Pre-conception clinic for diabetes.

Toni - posted on 08/04/2009 ( 27 moms have responded )

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I've been diabetic for a couple of years now. And the OH and I are planning to start trying for a baby in October. I had my 6 month check up at the diabetic clinic today, told the nurse of our plans and she has suggested we go to a preconception clinic before hand. I know my glucose levels are good and my nurse was very happy about the weight I've lost and the control I've gotten over my blood sugar, to the point where I can now come off my insulin!!!! But I would be interested to know if anyone else had been to one of these clinics for diabetes and if they found them helpful.

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I had a C section w/ my daughter- and i truly believe that it has caused me to become infertile. They say C sections can. My doc was so in a rush to get the baby out of me, when she could have just labored me down and waited until the baby turned it's head. Oh well, theories and time too late. I have a beautiful smart daughter, but no telling if I'll ever be able to concieve again- so far 3 years of trying and nothing.

Toni - posted on 08/27/2009

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Thanks for that Elizabeth. Although I have not been confirmed pregnant (to early yet), there is a chance that I could be and I was told to come off of Metformin before I started trying for a baby. The reason being because Metformin is not licensed for use in pregnant women in this country. So the morning after our little accident I stopped taking the Metformin. But since reading some replies on here and a little investigating on the web, I've decided to go back on it. I've heard that Metformin is used in the treatment of PSCO in this country, even though once the mother is past the 14 wk period she is taken off of it. I don't know if the doses are much less then mine. I'm currently on 1500mg a day - 500mg with each meal.
I don't know why Metformin isn't licensed for use with pregnant women either. I can't find an answer to that question. It may be a valid reason based on research or it may not.
Once I am pregnant, over here in the UK I will automatically be assigned a diabetic consultant, a diabetic OB as well as the normal community midwives. I have had one baby already, but the difference being, I wasn't diagnosed as being diabetic until my 24th week, so I'm not sure of the difference in treatment for those weeks beforehand.
I also had a c-section due to failure to progress as well as the baby got into distress. I don't know if I would have to have a c-section again, if I could choose to or would be expected to have a V-bac. I'm not sure what my options are. I don't think I would mind either way so long as there is no risk to baby.

Elizabeth - posted on 08/27/2009

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Good Morning. I also wanted to send out some encouragement. I work with pregnant women (I am not a doctor or nurse) who are high rish for many different reasons. Some of which are diabetic and are on metformin and insulin before they are pregnant, or after they become pregnant. Toni, my first recommendation to you would to be look into the different OB practices in your area. Because you are diabetic, you want to be followed by an OB who has experience with diabetics. Many will refer their patients to Internists to manage the blood sugars or they will refer to a Perinatologist, if one is available in the area. Our community has only 1 board certified Perinatologist and she is amazing with the diabetics. As far as the c-section question, I would ask that as well. In general, most do not just dive in and do c/s on first time moms unless there is indication; breach presentation, distress to mom or baby during delivery, size of baby, etc. I know that State wide that the rate of c/s for first time moms is something that is being looked at, especially since many physicians are not choosing to offer vbac (vaginal births after c/s) any more. Always remember to continue with your medication unless otherwise told by your doctor, ALL medications. That was a general reminder. Too many times we try to educate ourselves, without knowing that the warnings that are out there can be based on 1 incident. Although I generally get this more with antidepressants than any other medication. Good luck to all of you!

Mindy - posted on 08/26/2009

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Hi - I just want to encourage you - I have PCOS and I took Metformin during our In-Vitro and throughout the whole pregnancy. I am currently breastfeeding and still taking 1000mg a day. It is safe and may even help prevent miscarriage.

Toni - posted on 08/24/2009

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Quoting Erin:

i'm not sure why your dr told you you couldn't be on metformin. i was diagnosed with pcos and was told to take metformin to get pregnant (like a lot of women). I know a LOT of ladies that have gotten pregnant on metformin and been told to stay on it throughout pregnancy to help with keep every thing leveled out.i ended up getting prg without it but they told me when i got pg that if i was taking it to stay on it.


