Pregnancy with Type 1 Diabetes: A1C Strategies that Work For Me

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I’m officially 20 weeks pregnant! Yahoo, half-way there (and if you’re a diabetic then you know they won’t let you go past 38 weeks, so I’m technically more than half-way there)!I’m so relieved to share that my latest A1C came back at 5.7 percent. While that is exactly what I’m aiming for and hoping for, it also feels like a slight miracle during this 2nd pregnancy when most of my day is about chasing after a toddler and trying to work part-time during each free moment I get! There’s little time left for obsessing about blood sugar levels and taking extra tiny little doses of correction insulin, let alone eating!(For example: today, I ate lunch at 4 p.m. because of dentist appointment + picking up toddler at friend’s house + walking dog + getting toddler down for nap + getting on the phone for an hour-long work meeting + toddler woke up from nap way too early = mama is just catching her breath.)

Here’s an A1C translation chart so you can see what your A1C means in terms of blood sugar levels.

During my 1st pregnancy, my A1C goals were “as low as possible” because I had all the energy in the world to devote to blood sugar management (exercising daily, eating healthy foods, planning all meals ahead so I can pre-bolus exactly the right amount of time for that meal…yada yada yada.) It led to A1Cs as low as 5.1 percent the first time around — something I’ve expressed in previous blogs I am not even interested in achieving as a pregnant gal with a toddler!

But I still have goals: like keeping my A1C between 5.7 and 6.1 percent.Here are a few simple things that help me achieve my A1C goals:1. Some low-carb meals: Eating some meals that are low-carb so the work involved in maintaining tight, in-range blood sugar levels after that meal is fairly effortless. For instance, a breakfast of hard-boiled eggs and strawberries, or an apple with peanut butter which is a little higher carb are both very predictable and effortless for me. What meals are effortless for you?2. Increasing my background insulin ASAP: When my blood sugars start lingering even just around 115 to 130 mg/dL between meals and in the morning, I know it’s usually time for another bump in my background insulin dose due to increasing pregnancy hormone production. By reacting quickly to these subtle increases in my blood sugar, I’m able to maintain an average of below 100 mg/dL between meals and while I’m sleeping which is essential to getting your A1C near or below 6.0 percent. 3. Avoiding the rollercoaster: I’m not wearing my CGM during this pregnancy (here’s why) so I am inevitably much more careful about not taking too much insulin or too little insulin…both of which can be triggers for the start of a day on the blood sugar rollercoaster! By treating lows with as few carbs as possible (sometimes even just 8 grams is enough) and treating highs very carefully (never RAGE-bolusing), I’ve had nearly zero rollercoaster experiences during this pregnancy. With my CGM on during my 1st pregnancy, it gave me a kind of “Ohh, I have an extra alert if this is too much, so I can be a little more careless” sense of security, and the result was an occasional rollercoaster day. This time, I don’t have that CGM for “security” so I have to use good old fashioned common sense and be more sensible overall.Here are a few links to past articles on A1C Tips:

• 10 Tips to Reach Your A1C Goal This Year
• 5 Things that Helped Me Improve My A1C
• A1C: What Is It and What Do the Numbers Mean?
• HbA1c: Everything You Need to Know
• A1c Meet EAG: Your “Estimated Average Glucose”

What helps YOU reach your A1C goals during pregnancy…or even when you’re NOT pregnant?Photo credit: Adobe Stock PhotoType 2 Diabetes Treatment
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