Linking Diabetics Coast 2 Coast
Diabetes and Pregnancy Chat Transcript with Nicole Johnson
*** (08:56):Welcome to Diabetes and Pregnancy with Nicole Johnson , Nicole Johnson !
Hi Nicole! Hi everyone. Nicole - went to a taping of Dlife and had a nice time. How is the baby?
Ellen5037 says to (09:00):
Hi all. Nicole it was nice to see you onstage at the end of Lois Jovanovic's speech at AADE. What was it like to have her as your doctor?
Nicole Johnson says to (09:01):
Hi there! So nice to join you this ev ening.
landileigh says to (09:01):
Hey Nicole!
Nicole Johnson says to (09:02):
Well, thanks for taking the time to be here. Frankly, as a mom of a 2 year old - I am just glad I woke up from the bedtime routine to sign on! LOL! The stories and songs work on me as well as her!
Nicole Johnson says to (09:03):
It was so great to have my little girl at AADE and then to be introduced at the end of Dr. Lois' talk was such a sweet experience. It was such an honor to have her care for me during my pregnancy.
Nicole Johnson says to (09:03):
Ava was thrilled to be on stage!
kiryu says to (09:03):
lots over people
Nicole Johnson says to (09:04):
So - lets talk pregnancy and babies!!!
Ellen5037 says to (09:04):
How tight did you need to keep your preprandial and post prandial blood sugars during pregnancy?
landileigh says to (09:04):
LOL Cali! She's one of the most famous Miss Americas EVER!
raymatzkin@hotmail.com says to (09:04):
90 PRE 120 POST
landileigh says to (09:04):
and she's one of us!
Nicole Johnson says to (09:04):
For those of you who don't know, I have had type 1 diabetes for 15 years.....I have been using a pump for 11+ years.
Nicole Johnson says to (09:05):
Pregnancy was tough.....frankly I was always told - and believed - that it was impossible for a woman with diabetes. That is wrong information!
raymatzkin@hotmail.com says to (09:05):
the steel magnolis syndrome
Nicole Johnson says to (09:05):
The basics....your BG's have to be in really, really tight control.
Gina says (09:06):
Nicole what was your A1c before you started trying
Nicole Johnson says to (09:06):
It is so difficult - 65 - 120 mg.....during pregnancy
Nicole Johnson says to (09:06):
but - what people don't tell you is the baby helps a ton at keeping those BG's in range because he/she is taking so much sugar from mom's system to grow
Nicole Johnson says to (09:06):
but you really have to limit carbs to do it well
Gina says (09:07):
What kind of diet were you on?
raymatzkin@hotmail.com says to (09:07):
nicole, what was your meal plan like?
Nicole Johnson says to (09:07):
A1c -- well, I varied from 6.5 - 7.0 before pregnancy....it was tough to be consistently at 6.5
Caro says to (09:07):
how many carbs did you eat on an average day?
Nicole Johnson says to (09:07):
during pregnancy, my A1c was around 5.0-5.8!!!!!
Gina says (09:07):
wow!
dandddeb3242 says to (09:07):
Nicole - even with limiting carbs I cannot seem to get in that tight control (with the pump). I am 39 and not sure that it would be safe between both the age and diabetes.
Nicole Johnson says to (09:07):
The baby helps soooooo much
Nicole Johnson says to (09:08):
Now - I was low often. Several times a day. But, that is what it takes.....the baby LOVES lows, according to Dr. Lois and is really affected negatively with highs
Gina says (09:08):
thats interesting
Ellen5037 says to (09:08):
Did you wear a CGM during pregnancy?
Nicole Johnson says to (09:08):
I wish CGMS would have been available to me.
esekine says to (09:09):
Did you have any problems with hypoglycemia unawareness when you were pg?
Nicole Johnson says to (09:09):
It wasn't approved yet....so I tested between 15-20 times a day
raymatzkin@hotmail.com says to (09:09):
i have a cgms and it's not alway accurate, so I am still testing that often -- between 13-15+
Nicole Johnson says to (09:09):
I didn't really have trouble with unawareness. But hypos are very different during pregnancy. I didn't feel hypo until I was below 50.
Gina says (09:10):
what advice do you have for someone that wants to get pregnant
deeandbee says to (09:10):
are hypos more frequent during pregnancy?
Nicole Johnson says to (09:10):
You are right about the CGMS - I have a lot of problems with mine too. It is mainly for trend information right now. I would never rely on it during pregnancy.
Gina says (09:10):
besides getting your A1c to 6.5
dandddeb3242 says to (09:11):
If you don't mind me asking, how old were you when you got pregnant?
Nicole Johnson says to (09:11):
They hypos are more frequent - because you are keeping your sugars so low. It would often feel like I would have a hypo walking to the mailbox. It takes effort to learn how to manage everything - I used to complain that I felt like I was relearning diabe
Ellen5037 says to (09:11):
Did you experience a period of time during your pregnancy when your insulin needs sharply declined?
Nicole Johnson says to (09:12):
I was 31 when I got pregnant and then delivered 2 days before my birthday. :-)
Nicole Johnson says to (09:13):
My insulin demands never declined....we increased my insulin every 4 days throughout the pregnancy. Sometimes the increases were really small - sometimes, when the baby was growing dramatically, they were big.
Ellen5037 says to (09:13):
How often were you in touch with Dr. J. and her team?
Nicole Johnson says to (09:13):
I could see patterns in her growth.....it was almost every 6-8 days my BG's would change and I would need to examine some element.
Gina says (09:13):
Nicole Dr. Jovanovic was your doctor?
kmet13 says to (09:14):
Nicole, did/do you have any other health issues (ie - thyroid, hypertension,etc)?
raymatzkin@hotmail.com says to (09:14):
my issue with running myself so low that i go low when i walk down the block is that I rebound from lows by going fairly high, which starts the whole cycle over again. I am only correcting to 90. what did you do?
DiabeticDiva says to Gina (private) (09:14):
Nicole, did you make it to term? Did you show any signs of pre eclampsia?
Nicole Johnson says to (09:14):
Dr. J and I talked at least once a week.....we emailed, faxed, called and visited over the course of my pregnancy. I had labs drawn every month - including an A1c.
dandddeb3242 says to (09:14):
Were you increasing your insulin because you had to increase your food intake as the baby was getting bigger?
Nicole Johnson says to (09:15):
I didn't have any other health issues during pregnancy or now.
DiabeticDiva says to (09:15):
Did you make it to term?
Nicole Johnson says to (09:15):
It is really important to watch your eyes and kidneys carefully during pregnancy though......for example, my glasses prescrip. changed half way during the pregnancy. Pregnancy does pose a risk for retina problems, etc.
*** (09:16):Rachio quit the room
kmet13 says to (09:16):
how long have you been T1?
Nicole Johnson says to (09:16):
I went into labor naturally at 37 weeks. Vaginal delivery too! ALL WITH MY PUMP ON! (I was really proud of that.)
ErinOConnor says to (09:16):
that's a problem I hadn't heard about before. :\ my eyes have stayed the same for a long time now.
ErinOConnor says to (09:16):
that's awesome, Nicole. totally what I'd like to do. :)
Nicole Johnson says to (09:17):
The vision change was slight and then returned to my old prescription about 3 months after delivery.
kmet13 says to (09:17):
my eyes did too. but my blood pressure went nutz
Gina says (09:17):
Did you have any concerns before you got pregnant?
DiabeticDiva says to (09:17):
mine too kmet
kmet13 says to (09:18):
Diva - did you deliver early? were you considered pre-eclamptic
Nicole Johnson says to (09:18):
Ah - I had some blood pressure issues at the end....last 4 weeks. But never was diagnosed with preeclampsia. I did have severe swelling - mainly in my legs. It was terrible, but not diabetes related - so I was told.
Ellen5037 says to (09:18):
Should one start seeing the "high risk " (I don't like that term) ob months prior to getting pregnant to get started bringing bg into tighter control?
DiabeticDiva says to (09:18):
Yes. Severe pre eclampsia... delivered at 34 weeks.... he's a healthy 3 year old now
raymatzkin@hotmail.com says to (09:18):
the high risk ob gyn won't be the one to help you tighten sugar control, ellen
Gina says (09:18):
My main concern right now is getting my A1c to 6,5
Gina says (09:18):
6,5
kmet13 says to (09:19):
I saw a perinatal before, just 2 b safe...
Gina says (09:19):
i feel like no matter what i do i cant get it down
Nicole Johnson says to (09:19):
The last month of the pregnancy is intense for women with diabetes.....you should be in the Dr. office twice a week for non-stress tests, BP evaluations, etc. They will also do at least 1 ultrasound. It was tough to manage diabetes, pregnancy and life at
Nicole Johnson says to (09:19):
I felt that diabetes and pregnancy became my full time job
full of life says to (09:20):
what are the risks with a high A1C and pregnancy
Nicole Johnson says to (09:20):
I know Gina! I felt like that too.
raymatzkin@hotmail.com says to (09:20):
i feel like it already has taken over my life and I am only 7 weeks preg. I look at my cgms every 3 minutes it seems
DiabeticDiva says to (09:20):
Women with diabetes are at an elevated risk for pre eclampsia. (20% greater chance than women without diabetes)
Gina says (09:20):
Nicole, my A1c is at 8.3 i just cant get it down
Gina says (09:20):
any tips?
raymatzkin@hotmail.com says to (09:20):
are you on the pumpo gina?
