Type 1 Diabetes & Pregnancy: The A1C

When I started this blog I often imagined I'd be documenting all the monumental moments of my life.  I imagined I'd write about going to college / university, and I imagined I'd write about living on my own. I also imagined writing about my wedding day and eventually about starting a family.  And while ten years has quickly passed since starting this blog, I can smile here knowing that I did manage to check quite a bit off my list of things to of course blog about, but also to experience.

It's a Boy!  Photo by: Girard Photography

In December 2018, Mike and I got the most exciting gift to date, a positive on our pregnancy test. This was probably one of the most emotional and overwhelming feeling to date.  We are going to be parents!  The first person I called was my endocrinologist, followed by my family doctor.  Having never had a child before, I had no clue who I was supposed to tell first.  I knew that my endocrinologist had said that as soon as we were pregnant to give her a call, so that's what I did.

A year prior I wanted to prove to myself and my diabetes team that I was capable of maintaining an A1C that was safe for conceiving and carrying a baby.  I aimed for the low 6's every couple months that I got my A1C done. My endocrinologist told me that I could get one done every month, which really allowed me to stay motivated and on track.  I bounced between 6.5% and 6.2% which was deemed great. This was done with minimal highs and minimal lows, as I know that sometimes an A1C test is not a great predictor of blood sugar control.

I knew that I was capable of maintaining a good A1C all while still enjoying the food I enjoyed. It really amounted to pre bolusing (taking insulin x amount of time before my meal versus just as I was putting food in my mouth or after)  and paying attention to my blood sugars, rather than guessing and bolusing.

After conceiving, the new step of diabetes management was now in place.  The first trimester meant a lot of lows. This meant that I needed to be checking often and be prepared to drink juice or eat rockets at any moment.  This was an interesting balance of making sure that I wasn't overeating my lows out of fear, and hunger frankly and keeping that balance between the lines of 4.9 and 8 mmol/L where I wanted to be. (Everyone is different, that was just my goal target for myself!) 

With the lows in mind, but also knowing that I felt my lows, I was watching for them and I was prepared, I managed to have A1C's in the high 4 and low 5's since.  I am now in my second trimester and I am having less lows, but still attempting to keep within my personal goal target.    This is not to say that I do not ever go above 8 mmol/L, in fact more recently it has proven to be more difficult, and require a tremendous amount of brain power to try and prevent spikes. There are for sure moments that I go above and to be honest, panic a little.  My doctor reassured me that a random high was not going to be detrimental, which eased my worry.

A1C has always been a daunting phrase within the diabetes community because it holds so much power over how we personally view our diabetes management and also how health care providers gather an idea of our management, while I look forward to having some brain space for other things and not diabetes, for now, I will do anything for that little guy in my belly!

Kayla

Note: The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. (https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test)