergency c section then you are ready to go. I have heard that diabetic patients sometimes find they have slower labours that don’t progress as well. You will see a diabetic consultant at maternity regularly, almost weekly. My appointments are fortnightly at the moment as my diabetic control has been excellent throughout the pregnancy. You will be monitored closely and as long as you are doing everything by the book you should be able to have a fairly normal pregnancy.

Yes there are increased risks but I am high risk anyway before the diabetes even comes into play thanks to high bmi, age, risk of pre-eclampsia etc. I go to the clinic each time and see diabetic pregnant women of all shapes, sizes and ages.

In terms of trying to conceive it is best that you contact your diabetic clinic and get booked in with a pre-pregnancy consultant. I was under one all year. They will recommend that you wait until your hba1c is at a specific target, mine was 48 which I managed to achieve, before conception as this significantly lowers the risk.

Obviously I’ve shared the horrendous side of pregnancy with uncontrolled diabetes. I don’t know how long I lived with it before it was diagnosed. I know I didn’t have it in 2011 as I had a test and my results were normal. However it came on sometime after and could have been lingering a few years before I was pregnant the first time. It doesn’t mean that all diabetic pregnancies end in disaster though.

I wish you luck in your baby quest.

 

[Thebearcametoo]

You can talk everything through with your DSN and if you want with a doctor or specialist midwife even before getting pregnant. Diabetes in pregnancy does come with additional risks to you and the baby but that’s partly why you get a lot more care. If your glucose levels are well managed then there’s no reason you can’t have a healthy pregnancy. Delivery method is your choice even if the advice is to have a csection. The risks will be discussed with you during a pregnancy and you can think about it more clearly as the time approaches.

As for the possibility of passing on T1D. There is a genetic link to diabetes so it does make it more likely than for someone with no diabetes in the family. When looking at the numbers remember that they are an average based on the current data and aren’t predictive of your situation. There’s some information in this article https://www.diabetes.org/diabetes/genetics-diabetes

I’m sorry you’ve had such distressing times with your dad’s diabetes and your diagnosis. Diabetes will never be easy and there are always risks. Management is improving all the time though and with technology likely to improve more so if you do have a child with diabetes it won’t be the same as your experience. It may be worth looking into some counselling around the issues as you’re considering the impact of those feelings on your choice to have children or not. Pregnancy & trying to conceive can be an emotional time anyway so having support in place beforehand helps.

Good luck. We’re here to support you.

 

[Pin-Cushion]

Thank you for your reply @merrymunky
I'm sorry to hear of everything you've been too, but I'm glad things are going well for you currently. Good work getting your health to a much better place 🙂

 

[Pin-Cushion]

@Thebearcametoo Thank you for your reply, and the link, which has some very interesting statistics. I will start with booking an appointment with my DSN I think. I was lucky enough to have access to a diabetes psychologist a few years ago, which helped a little, however my mental health has not been good for sometime, and I started on Sertraline recently for anxiety, and I'm awaiting a referral for counselling, so hopefully that will help. The Sertraline has helped me to feel less 'numb' which I think I have been for a few years now, and hence it's allowing me to confront things I haven't allowed myself to think about - such as having children!
Thank you for your kindness.

 

[merrymunky]

Thank you for your reply @merrymunky
I'm sorry to hear of everything you've been too, but I'm glad things are going well for you currently. Good work getting your health to a much better place 🙂

Thank you. I know my story has been quite traumatic but it doesn’t always have to be that way. As long as you are well within that threshold target, taking 5mg folic acid prior to pregnancy (available on prescription) and looking after yourself it can be a good experience.
Please keep us updated.

 

[Pigeon]

Currently breast feeding my 10 day old baby! First child at age 38. Will post more when things settle down but just wanted to let you know it is doable!

 

[Pin-Cushion]

Currently breast feeding my 10 day old baby! First child at age 38. Will post more when things settle down but just wanted to let you know it is doable!

Thank you for replying! I’m happy to hear you have a beautiful baby 🙂

 

[everydayupsanddowns]

Congratulations @Pigeon

 

[everydayupsanddowns]

Good luck with your decision @Pin-Cushion

it is certainly more than possible to successfully bear children alongside diabetes - and these days there are added technological gizmos that can support you with the very challenging blood glucose targets.

Only you can know if having a child is right for you and your partner at this stage in your lives - and even then, you can only make your best guess, and then work it out as you go along.

But it is doable (as Pigeon and many of our D-Mums demonstrate).

I found this series of blog posts (which are very funny as well as informative) a great insight into pregnancy and Diabetes.

https://www.shootuporputup.co.uk/2012/11/diabetes-pregnancy-the-first-12-weeks/

you’ll find lots of other posts tagged ‘pregnancy’

 

[Pin-Cushion]

Thank you @everydayupsanddowns , and thank you for the web link 🙂
I've got a DSN appt booked for the 30th Jan, so hopefully I'll have some more information by then!

 

[Cleo]

Hello Pin Cushion
I’m a type 1 mum to 2 boys aged 3 and 5. I was 37 And 39 when my two were born.
It is absolutely do-able. It’s hard work, in fact it’s very hard work but it’s absolutely possible for you to have a healthy pregnancy and a healthy baby as long as you look after yourself pre pregnancy (manage BGs, take high dose folic acid etc ) and during. You’ll have plenty of appointments and extra scans as well so you’ll be well looked after. I can’t comment on risks of passing it on. As a parent you always worry about your children, but I just try to manage that as best as I can.
It sounds like you a rough time at diagnosis, but please rest assured plenty of diabetic women have perfectly healthy pregnancies!
Wishing you the very best of luck, and please do let us know how you get on with the DSN x

 

[Pin-Cushion]

Thank you @Cleo that's very reassuring. Congratulations on both your boys!
I'm finding it very odd that I have been so against having children for so long, and suddenly my hormones have woken up! It's such a strange feeling!