Nicole Johnson says to (09:20):
There is research that says if A1c is over 8% there is really high risks for fetal abnormalities, brain damage, etc.
Gina says (09:20):
yes ray
*** (09:20):Karen112173 quit the room
Nicole Johnson says to (09:20):
There is not a lot out there - which is really frustrating.
sixuntilme says to Gina (09:20):
Nicole, did you feel like you needed to be in close physical proximity to your medical team the entire 9 months, or just for the last trimester?
deeandbee says to (09:20):
Hi Nicole... what if you just can't get the bg into "normal" range... can you still plan to get pregnant?
kmet13 says to (09:21):
Diva - can I get your e mail? I'd like 2 talk 2 u offline
Nicole Johnson says to (09:21):
i am not a Dr., but I will tell you that you should try to get your BG's as low as possible....use whatever you can to help. Symlin might be a good option.
Nicole Johnson says to (09:21):
I was not below 6.5 when I got pregnant.
full of life says to (09:21):
wow I am pregnant now very beginning and my A1C levels as of 2mos ago was 11
Gina says (09:22):
Symlin was just on the TV saying people that use it have been getting pancreatitis
Nicole Johnson says to (09:22):
I did - during pregnancy - start to immediately cut carbs out of my diet. I couldn't cut everything, but that really happened.
Nicole Johnson says to (09:22):
I would be skeptical of the reports on symlin / byetta. It is only 6 people out of over 18 million users
raymatzkin@hotmail.com says to (09:22):
my nutritinist did not tell me to cut out carbs. based on my weight they want me to have 195/day. but everything should have 4-5 g of fiber per serving. I have been eating lots of apples
Ellen5037 says to (09:23):
There was a good article late today in Forbes about it.
esekine says to (09:23):
i found that checking often and not letting my bg's go over 130 was the key. and not eating anything that I did not know exactly how many carbs were in it and how it would affect my bg.
DiabeticDiva says to (09:23):
Were you nausiated in the first few months? I had a lot of trouble keeping my blood sugars up because of morning...err....all day sickness.
Nicole Johnson says to (09:23):
Pregnancy diet -- no tuna, no lunch meat, no pasta, no white bread, no snack food, no juice.......really I ate cottage cheese, yogurt, chicken, carrots and eggs.
Nicole Johnson says to (09:24):
No - I didn't have the morning sickness. I can't imagine how that complicates things!
DiabeticDiva says to (09:24):
me too!! Cottage cheese and fruit cups were the only thngs I could keep down.
Gina says (09:24):
interesting
ErinOConnor says to (09:24):
(uh oh, guess I better learn to like cottage cheese)
Nicole Johnson says to (09:24):
lots of apples too and almonds
Gina says (09:24):
i love almonds
DiabeticDiva says to (09:24):
haha... I know you either love it or hate it... not much middle ground.
Ellen5037 says to (09:24):
Bumbling Over Byetta
David Kliff, Diabetic Investor 08.19.08, 5:35 PM ET
Nicole Johnson says to (09:24):
it was so tough - craxings are not a reality.
kmet13 says to (09:24):
did anyone else have an esp hard time with fast bgs? if i started a day while preg over 100, the rest of the day was tough
DiabeticDiva says to (09:24):
Ginger trips helped me too. A natural anti nausea trick
Ellen5037 says to (09:24):
http://www.forbes.com/finance/2008/08/19/amylin-byetta-diabetes-pf-...
Gina says (09:25):
Nicole did you eat 6 small meals during the day or three meals
raymatzkin@hotmail.com says to (09:25):
what do ppl think about splenda and equal intake?
raymatzkin@hotmail.com says to (09:26):
my docs say it's fine but i am skeptical, still using it
Gina says (09:26):
is it true that people that have diabetes have larger babies?
DiabeticDiva says to (09:26):
I ate quite a bit of watermelon also... in moderation each day.
landileigh says to (09:26):
gina, Holly was 9lbs 15 oz.
Gina says (09:26):
watermelon is the only fruit i dont like
esekine says to (09:26):
I ate splenda/equal. It was so hard to think about more than how food would affect my bg.
landileigh says to (09:26):
they believe now that I had gestational diabetes
DiabeticDiva says to (09:26):
If their blood sugars are high through out pregnancy than it is true
Nicole Johnson says to (09:26):
interesting question about sweeteners......I typically used Splenda. I was never more happy than when my Dr. told me I could have 1-2 Diet cokes a day!
landileigh says to (09:27):
i couldn't live without my diet pepsi
raymatzkin@hotmail.com says to (09:27):
true!
raymatzkin@hotmail.com says to (09:27):
cyrstal light is my savior
*** (09:27):odonnellp10 quit the room
Gina says (09:27):
i like seltzer
raymatzkin@hotmail.com says to (09:28):
nicole, what were you correcting too? i am correcting to 90 and know i should go lower but fear too many lows b/c they drive my higher later on
Nicole Johnson says to (09:28):
Another reason we work so hard on the food intake is that we don't want to baby to be too big at delivery. That is what some Dr.s call the "Big, Bad, Baby Syndrome" - meaning Mom can't deliver because baby is so big
Gina says (09:28):
how big was Ava?
Nicole Johnson says to (09:29):
I was really scared of lows too. Had too many bad experiences before. I corrected to about 90 too.
Nicole Johnson says to (09:29):
Ava was 8.4
Gina says (09:29):
is that average baby size?
Nicole Johnson says to (09:29):
Dr. Lois worked with me so much on not being afraid of insulin
Nicole Johnson says to (09:29):
She even got me to give insulin when I was treating lows.
raymatzkin@hotmail.com says to (09:29):
what do you mean afraid of insullin?
ErinOConnor says to (09:29):
!!!
Nicole Johnson says to (09:29):
I was supposed to give at least 1 unit for every low
Gina says (09:30):
why did she tell you that?
DiabeticDiva says to (09:30):
What??
raymatzkin@hotmail.com says to (09:30):
ditto?
Gina says (09:30):
i would be scared to death to do that
Gina says (09:30):
was that during or before you got pregnant
Nicole Johnson says to (09:30):
Because the treatment for the low would shoot my BG over the top.....she was trying to counter act the glucose, the glycogen from the liver - I think, and the food.
ErinOConnor says to (09:31):
that makes sense, if you overtreat, which is very common :)
Ellen5037 says to (09:31):
I've heard from some women, they felt they worked so hard at keeping tight control during pregnancy, they really slacked after delivery....any comments?
Gina says (09:31):
i overtreat
raymatzkin@hotmail.com says to (09:31):
during the low or 30 min after you coreected?
Nicole Johnson says to (09:31):
Yea - I know - it was so hard to do. And then after pregnancy you all of a sudden have to relearn how to manage diabetes without the baby.
DiabeticDiva says to (09:31):
I bet with a CGM you might not have to do that. Maybe?? Could correct a rebound faster.
Nicole Johnson says to (09:31):
Corrected during the low - while I was treating
Gina says (09:31):
how did you get over that fear
Nicole Johnson says to (09:32):
I think I would still give the insulin on top of the low, even with CGM because my results the first time were so great.
DiabeticDiva says to (09:32):
Nicole... hope this isn't too personal... but did you breast feed? And how did that affect your blood sugars and diet?
Rachio says to (09:32):
wow a big room that's going on here
Nicole Johnson says to (09:33):
The fear - was constant. You really often feel alone during pregnancy. It is tough - because you are fighting so many battles at once. I often got overwhelmed. I had good friends that listened and helped encourage a lot
Nicole Johnson says to (09:33):
Charting my BG's helped too - the old fashioned way! With all kinds of notes about life "happenings" with the numbers!
ErinOConnor says to (09:33):
that is what I am afraid of. no one to relate to.
Nicole Johnson says to (09:34):
I did breastfeed.....for 8 months.
Nicole Johnson says to (09:34):
I encourage anyone to do it.
Nicole Johnson says to (09:34):
Not enough women with diabetes do....beacuse it is difficult with your BG's
Nicole Johnson says to (09:34):
When you feed the baby, you will go low
ErinOConnor says to (09:34):
yeah, I was going to ask
Ellen5037 says to (09:34):
This is really interesting information.
Nicole Johnson says to (09:34):
If your BG is high, you can't feed - it will hurt the baby
DiabeticDiva says to (09:35):
That's great. I breat fed my daughter for almost a year.... I had to deal with a lot of hypos and could never really get a handle on it, but after I got a CGM it helped tremendously
Gina says (09:35):
do you know why you go low during breast feeding?
*** (09:35):Laura329 quit the room
Nicole Johnson says to (09:35):
maybe even give him or her a yeast infection in the mouth
Gina says (09:35):
from a high blood while breast feeding?
DiabeticDiva says to (09:35):
Wow. I did not know that Nicole.
raymatzkin@hotmail.com says to (09:35):
so when did you breast feed,just after eating? that wouldn't work either
ErinOConnor says to (09:35):
yeah, that's good info.
DiabeticDiva says to (09:35):
About high bloog sugar harming the baby. My doctor never mentioned that
Nicole Johnson says to (09:35):
Ah - you go low because the baby is taking the sugar out of your system faster than you can keep up. I always had a juice box while I was feeding my daughter - we called it eating with Mommy.
