Nicole Johnson's Diabetes and pregnancy questionnaire

[Gina]

Regardless of if you are pregnant, planning a pregnancy or if you have already had children, we need your help in formulating the “ideal” Q & A lists for healthcare professionals about pregnancy and diabetes from the patient perspective. Our aim is to present Q & A lists to various healthcare professionals in the field of pregnancy and diabetes and then to publish their responses in the book.
If you are interested in helping us, please respond to the following questions.

1. What questions do you have about preconception care?
2. What concerns you most about pregnancy, diabetes and exercise?
3. If you have been pregnant, did you have any unique experiences with diabetes and exercise during your pregnancy?
4. What exercises worked best during pregnancy?
5. How did you manage glucose levels during exercise while you were pregnant?
6. If you could ask an exercise expert anything about the topic of pregnancy, diabetes and exercise, what would you ask?
7. What concerns you most about pregnancy, diabetes and nutrition?
8. If you have been pregnant, what did you not know about diabetes and nutrition during pregnancy that you wish you had?
9. If you have been pregnant, what were your main questions about diabetes and nutrition during pregnancy?
10. If you could ask a dietitian anything about the topic of pregnancy and diabetes, what would you ask?
11. What general questions do you have about diabetes and pregnancy?
12. If you could ask a high-risk OB anything about pregnancy and diabetes, what would it be?
13. What questions do you think should be posed to a high-risk OB about diabetes, pregnancy and labor / delivery?

Thank you for your input, time and efforts. We hope to create a resource for women with diabetes that is unlike any other - created by and with women with diabetes who will be, are and have been pregnant.

~Nicole Johnson

[annie keys]

The forum, I read the transcript, was really great! It would have been so great to have had a support system like 'ya'all' when I was pg! (My 'baby' is 36 years old now! I was diagnosed as type I right before my 11th birthday )

There was no pre-conception care. At the pre-wedding physical, I was told getting pg was impossible, so I didn't use any birth control. Within two months, I was pg. Surprise! My bg ran in the upper 250's--400's throughout. No blood testing then, except at the Dr. and it took a week to get the 'sugar' results back. The OB had a blood sugar test done every month to see what my BG was running.

My ob didn't know anything about diabetic pregnancy; more or less, I was left to manage it all on my own. No information about it--flying solo. It was really scary! I had an emergency C section at 7 months and delivered a 5lb. baby girl. Healthy! By BG settled right back down.

They tied my tubes telling me I would die if I ever got pg again--I was 19. Ya'all are SO blessed to have Dr.'s that are knowledgeable and so many tests to maintain control and a GREAT support group like this! Take advantage of every single consult, management technique, support group---use it ALL! Thanks, Gina, you have provided a fabulous site--the support everyone gives each other is--awesome.

[Sarah Elizabeth]

My biggest concern and what I would like to see addressed is basically the effects pregnancy has on our bodies. I know that a diabetic can have a healthy pregnancy, as long as we keep our blood sugars in the normal range. Not the easiest feat ever but its something that can be done. I want to know how pregnancy an already stressful occurrence for a healthy normal woman affects our bodies that already are under stress.

I know that steel magnolias is a thing of the past ( my mom a type 1 same as I lived through that) and I think i still have residual fear that even though I am healthy now, and even if i get pregnant with my blood sugars in the right range, that this will put some un due strain on my body that can later effect my kidneys.

My mom had kidney disease and eventually kidney failure. This is my biggest fear and concern of diabetic pregnancy. All the books I read do not in anyway address this. Everything is about what to do to make sure the baby is healthy and to have a healthy pregnancy. I want to know about long term effects of this choice. I mean How do I protect myself?

[Lisa]

3. If you have been pregnant, did you have any unique experiences with diabetes and exercise during your pregnancy?
My first experience with diabetes was when I developed gestational diabetes during my second pregnancy- which was a twin pregnancy. I was told I might be predisposed to develping T2 later in life. Sure enough, despite losing all my pregnancy weight, my T2 diagnosis came when the twins were 9 years old.


5. How did you manage glucose levels during exercise while you were pregnant?

I followed the advice of my doctor and the diabetic counselor to whom I was referred. I used my glucometer to monitor my levels, drank water and walked to combat highs, and ate a light snack to combat lows.

7. What concerns you most about pregnancy, diabetes and nutrition?

The fact that I was told I might be "predisposed" to developing type 2 later in life, after having had gestational diabetes. What about developing gestational diabetes leaves one prone to type 2 later on in life? I lost all my weight (got down to 111 lbs at 5'3"), and still developed T2.

8. If you have been pregnant, what did you not know about diabetes and nutrition during pregnancy that you wish you had?

To eat VERY low carb. Even lower than what a lot of literature and medical professionals would have you eat. I am very carb senstivie and have T2 with insulin resistance. Even though I felt I was eating healthily during and after pregnancy, I could probably have benefited from eating less bread-type carbs than what was suggested.

9. If you have been pregnant, what were your main questions about diabetes and nutrition during pregnancy?

I realized that elevated BG levels could result in higher-than normal birth weights for the babies, but I have always wondered if being heavy at birth is necessarily bad for the baby/babies. Since they were twins, I was rather grateful that they weighed what they did (six and seven pounds at 36 wks).

10. If you could ask a dietitian anything about the topic of pregnancy and diabetes, what would you ask?

How many carbs a day do you reccommend? For singleton? twins?


11. What general questions do you have about diabetes and pregnancy?

Should those who are diagnosed with T2 after pregnancy avoid future conceptions/pregnancies?


12. If you could ask a high-risk OB anything about pregnancy and diabetes, what would it be?

Why did I get gestational diabetes with my twins and not with my singleton pregnancy? I actually gained LESS weight with my twins, than I did with my singleton (She was delivered prematurely due to my eclampsia, which I did not develop with my twins).

13. What questions do you think should be posed to a high-risk OB about diabetes, pregnancy and labor / delivery?

May a diabetic mother-to-be with larger-than-average baby be allowed to deliver vaginally? Or must she have a Caeseran due to the potential for cephalopelvic disproportion?

[kristy]

1. n/a
2. my biggest concern was if my daughter would be diabetic or have any other problems
3. I did not exercise much when I was pregnant, it made me dizzy
4. Walking was my favorite
5. Test, test, test
6. Why is it when I exercise when my bs is high, it stays high or goes even higher?
7. If my pre-mature delivery had anything to do with my diabetes
8. I did not know that my bs would drop dramatically after giving birth and would stay low while I breast fed
9. My main questions were regarding carbs, how many to eat and when
10. If anything has changed in the last 5 years
11. I don't really have any questions at this time, I had my daughter 5 years ago and have since had a tuba ligation
12. If I could have possibly survived another pregnancy, contrary to what my doctors said
13. I would want to know about breastfeeding and low blood sugar, also what to do when/if your bs goes to 700 during labor like mine did!

[Sarah S.]

11/12/13: Do I have to have a Cesarean, or can I deliver vaginally?
1: If I'm already at under 6.5 on my A1cs, do I need to aim for even tighter control?
12: What specific things should I be concerned about developing (complications of diabetes and/or pregnancy) and precisely what is the likelihood I will develop them? There's a lot of misinformation out there and I want to have the best information before thinking about or trying to get pregnant.