My story: I have a 6 months old and thinking about #2 already… about six months before I got pregnant the first time I tried really hard to get my A1C down while maintaining that (sometimes elusive) normoglycemic stability… I found that low carb and dexcom stalking worked well for me, personally. I am happy to have had a successful pregnancy. Now I am trying to get all my stuff together as I plan for the next (and maybe even one other)… unlike many, I chose not to see a giant team of specialists. I was seen by and delivered by a high-risk practice,
While managing my own diabetes throughout (You can read more at walkthedragon88.blogspot.com)
What about you? Is pregnancy daunting? How do you address it? Have you found that having kids adds motivation to be diligent about diabetes management, pregnant or not? Do you prefer to manage things yourself or have a health care team intimately involved? Why? 
Hi! Congratulations on your 6 month old and for already considering #2! I have two daughters, now ages 13 and 7. My experience with both was with a giant team of specialists. (Boston’s Beth Israel/Joslin program) There are positives and negatives to this sort of program. I am definitely the type who prefers to observe and manage on her own, requesting input from specialists as necessary. As you can imagine, this is NOT how the Joslin program worked. There were times that I had to stand my ground to go against protocol that just didn’t work for me (pump therapy just isn’t for me); I also had to involve my scientist husband to fight to continue to use Lantus (not then approved in pregnancy) vs NPH after I declined the pump. In retrospect there were “invasive” tests performed on what appeared to be (and were) two perfectly healthy pregnancies. The fetal echocardiogram resulted in a 4-6 week scare that my 2nd daughter had a heart defect. After the second scan it was perfectly resolved. So there were tests that I wouldn’t think necessary unless a specific issue within a specific pregnancy recommended them. For me, having the giant team may have resulted in more stress than going with a simple MFM option and being referred out to specialists as necessary, not just as a “diabetic risk profile” determined.
For diabetes management and motivation, my two pregnancies were slightly different. In my first, I was terrified. I was scared that a high or a low could cause lasting damage to my baby (it won’t). I had “morning” sickness throughout most of the pregnancy and was throwing up all the time. Trying to eat when my stomach was saying no way lady. Had A1cs ranging from 4.9 to the low 5s. My endo was worried about me driving b/c I was always teetering on lows. I was constantly testing and adjusting. And I had a healthy, wonderful baby. For pregnancy #2, I was just so much more confident in my own ability to manage things. I declined some of the tests and many of the monitoring appointments (especially at the end of the pregnancy – in my mind you shouldn’t wear too many belts and suspenders). It is stressful to be constantly driving to the hospital for a test that you know will come out fine. I set a higher A1c goal for myself (it is wonderful that CGM is reliable now - this must be an invaluable tool for the crazy blood sugars of pregnancy!). This time I was more relaxed, strangely didn’t have the morning sickness, and had another healthy wonderful baby.
I think when you are diabetes-educated and motivated you should feel comfortable choosing the primary members of your team. Pregnancy is intimate and wonderful and can become overwhelming, so having a loose “pregnancy plan” for yourself (that of course you can modify on the fly as necessary) can be helpful. The very best of luck to you! Jessica
I love this topic and hope to see it grow as the site does. I am amazed by the preparation required going into a pregnancy with diabetes. Since my diagnosis didn’t come until the middle of my third pregnancy, I didn’t have the level of prep work that you mamas did. Hats off to you!
And I’m thrilled to read, @walkingthedragon88, that you are considering #2! Our #s 2 and 3 came almost 13 months apart, and it has been such a delight to have them so close. Wouldn’t change a thing!
I didn’t have a CGM during the pregnancy. Wish I had, and just as a side rant, I think any mama on insulin during a gestational pregnancy should have one. I had no training whatsoever for insulin. Didn’t get to meet with a DE—just handed syringes and vials (not even pens) and sent on my merry, terrified way. Having a CGM would have taken away so much of the fear! And helped me handle the insane hormone surges with more confidence.
One of the things that I find most strange about pregnancy management with diabetes is the wide variance of bg targets issued by doctors. I’d say, YDMV, but it seems to be a top-down variance that is often out of step with tighter control. My doctor knew very little, as it turns out, about some of the other complications I experienced during pregnancy, but he did recommend really tight control with a 120 postprandial target. In retrospect, I am really, really glad he did. It set me up for being motivated by any numbers over 120 and probably set me on my course for maintaining a tight A1C post-delivery.