Gina says (09:36):
lol
Gina says (09:36):
thats cute
DiabeticDiva says to (09:36):
ha
Gina says (09:36):
how fast would you go low during breast feeding
raymatzkin@hotmail.com says to (09:36):
what about pumping? same effect, b/c I will have to go back to work and pump in my office
Ellen5037 says to (09:36):
Did you have any books you recommend on diabetes and pregnancy (or did you just rely on Dr. Lois for all advice)?
Nicole Johnson says to (09:36):
The high factor -- if your BG is over 200 / 250....you should pump the milk out, throw it away -- that will hurt because it is like liquid gold! Give the baby a formula sub.
Nicole Johnson says to (09:37):
I pumped from the second week. I am a huge fan - pump as much as you can and store it! We used frozen milk for a month after I stopped breastfeeding.....also think about the kind of formula you want to use....I chose Nutramigen because it doesn't contain
Nicole Johnson says to (09:37):
cow byproducts
DiabeticDiva says to (09:37):
Gina, I watch my CGM now while nursing and can go from 120 to 60 pretty quickly
Nicole Johnson says to (09:38):
some people hypothesize that cow byproducts may have something to do with type 1 diabetes
Gina says (09:38):
oh wow
ErinOConnor says to (09:38):
I have read that too
DiabeticDiva says to (09:38):
I have to sip on juice. It's hard though when it's a night feeding and I have her in bed with me and just want to snooze!
DiabeticDiva says to (09:38):
That's mostly when I get the hypos... when I'm not paying close attention
landileigh says to (09:38):
Do you need to be close to your medical team while pregnant - like do you need to be there all the time or mainly just for the last trimester?
Nicole Johnson says to (09:39):
ah - don't do it in bed. At least I couldn't. I had a really cushy chair - padded arms and wide in case of lows.
Nicole Johnson says to (09:39):
I flew all over the world while I was pregnant.....I stayed close to home after 33 weeks.
Gina says (09:40):
Nicole, did you fly out to meet Dr. Lois or did everything over the phone
raymatzkin@hotmail.com says to (09:40):
how did you manage your sugars while eating out, traveling etc? I spent my third week of preg in las vegas, and it was a nightmare!!!!!!!!!!!!!!
Gina says (09:40):
and did you work with her pre conception
Nicole Johnson says to (09:40):
The chair thing was a recommendation from my Dr. -- just in case my arms went limp during breastfeeding, they advised that I get an upholstered chair to nurse in.....not a wooden one.
Nicole Johnson says to (09:40):
I met with Dr. Lois in person 3 times during my pregnancy
DiabeticDiva says to (09:41):
Wow. That's very interesting about the chair.
Gina says (09:41):
did you also have a team close by you worked with?
Ellen5037 says to (09:41):
What supplements did you take? Did you take Expecta (DHA)?
Nicole Johnson says to (09:41):
I called her the night I found out I was pregnant....no one else knew until I hit the 12th week. Dr. Lois made me tell people.....I was so nervous something was going to go wrong that I didn't want anyone to know until I was sure the baby would survive.
Nicole Johnson says to (09:41):
In retrospect I guess that was a little silly
Gina says (09:42):
i can understand
Nicole Johnson says to (09:42):
I really thought I would lose the baby because of my diabetes though
Gina says (09:42):
i think i would be the same way
Gina says (09:42):
do you have any tips on finding a good team to work with
Nicole Johnson says to (09:42):
my mother didn't speak to me for months when she learned I was pregnant - she was so angry - again, steel magnolias
ErinOConnor says to (09:42):
wow, that's harsh
Gina says (09:42):
ugh that movie!
raymatzkin@hotmail.com says to (09:43):
my bro is a doctor and making the whole family scared diabetesless
landileigh says to (09:43):
were you on bed rest your last trimester?
kmet13 says to (09:43):
my mom swears she will move 2 another planet if i get preg again...
Nicole Johnson says to (09:43):
She was so worried and could think of nothing but the Dr. telling her to discourage pregnancy on the day I was diagnosed.
Gina says (09:43):
llol
Nicole Johnson says to (09:43):
HA HA
ErinOConnor says to (09:43):
the doctor really told your mother that?
Gina says (09:43):
my mom wants me to be healthy first, prego second
Nicole Johnson says to (09:44):
No bed rest -- my family kept me moving. I was at the gym the day before I went into labor. I was only walking at a 2.0 rate on the treadmill -- but I was there.
Gina says (09:44):
did you do any crazy pregnancy yoga moves!
Nicole Johnson says to (09:44):
Yes, the day I was diagnosed the Dr.s told my mother to make sure I never became pregnant and to try to encourage me to adopt.
Gina says (09:45):
whoa
Gina says (09:45):
my doctor is not like that
Ellen5037 says to (09:45):
:-(
raymatzkin@hotmail.com says to (09:45):
how did you handle traveling and eating out?
Nicole Johnson says to (09:45):
no yoga - i never learned that
he told me when i get in healthy range go for it!
landileigh says to (09:45):
after my daughter was born 18 years ago, they recommended that i never get pregnant again, as the next one would kill me, and i never did
Ellen5037 says to (09:46):
Did someone prepare your meals for you?
Nicole Johnson says to (09:46):
eating out is tough....during pregnancy all I wanted were hamburgers.....i just tried to avoid the bun and anything that wasn't neutral.
ErinOConnor says to (09:46):
my endo and diabetes educators have been super encouraging about pregnancy
landileigh says to (09:46):
the advancements in Diabetes care has changed so much!
Nicole Johnson says to (09:46):
I didn't have anything exotic or interesting
landileigh says to (09:46):
you can be healthy, deliver a healthy child and do it all over again!
landileigh says to (09:46):
look at Kelly Close! she's had 3 babies!
Gina says (09:47):
I want to have one before i get too old1
kellykellykelly says to (09:47):
wow Landileigh that is something. do you think that is right? (and thanks : > i wouldn't wait til i was so old if i did it again! 37, 39, 40)
Gina says (09:47):
old!
raymatzkin@hotmail.com says to (09:47):
burgers, i find the fat kills me and I am sky high 8 hour later, even with dual wa ve
Nicole Johnson says to (09:47):
It is so wonderful to be thinking about and talking about this now....you are right, the advancements are amazing. We can do this.
Nicole Johnson says to (09:47):
Awe - gina, go for it if your A1c is below 7!
kellykellykelly says to (09:47):
yeah Gina!!
Nicole Johnson says to (09:48):
I would love to have more children too!
Gina says (09:48):
i cant get it down! i need help!
Nicole Johnson says to (09:48):
maybe one day
Gina says (09:48):
i am also having a lot of lows
Gina says (09:48):
im working with my team l ike every week
Gina says (09:48):
they have me on speed dial at my CDE office lol
Nicole Johnson says to (09:48):
cut white flour......use fiber......eat the same boring stuff every day!
Gina says (09:48):
I am going on a CGM again next week
Gina says (09:48):
i do
Nicole Johnson says to (09:48):
walk in the morning and at night
landileigh says to (09:48):
YEAH GINA!
kellykellykelly says to (09:48):
and walk after meals
Gina says (09:48):
i am a boring eater
landileigh says to (09:49):
she goes to the gym every night!
Gina says (09:49):
i go to the gym every day
ErinOConnor says to (09:49):
do you overcorrect for your lows?
Gina says (09:49):
its the rebounds from lows
ErinOConnor says to (09:49):
sounds like it might be a good idea to take that extra insulin that nicole was talking about
Gina says (09:49):
yea
Gina says (09:49):
i was thinking the same
ErinOConnor says to (09:49):
:)
kellykellykelly says to (09:49):
if your A1c is under 7.3%, you can get it down MORE if your fasting improves more. the post-prandials impact A1c a lot but especially over 8% or so. if you haven't started checking in the middle of the night that's a good idea.
Nicole Johnson says to (09:50):
I will tell you guys that I am working on a book about diabetes and pregnancy.....Kelly Close is a part of this project too......we are trying to find some consensus on this topic from science. It is tough. We really want to provide something
Nicole Johnson says to (09:50):
of value to women who want to experience this miracle
Gina says (09:50):
i think that it is a book we all need
ErinOConnor says to (09:50):
definitely!
Gina says (09:51):
or we wouldnt all be here r ight! haha
Nicole Johnson says to (09:51):
I agree - there is not anything out there for women with existing diabetes that is readable and understandable!
Gina says (09:51):
and you both went through it already
raymatzkin@hotmail.com says to (09:51):
sorry to say this, but if I read a book that said everything we just talked about, I would want to jump off the roof b/c that is how overwhelming this all feels
Nicole Johnson says to (09:51):
Sweet - feel free to email us with comments and wants for this project
Gina says (09:51):
can you provide your emails?
Gina says (09:52):
i also have your survey up on my website
Gina says (09:52):
i will send it out to everyone again
Nicole Johnson says to (09:52):
It does sound so terrible and difficult, but there are ways that it can be done and there are stories of what others have done that will help you come up with ideas for your life.
DiabeticDiva says to (09:52):
great
Nicole Johnson says to (09:52):
Cool - take the survey!!!
