I never questioned whether or not I wanted to be a mom. I was a little girl who catalogued every personality trait of her twelve Cabbage Patch Kids (four of which happened to have type 1 diabetes) and who planned out exactly how many kids she would have someday and what their names would be and what color eyes they would have: one brown-eyed child, one blue.
When I was diagnosed with type 1 diabetes at age 10, one of my pediatric endocrinologist’s first reassurances to my parents was that I’d be able to have healthy pregnancies someday. I didn’t even know it was something I should have been worried about. And, after that reassurance, I really never worried about what a pregnancy with type 1 diabetes would entail until I got there.
I was 25 years old when I saw my first A1c under 8.5%. By the time I was married at age 28, my A1c was the lowest it had ever been – 7%. I was at a crossroad where I was emotionally ready to start a family but had to honestly assess where my diabetes management was. My healthcare team wanted my A1c at or below 6.0% before trying to conceive. This target seemed positively impossible for someone with my A1c history.
It was 2008. I turned to the Internet and discovered the marvel that is the Diabetes Online Community. On TuDiabetes.org in their Oh! Baby!!! group, I found women just like me. Just. Like. Me. They were close to my age, wanted to start families, and some of them were a step ahead or only a step behind where I was in the process. I found a wealth of information and support. Six months later, with an A1c of 6.1% and so many helpful words of wisdom put into practice, I began trying to conceive my daughter.
In the six years I have been a part of the Diabetes Online Community, I have seen so many would-be mommies realize their dream. I’ve had the pleasure of watching my two children play with theirs, of squeezing chunky baby thighs and discussing non-diabetes-related parenting topics like whether or not you carry crayons in your diaper bag.
I’ve also seen too many women struggle. Too many women bombarded with bad information. Too many women whose medical teams seemed unsupportive, uncooperative – supposed caregivers who feel that scare tactics are the way to whip a diabetic mommy into shape.
I want to offer those women some of the encouragement and support that I’ve enjoyed over the years. To do so, I’ve reached out to some of my favorite moms with diabetes in the online community and asked each of them what pearls of wisdom they would offer to the wanna-be moms, pregnant moms, and new moms who also carry the burden of pre-existing diabetes.
Kerri Sparling, author of Balancing Diabetes: Conversations about Finding Happiness and Living Well and of the blog Six Until Me, says “Diabetes is tough. We know that. Diabetes and pregnancy is tough, amplified. But don’t let the diatribes about “what could happen” sway you if you are planning to pursue a pregnancy and you have diabetes.”
Heidi Shell, hard-working nursing student and writer of the blog The D-Log Cabin,says, “In pregnancy, I was a worrier. Every pregnant woman is to some degree but a woman with diabetes is much more likely to be so. I did my best in the day-to-day grind of things: eating well, managing blood glucose as well as I could, going for extra doctors appointments, taking my meds. Extreme worrying was my new hobby (fueled in part by my doctor’s oft dire predictions.) Doctors may tell you worse case scenarios, which (as a first time mom-to-be) will scare you, but the future isn’t written in stone and I wish that I hadn’t taken every word from their mouths as absolute truth.”
Jacquie Wojcik of the blog Typical Type 1 and author of a must-read piece on diabetes and pregnancy at What to Expect.com couldn’t agree more. “I wish I hadn’t known about all the things that could have gone wrong with my pregnancy, and that I could have focused instead on all the things that were going right. We get so used to our bodies being broken, so it’s that much more important to focus on the cool stuff, like baby building. I still can’t believe I pulled it off.”
Tziporah Rosenberg, mom of one gorgeous and vivacious three year old girl, wishes instead that she had been told that “you can enjoy your pregnancy with diabetes. It was the best time of my life, you know, until the baby was born. You can still have a normal-ish pregnancy. But, she wishes she had been told up front that “diabetes just doesn’t behave during pregnancy. It becomes like a kind of diabetes I’d never known…alien diabetes. This is why I learned to test a bajillion times a day; since every day was a new one, and things changed quickly, testing was the only way I could keep tabs and correct as best I could.”
Kate Boylan, mother of a beautiful four month old boy and writer at the blog Tenaciously Sweet also learned the importance of frequent blood sugar checks as a way to trust that she was on top of her pregnancy management. She says that her “most important piece of advice to future parents with diabetes with is to be gentle with yourself, most especially in the beginning.”
Karmel Allison here at A Sweet Life says, “it was easier than I expected based on what everyone told me!” To help maintain tight control over blood sugars in her pregnancy with type 1 diabetes, she recommends “CGM, CGM, CGM. Get one, and learn to love it.” Karmel reminds us, also, to take care of our blood sugars post-partum, as well: “Don’t forget that pregnancy is a whole ton of work just to get up to the starting line, and everything really starts when the baby is born. That includes blood sugar management. Don’t let all your dedication during pregnancy disappear as soon as the baby is born, for the good of both of you.”
If you don’t have access to a tool like a CGM, however, do not despair. Kristin was the first person I met in the TuDiabetes Oh Baby group and is, to this day, my “dia-bestie.” She says, “I managed my pregnancy without a CGMS, but the secret to stable blood sugars came from reducing the number of variables. I ate six times a day eating the same types of food at the same time every day (more detailed on my diet here). This meant that when I adjusted my basal rates and insulin doses for meals, there was less likelihood for error. This consistent schedule (which my endo insisted on) ended up working great for me. Also, I think that eating every three hours from the beginning helped me avoid nausea and hunger.”
Jen Jacobs, contributing writer here at A Sweet Life, says, “My best piece of D+P advice is to take care of yourself! If there’s ever a time to be obsessive about your diabetes, it’s now. Keep your A1C in range. Test often: ten…twelve…fifteen times a day if you have to. Speak up for yourself. If you need special accommodations at work, ask. Everyone likes to help a pregnant lady!” Like Kristin, she found paying careful attention to her diet helped reduce variables. “Avoid restaurants,” she says. “There’s too much uncertainty. Those hidden breadcrumbs in your burger will appear in your blood sugar later and it’s not worth the worry.”
I have no regrets about how I managed my pregnancies with either child. I took care of myself, I found a healthcare team I really trusted, I checked my blood sugar every few hours and caught problems as they happened (with the help of a CGM), and today I am the mom of the two kids I planned to have: one brown-eyed child, one blue.
Jen Jacobs sums up what I believe we are all trying to tell you, encouraging that you should “most importantly, keep a positive attitude. Know that you can have a healthy pregnancy and a healthy baby. It takes tremendous effort, discipline, and courage. But the 40 weeks flies. And then you have the best gift in the world. Happy Mother’s Day!”
Additional recommended resources for Diabetes and Pregnancy:
Melissa Lee writes the blog Sweetly Voiced.