This post is on type one diabetes and pregnancy. Please keep in mind this is not gestational diabetes. This is a different ball game. 

I’ve been wanting to write this post for quite some time now, but continue to find myself unsure of exactly what I want to share. My husband and I knew that our pregnancy would be especially difficult due to the type one diabetes. Truthfully though, we had no idea what was in store.

This is my attempt at sharing a few pearls of wisdom I’ve gained thus far…

1. IF YOU HAVE TYPE ONE DIABETES, DO NOT HAVE AN UNPLANNED PREGNANCY. Easy to say, also easy to do. I hear many women say they didn’t “mean” to get pregnant, yet they were not practicing abstinence or any form of birth control. Be responsible with your body. If medication does not agree with you or you are scared of the risk, practice other forms of birth control; there are a lot of options out there (I am sensitive to the fact that there are reasons for unplanned pregnancies, and obviously my advice here may not apply to those special and very sensitive circumstances). Here’s why this is important: the research tells us that not only is blood glucose control important during pregnancy, but tight glucose control is imperative prior to pregnancy. Pre-pregnancy glucose control can not only be predictive of the type of control you’ll have during pregnancy, but it also prepares the woman’s body to bear a child. Just as chronic high glucose destroys our organs, it will destroy our baby as well. Also, like me, most women do not learn they are pregnant until several weeks (sometimes months) into their pregnancy. The first trimester is one of the most crucial to that little baby’s development, so if we’re in good control prior to becoming pregnant or being aware that we are pregnant, we are already setting Baby up for health and success. 

2. LEAN HEAVILY ON YOUR SUPPORT SYSTEM. Don’t try to do this shit alone. I didn’t know how much I would need my friends during this time. Personally, I instantly felt isolated when I learned I was pregnant; I can’t explain well the reason for this, but I felt lonely. Once I was able to get outside of my head on this, I started drawing my friends more near by opening up to them. This, in turn, helped them to know that I needed them in a different (or additional) way than I did before. During this time, I have also found it incredibly helpful to lean into the friendships with women that have children. Even more so – lean hard into the friendships with women that have had a baby and that also have T1. 

3. TALK WITH YOUR PARTNER. By far, my husband is my biggest supporter and cheerleader. But he also cannot read my mind. Having been together for six years, he’s a bit of a type one expert, so he’s definitely got the hang of what the type one life is about. However, having him learn about T1 and pregnancy with me has helped us both support Baby B’s healthy development. Last night we ordered Mexican food, which I was pretty hesitant about. I don’t eat from the taco shop on a regular basis as it is, so this was entirely out of the ordinary. I thought I could manage my post-prandial sugars (these are, by far, the most important blood glucose targets during pregnancy), but the type of food I ate got the best of me. My one hour post-prandial was heavily out of target, and as soon as I communicated this to Danny, he instantly agreed that we won’t eat like this again until after Baby B is here. Those glucose spikes are 100% unsafe for the baby. 

4. THE PRE-BOLUS IS YOUR BEST FRIEND. I’m sure you remember the advice you got from your doctor or diabetes educator at diagnosis: take your meal time insulin 15 minutes before you start your meal. Eventually, the majority of us get away from this habit; if you’re anything like me, you probably bolus when you sit down to eat, leaving no time in between insulin administration and when you take your first bite. In pregnancy, keeping this same habit will destroy your one-hour post prandials (which, for reference, they want at 140mg/dL or below). Pre-bolusing takes a ton of planning and forethought, but it is worth it. See #3, and gain their buy-in on the pre-bolus for when they are the one preparing the meal. I can’t tell you how many times I’ve gotten the “take your insulin” or “dinner will be ready in 30 minutes” text on my way home from work. This is not medical advice, but my magical number is 15-20 minutes before the start of my meal. 

5. BE GENTLE WITH YOURSELF. Verbatim from my therapists’ lips. It is so easy to beat yourself up during these nine months. For me, the guilt I feel when I have an out of range blood sugar is staggering. It is too easy to get wrapped up in this warped mindset that any bad outcome is going to be “my fault”. If you start to feel this way, ask yourself a few questions: Did you correctly count your carbs? Did you pre-bolus? Did you do everything in your power to set yourself up for success, but you happen to have a bad blood sugar outcome? Instead of feeling guilty, assess your approach. If you did everything you could, then correct your blood sugar and move on; don’t allow yourself to wade in the guilt-pool any longer. If you can identify a mistake you made, make a mental note to do it differently next time, and move on. 

6. WEIGH YOUR FOOD. Another back-to-basics concept. I eat so many fruits and vegetables; over the years, I have gotten used to counting the carbs in these items by eyeing them. For the most part, I’m pretty damn good at this. But my guesstimates aren’t good enough for Baby B; by weighing my food, I have a precise carb count, which leads to on-target after meal sugars. I treated myself to a new scale from Amazon for 20 bucks! https://www.amazon.com/gp/product/B0113UZJE2/ref=ppx_yo_dt_b_asin_title_o01_s00?ie=UTF8&psc=1

This will be an evolving post. I’m only 18 weeks into this. I hope this helps someone somewhere 😉

Cheers,

Kelly