Gina says (09:52):
hold on i will post it up in here right now
Nicole Johnson says to (09:52):
Emails -- MissAmerica1999@aol.com
Ellen5037 says to (09:52):
I'd like to know what supplements were recommended that you take during pregnancy - DHA for example is being studied to prevent onset of type 1 in offspring (example Expecta)...and is being added to formula
kellykellykelly says to (09:53):
i know. Ray - I agree. going through it at least knowing the rough parts are coming is really important though and knowing there is a community. people can always write me at kelly@diatribe.us if they want to talk about anything....huge thanks to Nicole fo
DiabeticDiva says to (09:53):
It is a scary ride ladies, but it can be done and your best resource is knowledge. =) I've had two healthy kids and been T1 for over 20 years.
Nicole Johnson says to kellykellykelly (09:53):
I thought that was you!!!!! :-)
Gina says (09:53):
Here is the survey Nicole was talking about http://diabetestalkfest.ning.com/forum/topic/show?id=855504%3ATopic...
Nicole Johnson says to kellykellykelly (09:54):
The only supplement was Folic Acid and a solid mulivitamin
Gina says (09:54):
Kelly Close in the House!
raymatzkin@hotmail.com says to (09:54):
thanks for the encouragement, it;s only been 7 weeks -- 5 really, and I am exhausted from the intensity of the management
Ellen5037 says to (09:54):
Thanks.
raymatzkin@hotmail.com says to (09:54):
bye everyone
Nicole Johnson says to kellykellykelly (09:54):
Ah - it gets better on the first day of the 2nd trimester!
Ellen5037 says to (09:55):
Will there be suggestions in the book for how family can best support the woman who is pregnant?
Gina says (09:55):
Nicole and Kelly if you want to keep answering question after 10pm you can if not everyone has 5 more minutes of questions
Nicole Johnson says to (09:55):
Not sure if this was up before......the tired factor gets better as soon as the second trimester starts.
Katie I. says to (09:55):
Hi Nicole, I joined this chat late so I apologize if this question is repetitive... I wanted to ask you if you remember when your insulin resistance in pregnancy began? (I am in my 19th week right now and still running low all the time.)
kellykellykelly says to (09:55):
you know, i think it IS exhausting - i found it like a full time job. but come over anytime (where to you live!) to see the good side! and just wait ...til you see the little one!
DiabeticDiva says to (09:56):
Amen Kelly!
Nicole Johnson says to (09:56):
Well, the insulin resistance issue......that was not something I experienced.
landileigh says to (09:56):
well dang, i've been half way cooking all this time!
kmet13 says to (09:56):
I have been t1 for 35+ years and have a beautiful heathy 2 yr old. I would welcome talking if anyone has questions or just wants some empathy - kmet612@epix.net
Gina says (09:56):
JUST HAVING DIABETES IS EXHAUSTING!
landileigh says to (09:56):
kelly, so good to "see" you again!
Gina says (09:57):
i cant imagine what its going to be like with pregnancy t oo ohhh boy!
Gina says (09:57):
my husband is going to really love me lol
kellykellykelly says to (09:57):
yes hi landileigh! how great to have Nicole on! she can tell us SO much as she did her masters in public health on this topic - whew. we are lucky to learn ... i have found it incredibly encouraging to talk to her
ErinOConnor says to (09:57):
heheh, I'm with Gina
Nicole Johnson says to (09:57):
I did experience the natural production of insulin during pregnancy.....that might be what is happening to you. Some women with type 1 - 20% - start to create insulin again because of hormones from the placenta.
DiabeticDiva says to (09:57):
Gina, weirdly enough, I was in the TIGHTEST control of my LIFE when I was preggo. A1c's were 5.0-7.0 the whole nine months. It was crazy.
landileigh says to (09:57):
i think there is alot to learn on this subject!
Gina says (09:58):
Nicole that is really interesting
DiabeticDiva says to (09:58):
Of course... the constant barfing probably had something to do with it.... (sorry.. not helping)
Gina says (09:58):
i wonder if scientists can figure something out with that
kmet13 says to (09:58):
having a support network is key
landileigh says to (09:58):
do they keep producing insulin after the birth? or does it shut off immediately?
Nicole Johnson says to (09:59):
Yes - JDRF is looking at the research.....most of it from Dr. Lois....and trying to expand. Others are interested too. It was a really cool thing to experience. Went away shortly after delivery -- breastfeeding made it hang on marginally for a few weeks
Gina says (09:59):
oh i hope that happens to me! haha
Nicole Johnson says to (09:59):
Really most producation was gone when the placenta left the body. Ugh
Ellen5037 says to (09:59):
Was it recommended to store cord blood after the birth?
Gina says (09:59):
really
DiabeticDiva says to (10:00):
That is crazy!
Gina says (10:00):
that is crazy
kellykellykelly says to (10:00):
wow that is amazing. i found CGM so helpful in 2nd and 3rd pregnancies to monitor stress, extra insulin made, how fat worked in my system in pregnancy, how walking affected it, everything! wow was it a lot of work though. i stored the core blood but like
DiabeticDiva says to (10:00):
You have some seriously cool tid bits of info that I never got from my endo or high risk OB
kellykellykelly says to (10:00):
all else this is super controversial at least at our hospital in San Fran. i did it just in case....
Nicole Johnson says to (10:00):
Cord blood - either store it or check out diabetes donation.....Univ. of FL was doing a ton of research on cord blood and diabetes a year or so ago.
Katie I. says to (10:00):
Nicole, do you think you could have also avoided the insulin resistance by exercising? I've been thinking it's my exercise routine that is keeping me so low... But I am only on like 20 units of insulin / day and I'm still low! It's crazy
Gina says (10:00):
how much was it to store your core
Gina says (10:00):
cord
Nicole Johnson says to (10:01):
That is really low!
Gina says (10:01):
i think it cost my cousin a lot
Gina says (10:01):
20 units!
Nicole Johnson says to (10:01):
My insulin went up to about 80u. a day!
ErinOConnor says to (10:01):
wow
Nicole Johnson says to (10:01):
That was only double - most women go to over 100u - so I am told
DiabeticDiva says to (10:01):
My insulin was at about 65-70 per day in 3rd trimester
ErinOConnor says to (10:01):
I'm at 30 u/day, I thought that was high
kellykellykelly says to (10:01):
wow it was unbelievably expensive. i got a lot of coupons but still was over $1000 each time.
Gina says (10:01):
i know someone they had to take 175 units
Ellen5037 says to (10:01):
Did they check vitamin d levels during pregnancy?
Nicole Johnson says to (10:02):
I didn't store mine.....but wish I had.
Katie I. says to (10:02):
I know, it's insane. I am just wondering when the insulin resistance is going to start. I'm sure it will double or triple.
deeandbee says to (10:02):
you can also store cord blood for research... they'll pay the cost
Nicole Johnson says to (10:02):
I am waiting to hear about my daughter's antibody risk for typw 1 -- this has made me think a lot about the cord blood issue.
Katie I. says to (10:03):
I'm going to check in to storing my cord blood, too, but I remember on the Dr. Lois chat she said she didn't recommend it. She didn't elaborate.
Gina says (10:03):
oh right
Gina says (10:03):
i remember that katie
Gina says (10:03):
Nicole do you know any good diabetes and pregnancy doctors in NY area?
Nicole Johnson says to (10:04):
It seems there is so much left to learn about pregnancy and diabetes and how HCP should talk to women with diabetes.
Nicole Johnson says to (10:04):
Really, we shouldn't have so many questions and we shouldn't feel so isolated.
Gina says (10:04):
none of the doctors talk to you about d and preg unless you ask
Nicole Johnson says to (10:04):
Someone in healthcare is not stepping up to the plate like they should.....or maybe not enough people are demanding it.
Gina says (10:04):
and i dont think they know enough
kellykellykelly says to (10:04):
they havent proven anything positive yet but we have heard if you get it, it is good for any siblings but likely not for the child whose cord blood it is. we did it just in case. must run baby crying ! thank you Gina and Nicole! xox
Gina says (10:05):
bye kelly thank you for coming!
Nicole Johnson says to (10:05):
Bye
Nicole Johnson says to (10:05):
Thank you
Nicole Johnson says to (10:05):
I need to go too....it has been such fun talking with you all
DiabeticDiva says to (10:05):
Thank you Nicole
Gina says (10:05):
thank you Nicole for answering our questions
Nicole Johnson says to (10:05):
I hope you gathered from this that I am enthusiastic about this topic
Katie I. says to (10:05):
Nicole, thank you so much!! And thanks for all you do in the T1 community
Nicole Johnson says to (10:05):
and that I totally support your decision to learn about the process
Gina says (10:05):
I hope you come back again
ErinOConnor says to (10:06):
thank you! yes, it's very eoncouraging
Ellen5037 says to (10:06):
Empowering and interesting. Thank you for taking the time to share.
Nicole Johnson says to (10:06):
Gina, go for it -- get the BG's as low as you can and go for it. (If you are not over 7%)
Gina says (10:06):
I will have this chat t ranscript up tomorrow everyone
Gina says (10:06):
i will send it to you too nicole
Nicole Johnson says to (10:06):
Thanks - please take our survey -- if you are interested in being interviewed for the book, please send an email. We are developing a focus group.
Gina says (10:07):
http://diabetestalkfest.ning.com/forum/topic/show?id=855504%3ATopic...
Gina says (10:07):
here is the survey everyone
Nicole Johnson says to (10:07):
Thank you again!