Apparently Metformin isn't licenced for use during pregnancy in the UK. Not enough studies have been done and therefore insulin is considered the safer option.

Emma - posted on 08/22/2009

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Quoting Toni:

My most recent HBA1C was 6.7. Before that it was 7.4 and before that it was 6.4. The 7.4 result was after Christmas so I guess that might be why that result was a little higher. I don't really know much about the HBA1C test but have been told my results are very good. I'm hoping the pre conception clinic agree as I'm not sure that I can get them any lower without going back on insulin and whilst I know I'll have to be on insulin once I start trying for a baby, I don't want to go back on to insulin just yet.



your HBA1c's are excellent. Mine were something like that and I was told when I rang the pre-conception clinic to cancel my appointment I had b/c i was already pregnant that these were good and it was safe for me to be pregnant. They only send you to pre-conception clinic to do more tests and make sure everything is ok for you to become pregnant. Good luck once again

Emma - posted on 08/22/2009

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Pre-conception clinic isn't what it's hooked up to be if I'm honest. I've been type 2 since last november and I'm now about 10 weeks pregnant. I went to my gp the week before I found out I was pregnant and explained we were trying for a baby so he referred me to the pre-conception clinic but obviously it was pointless me going b/c I was already pregnant. As long as your blood sugars are in the norm then everything will be smoothly. They say women with diabetes have trouble conceiving but I didnt b/c I was pregnant within the first coupld of weeks of coming off the pill. Good luck with everything. I have set up a group for women with diabetes and women with children with diabetes it would be a pleasure if you joined if you havent already. Kind regards

Rachael - posted on 08/21/2009

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I also questioned metformin when the diabetic doctor prescribed it for me and I asked if it is safe during pregnancy. My diabetic doctor told me that this is what they use for pregnant women in the 3rd world where insulin is not readily available and is perfectly safe. I took one 500mg tablet per day and my DD was perfect, thank God. You don't need to worry about metformin IMHO.

Sandee - posted on 08/07/2009

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knowledge is power so why not go. Beside is for your baby. Maybe you are under control now but maybe they have more information for you. Beside they are there for reason right? Good luck and God Bless.:)

Erin - posted on 08/07/2009

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btw, i recommend going to this site www.tcoyf.com. there are a lot of ladies there you can talk to that might give some awesome advice. :)

Erin - posted on 08/07/2009

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i'm not sure why your dr told you you couldn't be on metformin. i was diagnosed with pcos and was told to take metformin to get pregnant (like a lot of women). I know a LOT of ladies that have gotten pregnant on metformin and been told to stay on it throughout pregnancy to help with keep every thing leveled out.i ended up getting prg without it but they told me when i got pg that if i was taking it to stay on it.

Toni - posted on 08/07/2009

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My most recent HBA1C was 6.7. Before that it was 7.4 and before that it was 6.4. The 7.4 result was after Christmas so I guess that might be why that result was a little higher. I don't really know much about the HBA1C test but have been told my results are very good. I'm hoping the pre conception clinic agree as I'm not sure that I can get them any lower without going back on insulin and whilst I know I'll have to be on insulin once I start trying for a baby, I don't want to go back on to insulin just yet.

Shelley - posted on 08/07/2009

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i have had type 1 diabetes since i was 8 months old and am now 27 it took hubby and me over 8 years to conceive i never found the pre conception diabetic any help but think thats because i live in a remote area. my hba1c while pregnant was 7 but back up now to 11 which isnt good i know. i now have a healthy baby daughter who was born 4 weeks early by ecs as they tried to start labour it never worked she weighed 8 lb 10 and a 1/2 but shes perfectly healthy. i was glad that i had c section didnt go into labour or end up with stitches down below. ok your sore for a few days afterwards but you feel nothing at the time

Kendra - posted on 08/06/2009

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Every pregnacy is different I had a c-section with my first and vaginal with my other two. I was very closly monitered in my second and third and my dr said there was no medical reason for a planned c-section.

Nicole - posted on 08/06/2009

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I agree with Elena.... every mommy and baby are different. There are so many reasons any woman healthy or not so healthy can have a c section. Be thankful there is an option for C Section.... not afraid.

