Hi Becca! I was as nervous as you sound. Diagnosed at age 13 and finally ready for kids at age 29, I had plenty of time to worry.
I saw Florence Brown at Joslin in Boston. She was fantastic. I checked my glucose 12-14 times per day. I got my A1C down to a 5.1. I obsessed, also afraid of one high reading. While pregnant with my first, I saw 200 mg/dL and sobbed.
Not to worry! It turns out that an occasional excursion does absolutely no harm AND seems completely unavoidable! Your hormones will be going nuts, weight changing… perfection is impossible. At first, your insulin needs may decrease slightly. By the end however, my insulin needs were more than 5 times higher. I drained my pump reservoir with my basal rate alone in one day and used syringes for boluses. I needed to take insulin 30 minutes before eating, then “enjoy” my low-carb meal. My doc recommended a high protein snack before bed and check for ketones in the morning. I had to take insulin to cover the dawn phenomenon when I woke then eat breakfast a little later.
Large babies are normal for my family. My grandmother had 6 kids and no diabetes; none were under 9 pounds.
First baby induced at 38 weeks:
8 lbs. 1 oz., 64 mg/dL, no NICU
Twins at 35 weeks 5 days:
8 lbs 1 oz, NICU 8 days for apnea due to age
6 lbs 13 oz, NICU 24 hours to monitor glucose
Fourth baby, 39 weeks:
9 pounds 13 ounces, 49 mg/dL, no NICU but glucose checked for 24 hours
Now, baby #4 is a post-tubal-ligation miracle. I was 35, unprepared for pregnancy in every way and was a completely overwhelmed primary caregiver for 3 young kids throughout. (Two thumbs down. Don’t try that at home.) When I found out I was pregnant, my A1C was 6.8 (I got it down to 6.1), I was at least 30 pounds overweight, and my lifestyle was… just survival. Very stressful. (Twins babies/toddlers are intense.)
So far, all my kids are completely healthy. You get extra OB visits, tests, etc… It IS a lot of extra work, but not to worry! You can have T1D and healthy babies (twins! Surprises! You never know!). No point in worrying anyway: it just messes up your blood sugar.
My average non-pregnant A1C is around 7 (6.5-7.2 maybe). I am not motivated to make glucose control top priority unless my child’s well-being is at stake, evidently. Sure, 40 weeks seems like a long time to engage in extreme behavior (e.g. no dessert?!?), but when you see the little flickering heartbeat, it really is inspiring. It is easy to do anything, give up anything, to keep your child safe. Gestation is less than a year. When faced with a lifetime, (up to) 40 weeks of pregnancy is nothing.