Gina says (10:07):
thank you!
dandddeb3242 says to (10:07):
Thank you!
deeandbee says to (10:07):
thanks
Hi Nicole! Hi everyone. Nicole - went to a taping of Dlife and had a nice time. How is the baby?
Ellen5037 says to (09:00):
Hi all. Nicole it was nice to see you onstage at the end of Lois Jovanovic's speech at AADE. What was it like to have her as your doctor?
Nicole Johnson says to (09:01):
Hi there! So nice to join you this ev ening.
landileigh says to (09:01):
Hey Nicole!
Nicole Johnson says to (09:02):
Well, thanks for taking the time to be here. Frankly, as a mom of a 2 year old - I am just glad I woke up from the bedtime routine to sign on! LOL! The stories and songs work on me as well as her!
Nicole Johnson says to (09:03):
It was so great to have my little girl at AADE and then to be introduced at the end of Dr. Lois' talk was such a sweet experience. It was such an honor to have her care for me during my pregnancy.
Nicole Johnson says to (09:03):
Ava was thrilled to be on stage!
kiryu says to (09:03):
lots over people
Nicole Johnson says to (09:04):
So - lets talk pregnancy and babies!!!
Ellen5037 says to (09:04):
How tight did you need to keep your preprandial and post prandial blood sugars during pregnancy?
landileigh says to (09:04):
LOL Cali! She's one of the most famous Miss Americas EVER!
raymatzkin@hotmail.com says to (09:04):
90 PRE 120 POST
landileigh says to (09:04):
and she's one of us!
Nicole Johnson says to (09:04):
For those of you who don't know, I have had type 1 diabetes for 15 years.....I have been using a pump for 11+ years.
Nicole Johnson says to (09:05):
Pregnancy was tough.....frankly I was always told - and believed - that it was impossible for a woman with diabetes. That is wrong information!
raymatzkin@hotmail.com says to (09:05):
the steel magnolis syndrome
Nicole Johnson says to (09:05):
The basics....your BG's have to be in really, really tight control.
Gina says (09:06):
Nicole what was your A1c before you started trying
Nicole Johnson says to (09:06):
It is so difficult - 65 - 120 mg.....during pregnancy
Nicole Johnson says to (09:06):
but - what people don't tell you is the baby helps a ton at keeping those BG's in range because he/she is taking so much sugar from mom's system to grow
Nicole Johnson says to (09:06):
but you really have to limit carbs to do it well
Gina says (09:07):
What kind of diet were you on?
raymatzkin@hotmail.com says to (09:07):
nicole, what was your meal plan like?
Nicole Johnson says to (09:07):
A1c -- well, I varied from 6.5 - 7.0 before pregnancy....it was tough to be consistently at 6.5
Caro says to (09:07):
how many carbs did you eat on an average day?
Nicole Johnson says to (09:07):
during pregnancy, my A1c was around 5.0-5.8!!!!!
Gina says (09:07):
wow!
dandddeb3242 says to (09:07):
Nicole - even with limiting carbs I cannot seem to get in that tight control (with the pump). I am 39 and not sure that it would be safe between both the age and diabetes.
Nicole Johnson says to (09:07):
The baby helps soooooo much
Nicole Johnson says to (09:08):
Now - I was low often. Several times a day. But, that is what it takes.....the baby LOVES lows, according to Dr. Lois and is really affected negatively with highs
Gina says (09:08):
thats interesting
Ellen5037 says to (09:08):
Did you wear a CGM during pregnancy?
Nicole Johnson says to (09:08):
I wish CGMS would have been available to me.
esekine says to (09:09):
Did you have any problems with hypoglycemia unawareness when you were pg?
Nicole Johnson says to (09:09):
It wasn't approved yet....so I tested between 15-20 times a day
raymatzkin@hotmail.com says to (09:09):
i have a cgms and it's not alway accurate, so I am still testing that often -- between 13-15+
Nicole Johnson says to (09:09):
I didn't really have trouble with unawareness. But hypos are very different during pregnancy. I didn't feel hypo until I was below 50.
Gina says (09:10):
what advice do you have for someone that wants to get pregnant
deeandbee says to (09:10):
are hypos more frequent during pregnancy?
Nicole Johnson says to (09:10):
You are right about the CGMS - I have a lot of problems with mine too. It is mainly for trend information right now. I would never rely on it during pregnancy.
Gina says (09:10):
besides getting your A1c to 6.5
dandddeb3242 says to (09:11):
If you don't mind me asking, how old were you when you got pregnant?
Nicole Johnson says to (09:11):
They hypos are more frequent - because you are keeping your sugars so low. It would often feel like I would have a hypo walking to the mailbox. It takes effort to learn how to manage everything - I used to complain that I felt like I was relearning diabe
Ellen5037 says to (09:11):
Did you experience a period of time during your pregnancy when your insulin needs sharply declined?
Nicole Johnson says to (09:12):
I was 31 when I got pregnant and then delivered 2 days before my birthday. :-)
Nicole Johnson says to (09:13):
My insulin demands never declined....we increased my insulin every 4 days throughout the pregnancy. Sometimes the increases were really small - sometimes, when the baby was growing dramatically, they were big.
Ellen5037 says to (09:13):
How often were you in touch with Dr. J. and her team?
Nicole Johnson says to (09:13):
I could see patterns in her growth.....it was almost every 6-8 days my BG's would change and I would need to examine some element.
Gina says (09:13):
Nicole Dr. Jovanovic was your doctor?
kmet13 says to (09:14):
Nicole, did/do you have any other health issues (ie - thyroid, hypertension,etc)?
raymatzkin@hotmail.com says to (09:14):
my issue with running myself so low that i go low when i walk down the block is that I rebound from lows by going fairly high, which starts the whole cycle over again. I am only correcting to 90. what did you do?
DiabeticDiva says to Gina (private) (09:14):
Nicole, did you make it to term? Did you show any signs of pre eclampsia?
Nicole Johnson says to (09:14):
Dr. J and I talked at least once a week.....we emailed, faxed, called and visited over the course of my pregnancy. I had labs drawn every month - including an A1c.
dandddeb3242 says to (09:14):
Were you increasing your insulin because you had to increase your food intake as the baby was getting bigger?
Nicole Johnson says to (09:15):
I didn't have any other health issues during pregnancy or now.
DiabeticDiva says to (09:15):
Did you make it to term?
Nicole Johnson says to (09:15):
It is really important to watch your eyes and kidneys carefully during pregnancy though......for example, my glasses prescrip. changed half way during the pregnancy. Pregnancy does pose a risk for retina problems, etc.
*** (09:16):Rachio quit the room
kmet13 says to (09:16):
how long have you been T1?
Nicole Johnson says to (09:16):
I went into labor naturally at 37 weeks. Vaginal delivery too! ALL WITH MY PUMP ON! (I was really proud of that.)
ErinOConnor says to (09:16):
that's a problem I hadn't heard about before. :\ my eyes have stayed the same for a long time now.
ErinOConnor says to (09:16):
that's awesome, Nicole. totally what I'd like to do. :)
Nicole Johnson says to (09:17):
The vision change was slight and then returned to my old prescription about 3 months after delivery.
kmet13 says to (09:17):
my eyes did too. but my blood pressure went nutz
Gina says (09:17):
Did you have any concerns before you got pregnant?
DiabeticDiva says to (09:17):
mine too kmet
kmet13 says to (09:18):
Diva - did you deliver early? were you considered pre-eclamptic
Nicole Johnson says to (09:18):
Ah - I had some blood pressure issues at the end....last 4 weeks. But never was diagnosed with preeclampsia. I did have severe swelling - mainly in my legs. It was terrible, but not diabetes related - so I was told.
Ellen5037 says to (09:18):
Should one start seeing the "high risk " (I don't like that term) ob months prior to getting pregnant to get started bringing bg into tighter control?
DiabeticDiva says to (09:18):
Yes. Severe pre eclampsia... delivered at 34 weeks.... he's a healthy 3 year old now
raymatzkin@hotmail.com says to (09:18):
the high risk ob gyn won't be the one to help you tighten sugar control, ellen
Gina says (09:18):
My main concern right now is getting my A1c to 6,5
Gina says (09:18):
6,5
kmet13 says to (09:19):
I saw a perinatal before, just 2 b safe...
Gina says (09:19):
i feel like no matter what i do i cant get it down
Nicole Johnson says to (09:19):
The last month of the pregnancy is intense for women with diabetes.....you should be in the Dr. office twice a week for non-stress tests, BP evaluations, etc. They will also do at least 1 ultrasound. It was tough to manage diabetes, pregnancy and life at
Nicole Johnson says to (09:19):
I felt that diabetes and pregnancy became my full time job
full of life says to (09:20):
what are the risks with a high A1C and pregnancy
Nicole Johnson says to (09:20):
I know Gina! I felt like that too.
raymatzkin@hotmail.com says to (09:20):
i feel like it already has taken over my life and I am only 7 weeks preg. I look at my cgms every 3 minutes it seems
DiabeticDiva says to (09:20):
Women with diabetes are at an elevated risk for pre eclampsia. (20% greater chance than women without diabetes)
Gina says (09:20):
Nicole, my A1c is at 8.3 i just cant get it down
Gina says (09:20):
any tips?
raymatzkin@hotmail.com says to (09:20):
are you on the pumpo gina?
Nicole Johnson says to (09:20):
There is research that says if A1c is over 8% there is really high risks for fetal abnormalities, brain damage, etc.