Elena - posted on 08/06/2009

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Quoting Michelle:

I don't agree with the whole c-section thing. I had my daughter vaginally and everything worked out fine for me. My doctor has told me that there is no reason to do a c-section unless they feel the baby is to large (which is common in diabete pregnancies).


Actually Mchelle, gestational diabetes is not the only reason why doctrs perform c-sections.  I had one because my son was frank breech and there was not anough amniotic fluid to turn him around.  That is great you had your daughter vaginally.  but there are many reasons c-sections are nesceary and you may not be informed enough to be scarying people out of haivn them.  My second child was born emergently 4 weeks early becasue of elevated liver enzymes.  And again they performed a c-section.  They could have given me petosin and tried a VBAC delivery but after hours of being in labor my uterus could have torn  and I may have need a c-section anyway.  Every single birth is different.  Some are easy and some are difficult.  Everone has their own stories about what worked for them and what didn't.  Some vaginal deliveries turn out wonderful as well as some c-sections.  And then there are sad cases for both vaginal and c-sections.

Elena - posted on 08/06/2009

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Quoting Michelle:

I don't agree with the whole c-section thing. I had my daughter vaginally and everything worked out fine for me. My doctor has told me that there is no reason to do a c-section unless they feel the baby is to large (which is common in diabete pregnancies).


Actually Mchelle, gestational diabetes is not the only reason why doctrs perform c-sections.  I had one because my son was frank breech and there was not anough amniotic fluid to turn him around.  That is great you had your daughter vaginally.  but there are many reasons c-sections are nesceary and you may not be informed enough to be scarying people out of haivn them.  My second child was born emergently 4 weeks early becasue of elevated liver enzymes.  And again they performed a c-section.  They could have given me petosin and tried a VBAC delivery but after hours of being in labor my uterus could have torn  and I may have need a c-section anyway.  Every single birth is different.  Some are easy and some are difficult.  Everone has their own stories about what worked for them and what didn't.  Some vaginal deliveries turn out wonderful as well as some c-sections.  And then there are sad cases for both vaginal and c-sections.

Charie - posted on 08/06/2009

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I have had type 1 diabetes for 24 years. We tried to have a baby for 12 years. We tried everything. One day we had a big suprise!! We were pregnant on our on. With the help of 2 great doctors (my OBGYN and my diabetic MD) my sugars done great throughout my pregnancy. At 28 weeks my blood pressure got high and had to deliver at 29 weeks by c section. He weight 2-lbs and 5-oz. Little but healthy!! I could not help but go over in my mind that I missed out on everything by having a section. I thank the good Lord above for all he has given me. I feel like now that I did not miss a thing! I got what I prayed for and so what if things did not turn out the way I thought it would. I got a healthy most loving little boy I could ask for. Just be blessed and dont worry about the small stuff. Keep a good check on you blood sugars and above all keep God in the center of everything!! Good Luck!!

Toni - posted on 08/06/2009

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You had Metformin during pregnancy??? I was told that it's not licensed and to make sure that I'm completely off the Metformin before we start trying to conceive. I have to slowly wean myself off of it and onto insulin again. (I've just managed to lose a lot of weight and come off of insulin to Metformin only, in preparation for having another baby)

Rachael - posted on 08/06/2009

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I have type 2 diabetes and also ended up having an ECS as at 7cm my baby's heart rate kept dropping and they didn't know why so they pulled her out by c-section and thank God she was ok. I on gthe other hand found the whole thing to be extremely traumatic and honestly would not want a c-section again (I had my son 12 years ago naturally so have now had both and nothing compares to giving birth naturally IMHO). However, I agree with Toni, putting mine and the baby's health first, if I had to have another section then so be it. I was also advised by my diabetic nurse at the hospital to see her before TTC. I assume it's to check I'm controlling my sugars well and am oitherwise healthy to carry another baby. My last pregnancy threw my diabetes way out and I ended up on 215 units of insulin a day (plus corrections!) and Metformin, so I guess I need all the help I can get! lol

Toni - posted on 08/05/2009

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Hi Michelle
I would love to have a vaginal birth as I do feel that to some extent I have missed out on something wonderful. But I have already been declared to be built on the small side down there and as Christina said, the risk with diabetic babies is that they tend to have big shoulders and can get stuck.
With my first pregnancy I was fully dilated, contractions coming thick and fast but baby would not/could not come down the birth canal. In the future I would elect for another c-section because the risk in labour are too great for a diabetic baby and me. Although I would love to experience a vaginal birth the health for myself and most importantly for my baby would surpass all of my 'wants'.

