Diabetes and Pregnancy

posted in: Diabetes | 0

***DISCLAIMER*** This is NOT meant to be medical advice!  This blog post is strictly about my experiences with diabetes and pregnancy.  The thoughts and ideas are only those, not my medical opinion to be dispersed to others.***

I also apologize to those of you who don’t understand diabetes jargin… do ask if you have questions.

  So when you’re Type 1 diabetic before you get pregnant your endocrinologist will want your hemoglobin A1c to be below 6.0… Good luck.  I’ve tried.  It’s super hard.  I’m by no means perfect but low 7’s is the best I could do.

Darrin and I weren’t pushing to actively have a baby, but we certainly weren’t preventing it.  We were taking an approach so as not to put pressure on the situation and just let it happen if it was going to happen.  So I was trying for a lower A1c reading and BOOM I found out I was pregnant.

Most moms and dads to be start out by just worrying about calling their OBGYN.  Nope, not us.  First call, OBGYN.  Second call, endo.  Third call, Dexcom.

Obviously I needed to make the OBGYN appointment but the endo needed to know for several reasons.  MOST endocrinologists will not see you while you are pregnant.  Mine is one of those, which I knew ahead of time.  So I needed to be sure all of my prescriptions were up to date and I needed a referral/prescription for a continuous glucose monitor or CGM (Dexcom).  The CGM was my personal choice, and I’m glad I chose to do so.

Once I saw my regular OBGYN we decided to co-manage with a high risk OBGYN, often known as Maternal-Fetal Medicine (MFM).  We went with the co-management option because the closest MFM was a bit of a drive, about 30 minutes and the hospital for delivery is about an hour away.  So MFM was in control of diabetes and making sure Harper was doing ok as it relates to diabetes, and the regular OB was in charge of all other things.  Thankfully, they were part of the same network and could easily see my chart whenever they needed to.

My target blood sugars were supposed to be between 65 and 95 before meals, and no higher than 130 two hours after.  I hadn’t tested my blood sugar this much since I had done pre-basal testing before I went on a pump some 15 years before this.  I was checking some days 8 times, but others closer to 15.  Even with the CGM I was testing to make constant adjustments.  I did my best to keep numbers down.  I got to the point where I could go a couple of weeks without a 200 reading.  Usually if I was even that high it was because I misjudged a carb count.

I must say, the trickiest part though was the amount of insulin that I was using.  It seemed like each tri-mester brought more insulin.  It took a long time to not feel like I was low all the time because my targets were low, but man if I hit upper 100’s I knew it so it seemed like no matter what the blood sugar was- I was getting additional insulin.

By the time I had Harper my insulin to carb ratios seemed like a joke.  I was getting 1 unit of insulin for ever 2, yes TWO, carbohydrates (to put that into perspective for some of you, a chocolate chip Chewy granola bar has 17 carbs).  Lunch was about 1:4 and dinner was about 1:7.  Those have gone back up to normal by about 3 hours after she was born, plus not to mention by basal rates.  I was told to expect to be using about 3 times your normal amount of insulin by the time you start nearing the end of pregnancy… They were right.  My pump only holds about 200 total units of insulin.  So I started filling it less and using syringes to do shots for my meals instead of giving insulin through my pump.  It was easier, faster, and more cost efficient in the long run.

The other part that was hard… coming back up from a low!  I usually take about 30 carbs to come up from a low and it only takes me about 15 minutes or so… Nooooo not while pregnant!  It would still take 30 carbs, but it would sometimes take an hour and I would treat a couple of times.  Then about 2 hours later, I’m trying to bring myself down.  There were some days that it was an endless cycle.  But, thankfully there were some days that it wasn’t so bad.

As hard as it was to run the uphill battle against diabetes while pregnant, I have to say that I think I’d rather be type 1 and pregnant than have gestational diabetes.  At least I’m used to all of the monitoring and carb counting, adding the changes of pregnancy and it’s just a little harder.  But to have to be pregnant with all that it entails, and THEN be told you have to learn a new way of life- no thanks.

The reason for all of this?  Moms who are diabetic are high risk pregnancies.  We have a higher incidence of having “super babies” but with tight control can hopefully have a happy, healthy, baby.  Babies that are born big have a higher incidence of having diabetes (1 or 2) later in life.  Because of this we are monitored very closely.  An ultrasound at a minimum of every 4 weeks, and non-stress tests once a week and ending up twice a week.  This is all, of course, provided that everything goes according to plan.

For me, everything went great!  My blood pressure decided to jump about a week early and we induced but it ultimately lead to a c-section.  During the whole process I was in complete control of diabetes and we did really well!  Harper’s blood sugars were in target the whole time (at birth and every time she ate for about 12 hours).  The whole process is long enough for a whole other blog.

I’m just glad it all went well and Harper was born at a healthy 7 pounds 15 ounces and a long 21 inches.  I know some of my diabetic friends will read this and for those of you who are and are thinking about this stage of life- don’t be scared.  You can do it.  It is amazing how well you take care of yourself when you’re growing another human.  Plus, as you already know, we’re all here for each other, and those of us who have been through it will certainly help you out where we can!

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