Gina says (09:20):
yes ray
*** (09:20):Karen112173 quit the room
Nicole Johnson says to (09:20):
There is not a lot out there - which is really frustrating.
sixuntilme says to Gina (09:20):
Nicole, did you feel like you needed to be in close physical proximity to your medical team the entire 9 months, or just for the last trimester?
deeandbee says to (09:20):
Hi Nicole... what if you just can't get the bg into "normal" range... can you still plan to get pregnant?
kmet13 says to (09:21):
Diva - can I get your e mail? I'd like 2 talk 2 u offline
Nicole Johnson says to (09:21):
i am not a Dr., but I will tell you that you should try to get your BG's as low as possible....use whatever you can to help. Symlin might be a good option.
Nicole Johnson says to (09:21):
I was not below 6.5 when I got pregnant.
full of life says to (09:21):
wow I am pregnant now very beginning and my A1C levels as of 2mos ago was 11
Gina says (09:22):
Symlin was just on the TV saying people that use it have been getting pancreatitis
Nicole Johnson says to (09:22):
I did - during pregnancy - start to immediately cut carbs out of my diet. I couldn't cut everything, but that really happened.
Nicole Johnson says to (09:22):
I would be skeptical of the reports on symlin / byetta. It is only 6 people out of over 18 million users
raymatzkin@hotmail.com says to (09:22):
my nutritinist did not tell me to cut out carbs. based on my weight they want me to have 195/day. but everything should have 4-5 g of fiber per serving. I have been eating lots of apples
Ellen5037 says to (09:23):
There was a good article late today in Forbes about it.
esekine says to (09:23):
i found that checking often and not letting my bg's go over 130 was the key. and not eating anything that I did not know exactly how many carbs were in it and how it would affect my bg.
DiabeticDiva says to (09:23):
Were you nausiated in the first few months? I had a lot of trouble keeping my blood sugars up because of morning...err....all day sickness.
Nicole Johnson says to (09:23):
Pregnancy diet -- no tuna, no lunch meat, no pasta, no white bread, no snack food, no juice.......really I ate cottage cheese, yogurt, chicken, carrots and eggs.
Nicole Johnson says to (09:24):
No - I didn't have the morning sickness. I can't imagine how that complicates things!
DiabeticDiva says to (09:24):
me too!! Cottage cheese and fruit cups were the only thngs I could keep down.
Gina says (09:24):
interesting
ErinOConnor says to (09:24):
(uh oh, guess I better learn to like cottage cheese)
Nicole Johnson says to (09:24):
lots of apples too and almonds
Gina says (09:24):
i love almonds
DiabeticDiva says to (09:24):
haha... I know you either love it or hate it... not much middle ground.
Ellen5037 says to (09:24):
Bumbling Over Byetta
David Kliff, Diabetic Investor 08.19.08, 5:35 PM ET
Nicole Johnson says to (09:24):
it was so tough - craxings are not a reality.
kmet13 says to (09:24):
did anyone else have an esp hard time with fast bgs? if i started a day while preg over 100, the rest of the day was tough
DiabeticDiva says to (09:24):
Ginger trips helped me too. A natural anti nausea trick
Ellen5037 says to (09:24):
http://www.forbes.com/finance/2008/08/19/amylin-byetta-diabetes-pf-...
Gina says (09:25):
Nicole did you eat 6 small meals during the day or three meals
raymatzkin@hotmail.com says to (09:25):
what do ppl think about splenda and equal intake?
raymatzkin@hotmail.com says to (09:26):
my docs say it's fine but i am skeptical, still using it
Gina says (09:26):
is it true that people that have diabetes have larger babies?
DiabeticDiva says to (09:26):
I ate quite a bit of watermelon also... in moderation each day.
landileigh says to (09:26):
gina, Holly was 9lbs 15 oz.
Gina says (09:26):
watermelon is the only fruit i dont like
esekine says to (09:26):
I ate splenda/equal. It was so hard to think about more than how food would affect my bg.
landileigh says to (09:26):
they believe now that I had gestational diabetes
DiabeticDiva says to (09:26):
If their blood sugars are high through out pregnancy than it is true
Nicole Johnson says to (09:26):
interesting question about sweeteners......I typically used Splenda. I was never more happy than when my Dr. told me I could have 1-2 Diet cokes a day!
landileigh says to (09:27):
i couldn't live without my diet pepsi
raymatzkin@hotmail.com says to (09:27):
true!
raymatzkin@hotmail.com says to (09:27):
cyrstal light is my savior
*** (09:27):odonnellp10 quit the room
Gina says (09:27):
i like seltzer
raymatzkin@hotmail.com says to (09:28):
nicole, what were you correcting too? i am correcting to 90 and know i should go lower but fear too many lows b/c they drive my higher later on
Nicole Johnson says to (09:28):
Another reason we work so hard on the food intake is that we don't want to baby to be too big at delivery. That is what some Dr.s call the "Big, Bad, Baby Syndrome" - meaning Mom can't deliver because baby is so big
Gina says (09:28):
how big was Ava?
Nicole Johnson says to (09:29):
I was really scared of lows too. Had too many bad experiences before. I corrected to about 90 too.
Nicole Johnson says to (09:29):
Ava was 8.4
Gina says (09:29):
is that average baby size?
Nicole Johnson says to (09:29):
Dr. Lois worked with me so much on not being afraid of insulin
Nicole Johnson says to (09:29):
She even got me to give insulin when I was treating lows.
raymatzkin@hotmail.com says to (09:29):
what do you mean afraid of insullin?
ErinOConnor says to (09:29):
!!!
Nicole Johnson says to (09:29):
I was supposed to give at least 1 unit for every low
Gina says (09:30):
why did she tell you that?
DiabeticDiva says to (09:30):
What??
raymatzkin@hotmail.com says to (09:30):
ditto?
Gina says (09:30):
i would be scared to death to do that
Gina says (09:30):
was that during or before you got pregnant
Nicole Johnson says to (09:30):
Because the treatment for the low would shoot my BG over the top.....she was trying to counter act the glucose, the glycogen from the liver - I think, and the food.
ErinOConnor says to (09:31):
that makes sense, if you overtreat, which is very common :)
Ellen5037 says to (09:31):
I've heard from some women, they felt they worked so hard at keeping tight control during pregnancy, they really slacked after delivery....any comments?
Gina says (09:31):
i overtreat
raymatzkin@hotmail.com says to (09:31):
during the low or 30 min after you coreected?
Nicole Johnson says to (09:31):
Yea - I know - it was so hard to do. And then after pregnancy you all of a sudden have to relearn how to manage diabetes without the baby.
DiabeticDiva says to (09:31):
I bet with a CGM you might not have to do that. Maybe?? Could correct a rebound faster.
Nicole Johnson says to (09:31):
Corrected during the low - while I was treating
Gina says (09:31):
how did you get over that fear
Nicole Johnson says to (09:32):
I think I would still give the insulin on top of the low, even with CGM because my results the first time were so great.
DiabeticDiva says to (09:32):
Nicole... hope this isn't too personal... but did you breast feed? And how did that affect your blood sugars and diet?
Rachio says to (09:32):
wow a big room that's going on here
Nicole Johnson says to (09:33):
The fear - was constant. You really often feel alone during pregnancy. It is tough - because you are fighting so many battles at once. I often got overwhelmed. I had good friends that listened and helped encourage a lot
Nicole Johnson says to (09:33):
Charting my BG's helped too - the old fashioned way! With all kinds of notes about life "happenings" with the numbers!
ErinOConnor says to (09:33):
that is what I am afraid of. no one to relate to.
Nicole Johnson says to (09:34):
I did breastfeed.....for 8 months.
Nicole Johnson says to (09:34):
I encourage anyone to do it.
Nicole Johnson says to (09:34):
Not enough women with diabetes do....beacuse it is difficult with your BG's
Nicole Johnson says to (09:34):
When you feed the baby, you will go low
ErinOConnor says to (09:34):
yeah, I was going to ask
Ellen5037 says to (09:34):
This is really interesting information.
Nicole Johnson says to (09:34):
If your BG is high, you can't feed - it will hurt the baby
DiabeticDiva says to (09:35):
That's great. I breat fed my daughter for almost a year.... I had to deal with a lot of hypos and could never really get a handle on it, but after I got a CGM it helped tremendously
Gina says (09:35):
do you know why you go low during breast feeding?
*** (09:35):Laura329 quit the room
Nicole Johnson says to (09:35):
maybe even give him or her a yeast infection in the mouth
Gina says (09:35):
from a high blood while breast feeding?
DiabeticDiva says to (09:35):
Wow. I did not know that Nicole.
raymatzkin@hotmail.com says to (09:35):
so when did you breast feed,just after eating? that wouldn't work either
ErinOConnor says to (09:35):
yeah, that's good info.
DiabeticDiva says to (09:35):
About high bloog sugar harming the baby. My doctor never mentioned that
Nicole Johnson says to (09:35):
Ah - you go low because the baby is taking the sugar out of your system faster than you can keep up. I always had a juice box while I was feeding my daughter - we called it eating with Mommy.
Gina says (09:36):
lol
Gina says (09:36):
thats cute
DiabeticDiva says to (09:36):
ha
Gina says (09:36):
how fast would you go low during breast feeding
raymatzkin@hotmail.com says to (09:36):
what about pumping? same effect, b/c I will have to go back to work and pump in my office
Ellen5037 says to (09:36):
Did you have any books you recommend on diabetes and pregnancy (or did you just rely on Dr. Lois for all advice)?