I wouldn't say all diabetic mothers should opt for a c-section, but after my previous experience I know what is right for me.

--- - posted on 08/04/2009

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actually michelle the reason a section is a good idea is because it is very common for babies of diabetic moms to be born with enlarged sholders even if the blood sugars are controlled and even if the child is not born large. My baby was less than 8 pounds and my sugars were rarely over 5.9 which is pretty good for being pregnant with diabetes.
they can not tell by ultrasound if your baby will have sugar deposits or enlarged shoulders so it is really touch and go.
while a vaginal birth is possible I really recommend people to take the safe route of a section. like I said my baby was small but because of enlarged shoulders due to sugar deposits she got stuck and has brain damge. this is more common than doctors let up.

Michelle - posted on 08/04/2009

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I don't agree with the whole c-section thing. I had my daughter vaginally and everything worked out fine for me. My doctor has told me that there is no reason to do a c-section unless they feel the baby is to large (which is common in diabete pregnancies).

Michelle - posted on 08/04/2009

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I have been a diabetic for almost 8 years now. My daughter was a suprise and everything went well! As long as your sugars are controlled and everything seems to be doing alright I wouldn't worry about it. Do you see a specialist for your diabete's? I have one and she just told me that if my hubby and I want to try for another just to make an appoinment with her, she'd check me out and then we'd be good to go! Good luck!

--- - posted on 08/04/2009

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honestly I have never been to one but with a guess of having type one for so many years they are probably pretty standard. go over your blood sugar levels, tell you how the pregnancy could affect your blood sugars. remind you to start taking the prenatal vitamins now or at least a folic acid tablet. you will most likely see a nutritionist who will go over your current food plan with you and suggest any changes if they feel they are needed. I am assuming that you know all about carb counting and choosing foods on the low end of the glycemic index. (I learned this on my own as they never talked much about the glycemic index when I was diagnosed but if you have not heard about it urge you to google it as it makes a huge difference in your glucose readings) If you went to diabetes pregnancy clinic it is probably much the same as that

Toni - posted on 08/04/2009

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Thanks for your reply Christina.
I found out I had gestational diabetes when I ws pregnant with my little girl at 24wks, which is quite early on or so I was led to believe. I was monitored closely and induced at 38wks due to DD being supposedly too big....over 10lb!!!. (She was actually only 8lb 13oz) I also had pre-eclampsia at this point too. After 18 hrs of a painful back labour we were whisked away for an emergency C-section due to failure to progress and the fact that my DD heart rate was failing.
After the birth my midwife that had given me the prostyn before finishing her shift came to see me to see how I'd gotten on. I told her everything and she told me that she wasn't surprised that I'd had to have a C-section because she could tell when she gave me the prostyn that I built on the small side. I shall probably elect to have a c-section again.

Anyhoo!!, I guess I just wondered what these preconceive clinics were all about, what do they do and are they helpful?

--- - posted on 08/04/2009

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I had a surprise pregnancy with my daughter and I have been type 1 since 1997. Preconception clinic is not necessary. If you know your body and have done your own research and your blood sugar is in good control then there is no reason to attend this clinic. I suggest reading a book on pregnancy and diabetes.

Having a well maintained glucose level throughout your pregnancy will ensure you a healthy baby. One thing I do want to recommend is to opt for a c section even if they tell you that it is not necessary. I had my daughter at term and she was a healthy 7;12. they refused me a section and she got stuck and had severe dystocia. (extremely common in diabetes) she was basically dead when she was born and now suffers developmental delays relating to brain damage due to lack of O2 at birth. had I ben given the section that would not have happened.

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