Nicole Johnson says to (09:36):
The high factor -- if your BG is over 200 / 250....you should pump the milk out, throw it away -- that will hurt because it is like liquid gold! Give the baby a formula sub.
Nicole Johnson says to (09:37):
I pumped from the second week. I am a huge fan - pump as much as you can and store it! We used frozen milk for a month after I stopped breastfeeding.....also think about the kind of formula you want to use....I chose Nutramigen because it doesn't contain
Nicole Johnson says to (09:37):
cow byproducts
DiabeticDiva says to (09:37):
Gina, I watch my CGM now while nursing and can go from 120 to 60 pretty quickly
Nicole Johnson says to (09:38):
some people hypothesize that cow byproducts may have something to do with type 1 diabetes
Gina says (09:38):
oh wow
ErinOConnor says to (09:38):
I have read that too
DiabeticDiva says to (09:38):
I have to sip on juice. It's hard though when it's a night feeding and I have her in bed with me and just want to snooze!
DiabeticDiva says to (09:38):
That's mostly when I get the hypos... when I'm not paying close attention
landileigh says to (09:38):
Do you need to be close to your medical team while pregnant - like do you need to be there all the time or mainly just for the last trimester?
Nicole Johnson says to (09:39):
ah - don't do it in bed. At least I couldn't. I had a really cushy chair - padded arms and wide in case of lows.
Nicole Johnson says to (09:39):
I flew all over the world while I was pregnant.....I stayed close to home after 33 weeks.
Gina says (09:40):
Nicole, did you fly out to meet Dr. Lois or did everything over the phone
raymatzkin@hotmail.com says to (09:40):
how did you manage your sugars while eating out, traveling etc? I spent my third week of preg in las vegas, and it was a nightmare!!!!!!!!!!!!!!
Gina says (09:40):
and did you work with her pre conception
Nicole Johnson says to (09:40):
The chair thing was a recommendation from my Dr. -- just in case my arms went limp during breastfeeding, they advised that I get an upholstered chair to nurse in.....not a wooden one.
Nicole Johnson says to (09:40):
I met with Dr. Lois in person 3 times during my pregnancy
DiabeticDiva says to (09:41):
Wow. That's very interesting about the chair.
Gina says (09:41):
did you also have a team close by you worked with?
Ellen5037 says to (09:41):
What supplements did you take? Did you take Expecta (DHA)?
Nicole Johnson says to (09:41):
I called her the night I found out I was pregnant....no one else knew until I hit the 12th week. Dr. Lois made me tell people.....I was so nervous something was going to go wrong that I didn't want anyone to know until I was sure the baby would survive.
Nicole Johnson says to (09:41):
In retrospect I guess that was a little silly
Gina says (09:42):
i can understand
Nicole Johnson says to (09:42):
I really thought I would lose the baby because of my diabetes though
Gina says (09:42):
i think i would be the same way
Gina says (09:42):
do you have any tips on finding a good team to work with
Nicole Johnson says to (09:42):
my mother didn't speak to me for months when she learned I was pregnant - she was so angry - again, steel magnolias
ErinOConnor says to (09:42):
wow, that's harsh
Gina says (09:42):
ugh that movie!
raymatzkin@hotmail.com says to (09:43):
my bro is a doctor and making the whole family scared diabetesless
landileigh says to (09:43):
were you on bed rest your last trimester?
kmet13 says to (09:43):
my mom swears she will move 2 another planet if i get preg again...
Nicole Johnson says to (09:43):
She was so worried and could think of nothing but the Dr. telling her to discourage pregnancy on the day I was diagnosed.
Gina says (09:43):
llol
Nicole Johnson says to (09:43):
HA HA
ErinOConnor says to (09:43):
the doctor really told your mother that?
Gina says (09:43):
my mom wants me to be healthy first, prego second
Nicole Johnson says to (09:44):
No bed rest -- my family kept me moving. I was at the gym the day before I went into labor. I was only walking at a 2.0 rate on the treadmill -- but I was there.
Gina says (09:44):
did you do any crazy pregnancy yoga moves!
Nicole Johnson says to (09:44):
Yes, the day I was diagnosed the Dr.s told my mother to make sure I never became pregnant and to try to encourage me to adopt.
Gina says (09:45):
whoa
Gina says (09:45):
my doctor is not like that
Ellen5037 says to (09:45):
:-(
raymatzkin@hotmail.com says to (09:45):
how did you handle traveling and eating out?
Nicole Johnson says to (09:45):
no yoga - i never learned that
he told me when i get in healthy range go for it!
landileigh says to (09:45):
after my daughter was born 18 years ago, they recommended that i never get pregnant again, as the next one would kill me, and i never did
Ellen5037 says to (09:46):
Did someone prepare your meals for you?
Nicole Johnson says to (09:46):
eating out is tough....during pregnancy all I wanted were hamburgers.....i just tried to avoid the bun and anything that wasn't neutral.
ErinOConnor says to (09:46):
my endo and diabetes educators have been super encouraging about pregnancy
landileigh says to (09:46):
the advancements in Diabetes care has changed so much!
Nicole Johnson says to (09:46):
I didn't have anything exotic or interesting
landileigh says to (09:46):
you can be healthy, deliver a healthy child and do it all over again!
landileigh says to (09:46):
look at Kelly Close! she's had 3 babies!
Gina says (09:47):
I want to have one before i get too old1
kellykellykelly says to (09:47):
wow Landileigh that is something. do you think that is right? (and thanks : > i wouldn't wait til i was so old if i did it again! 37, 39, 40)
Gina says (09:47):
old!
raymatzkin@hotmail.com says to (09:47):
burgers, i find the fat kills me and I am sky high 8 hour later, even with dual wa ve
Nicole Johnson says to (09:47):
It is so wonderful to be thinking about and talking about this now....you are right, the advancements are amazing. We can do this.
Nicole Johnson says to (09:47):
Awe - gina, go for it if your A1c is below 7!
kellykellykelly says to (09:47):
yeah Gina!!
Nicole Johnson says to (09:48):
I would love to have more children too!
Gina says (09:48):
i cant get it down! i need help!
Nicole Johnson says to (09:48):
maybe one day
Gina says (09:48):
i am also having a lot of lows
Gina says (09:48):
im working with my team l ike every week
Gina says (09:48):
they have me on speed dial at my CDE office lol
Nicole Johnson says to (09:48):
cut white flour......use fiber......eat the same boring stuff every day!
Gina says (09:48):
I am going on a CGM again next week
Gina says (09:48):
i do
Nicole Johnson says to (09:48):
walk in the morning and at night
landileigh says to (09:48):
YEAH GINA!
kellykellykelly says to (09:48):
and walk after meals
Gina says (09:48):
i am a boring eater
landileigh says to (09:49):
she goes to the gym every night!
Gina says (09:49):
i go to the gym every day
ErinOConnor says to (09:49):
do you overcorrect for your lows?
Gina says (09:49):
its the rebounds from lows
ErinOConnor says to (09:49):
sounds like it might be a good idea to take that extra insulin that nicole was talking about
Gina says (09:49):
yea
Gina says (09:49):
i was thinking the same
ErinOConnor says to (09:49):
:)
kellykellykelly says to (09:49):
if your A1c is under 7.3%, you can get it down MORE if your fasting improves more. the post-prandials impact A1c a lot but especially over 8% or so. if you haven't started checking in the middle of the night that's a good idea.
Nicole Johnson says to (09:50):
I will tell you guys that I am working on a book about diabetes and pregnancy.....Kelly Close is a part of this project too......we are trying to find some consensus on this topic from science. It is tough. We really want to provide something
Nicole Johnson says to (09:50):
of value to women who want to experience this miracle
Gina says (09:50):
i think that it is a book we all need
ErinOConnor says to (09:50):
definitely!
Gina says (09:51):
or we wouldnt all be here r ight! haha
Nicole Johnson says to (09:51):
I agree - there is not anything out there for women with existing diabetes that is readable and understandable!
Gina says (09:51):
and you both went through it already
raymatzkin@hotmail.com says to (09:51):
sorry to say this, but if I read a book that said everything we just talked about, I would want to jump off the roof b/c that is how overwhelming this all feels
Nicole Johnson says to (09:51):
Sweet - feel free to email us with comments and wants for this project
Gina says (09:51):
can you provide your emails?
Gina says (09:52):
i also have your survey up on my website
Gina says (09:52):
i will send it out to everyone again
Nicole Johnson says to (09:52):
It does sound so terrible and difficult, but there are ways that it can be done and there are stories of what others have done that will help you come up with ideas for your life.
DiabeticDiva says to (09:52):
great
Nicole Johnson says to (09:52):
Cool - take the survey!!!
Gina says (09:52):
hold on i will post it up in here right now
Nicole Johnson says to (09:52):
Emails -- MissAmerica1999@aol.com
Ellen5037 says to (09:52):
I'd like to know what supplements were recommended that you take during pregnancy - DHA for example is being studied to prevent onset of type 1 in offspring (example Expecta)...and is being added to formula
kellykellykelly says to (09:53):
i know. Ray - I agree. going through it at least knowing the rough parts are coming is really important though and knowing there is a community. people can always write me at kelly@diatribe.us if they want to talk about anything....huge thanks to Nicole fo
DiabeticDiva says to (09:53):
It is a scary ride ladies, but it can be done and your best resource is knowledge. =) I've had two healthy kids and been T1 for over 20 years.
Nicole Johnson says to kellykellykelly (09:53):
I thought that was you!!!!! :-)
Gina says (09:53):
Here is the survey Nicole was talking about http://diabetestalkfest.ning.com/forum/topic/show?id=855504%3ATopic...
Nicole Johnson says to kellykellykelly (09:54):
The only supplement was Folic Acid and a solid mulivitamin
Gina says (09:54):
Kelly Close in the House!
raymatzkin@hotmail.com says to (09:54):
thanks for the encouragement, it;s only been 7 weeks -- 5 really, and I am exhausted from the intensity of the management
Ellen5037 says to (09:54):
Thanks.
raymatzkin@hotmail.com says to (09:54):
bye everyone
Nicole Johnson says to kellykellykelly (09:54):
Ah - it gets better on the first day of the 2nd trimester!
Ellen5037 says to (09:55):
Will there be suggestions in the book for how family can best support the woman who is pregnant?
Gina says (09:55):
Nicole and Kelly if you want to keep answering question after 10pm you can if not everyone has 5 more minutes of questions
Nicole Johnson says to (09:55):
Not sure if this was up before......the tired factor gets better as soon as the second trimester starts.
Katie I. says to (09:55):
Hi Nicole, I joined this chat late so I apologize if this question is repetitive... I wanted to ask you if you remember when your insulin resistance in pregnancy began? (I am in my 19th week right now and still running low all the time.)
kellykellykelly says to (09:55):
you know, i think it IS exhausting - i found it like a full time job. but come over anytime (where to you live!) to see the good side! and just wait ...til you see the little one!
DiabeticDiva says to (09:56):
Amen Kelly!
Nicole Johnson says to (09:56):
Well, the insulin resistance issue......that was not something I experienced.
landileigh says to (09:56):
well dang, i've been half way cooking all this time!
kmet13 says to (09:56):
I have been t1 for 35+ years and have a beautiful heathy 2 yr old. I would welcome talking if anyone has questions or just wants some empathy - kmet612@epix.net
Gina says (09:56):
JUST HAVING DIABETES IS EXHAUSTING!
landileigh says to (09:56):
kelly, so good to "see" you again!
Gina says (09:57):
i cant imagine what its going to be like with pregnancy t oo ohhh boy!
Gina says (09:57):
my husband is going to really love me lol
kellykellykelly says to (09:57):
yes hi landileigh! how great to have Nicole on! she can tell us SO much as she did her masters in public health on this topic - whew. we are lucky to learn ... i have found it incredibly encouraging to talk to her
ErinOConnor says to (09:57):
heheh, I'm with Gina
Nicole Johnson says to (09:57):
I did experience the natural production of insulin during pregnancy.....that might be what is happening to you. Some women with type 1 - 20% - start to create insulin again because of hormones from the placenta.
DiabeticDiva says to (09:57):
Gina, weirdly enough, I was in the TIGHTEST control of my LIFE when I was preggo. A1c's were 5.0-7.0 the whole nine months. It was crazy.
landileigh says to (09:57):
i think there is alot to learn on this subject!
Gina says (09:58):
Nicole that is really interesting
DiabeticDiva says to (09:58):
Of course... the constant barfing probably had something to do with it.... (sorry.. not helping)
Gina says (09:58):
i wonder if scientists can figure something out with that
kmet13 says to (09:58):
having a support network is key
landileigh says to (09:58):
do they keep producing insulin after the birth? or does it shut off immediately?
Nicole Johnson says to (09:59):
Yes - JDRF is looking at the research.....most of it from Dr. Lois....and trying to expand. Others are interested too. It was a really cool thing to experience. Went away shortly after delivery -- breastfeeding made it hang on marginally for a few weeks
Gina says (09:59):
oh i hope that happens to me! haha
Nicole Johnson says to (09:59):
Really most producation was gone when the placenta left the body. Ugh
Ellen5037 says to (09:59):
Was it recommended to store cord blood after the birth?
Gina says (09:59):
really
DiabeticDiva says to (10:00):
That is crazy!
Gina says (10:00):
that is crazy
kellykellykelly says to (10:00):
wow that is amazing. i found CGM so helpful in 2nd and 3rd pregnancies to monitor stress, extra insulin made, how fat worked in my system in pregnancy, how walking affected it, everything! wow was it a lot of work though. i stored the core blood but like
DiabeticDiva says to (10:00):
You have some seriously cool tid bits of info that I never got from my endo or high risk OB
kellykellykelly says to (10:00):
all else this is super controversial at least at our hospital in San Fran. i did it just in case....
Nicole Johnson says to (10:00):
Cord blood - either store it or check out diabetes donation.....Univ. of FL was doing a ton of research on cord blood and diabetes a year or so ago.
Katie I. says to (10:00):
Nicole, do you think you could have also avoided the insulin resistance by exercising? I've been thinking it's my exercise routine that is keeping me so low... But I am only on like 20 units of insulin / day and I'm still low! It's crazy
Gina says (10:00):
how much was it to store your core
Gina says (10:00):
cord
Nicole Johnson says to (10:01):
That is really low!
Gina says (10:01):
i think it cost my cousin a lot
Gina says (10:01):
20 units!
Nicole Johnson says to (10:01):
My insulin went up to about 80u. a day!
ErinOConnor says to (10:01):
wow
Nicole Johnson says to (10:01):
That was only double - most women go to over 100u - so I am told
DiabeticDiva says to (10:01):
My insulin was at about 65-70 per day in 3rd trimester
ErinOConnor says to (10:01):
I'm at 30 u/day, I thought that was high
kellykellykelly says to (10:01):
wow it was unbelievably expensive. i got a lot of coupons but still was over $1000 each time.
Gina says (10:01):
i know someone they had to take 175 units
Ellen5037 says to (10:01):
Did they check vitamin d levels during pregnancy?
Nicole Johnson says to (10:02):
I didn't store mine.....but wish I had.
Katie I. says to (10:02):
I know, it's insane. I am just wondering when the insulin resistance is going to start. I'm sure it will double or triple.
deeandbee says to (10:02):
you can also store cord blood for research... they'll pay the cost
Nicole Johnson says to (10:02):
I am waiting to hear about my daughter's antibody risk for typw 1 -- this has made me think a lot about the cord blood issue.
Katie I. says to (10:03):
I'm going to check in to storing my cord blood, too, but I remember on the Dr. Lois chat she said she didn't recommend it. She didn't elaborate.
Gina says (10:03):
oh right
Gina says (10:03):
i remember that katie
Gina says (10:03):
Nicole do you know any good diabetes and pregnancy doctors in NY area?
Nicole Johnson says to (10:04):
It seems there is so much left to learn about pregnancy and diabetes and how HCP should talk to women with diabetes.
Nicole Johnson says to (10:04):
Really, we shouldn't have so many questions and we shouldn't feel so isolated.
Gina says (10:04):
none of the doctors talk to you about d and preg unless you ask
Nicole Johnson says to (10:04):
Someone in healthcare is not stepping up to the plate like they should.....or maybe not enough people are demanding it.
Gina says (10:04):
and i dont think they know enough
kellykellykelly says to (10:04):
they havent proven anything positive yet but we have heard if you get it, it is good for any siblings but likely not for the child whose cord blood it is. we did it just in case. must run baby crying ! thank you Gina and Nicole! xox
Gina says (10:05):
bye kelly thank you for coming!
Nicole Johnson says to (10:05):
Bye
Nicole Johnson says to (10:05):
Thank you
Nicole Johnson says to (10:05):
I need to go too....it has been such fun talking with you all
DiabeticDiva says to (10:05):
Thank you Nicole
Gina says (10:05):
thank you Nicole for answering our questions
Nicole Johnson says to (10:05):
I hope you gathered from this that I am enthusiastic about this topic
Katie I. says to (10:05):
Nicole, thank you so much!! And thanks for all you do in the T1 community
Nicole Johnson says to (10:05):
and that I totally support your decision to learn about the process
Gina says (10:05):
I hope you come back again
ErinOConnor says to (10:06):
thank you! yes, it's very eoncouraging
Ellen5037 says to (10:06):
Empowering and interesting. Thank you for taking the time to share.
Nicole Johnson says to (10:06):
Gina, go for it -- get the BG's as low as you can and go for it. (If you are not over 7%)
Gina says (10:06):
I will have this chat t ranscript up tomorrow everyone
Gina says (10:06):
i will send it to you too nicole
Nicole Johnson says to (10:06):
Thanks - please take our survey -- if you are interested in being interviewed for the book, please send an email. We are developing a focus group.
Gina says (10:07):
http://diabetestalkfest.ning.com/forum/topic/show?id=855504%3ATopic...
Gina says (10:07):
here is the survey everyone
Nicole Johnson says to (10:07):
Thank you again!
Gina says (10:07):
thank you!
dandddeb3242 says to (10:07):
Thank you!
deeandbee says to (10:07):
thanks
Tags: and, diabetes, pregnancy
- Attachments:
-
-
Nicole J chat.doc, 106 KB
-
About
© 2009 Created by Gina on Ning. Create a Ning Network!
