Pregnancy and Type 1 Diabetes: When Can I Expect That Glow?

I am not spontaneous nor am I carefree. I make lists about things that don’t need to be listed, and every time I leave my apartment, I stock my bag with enough diabetes supplies to manage a small village of people with diabetes. So it’s probably no surprise to you that I started to think about getting pregnant a whole year before I wanted to get pregnant. In preparation, I began to use an insulin pump, got my A1C under 6%, and started to take prenatal vitamins. I even purchased an ovulation kit, which I stored in my bathroom cabinet until it expired.

When the time came and my husband, Gary, and I felt ready to have a baby, I had nothing left to do except pick up a new ovulation kit. I bought several. Even though I had tight blood sugar control and no fertility issues, I assumed I’d have trouble getting pregnant.  I didn’t.  I got pregnant with little drama.

When I read the positive result on my pregnancy test, I was in such shock that I sat on my couch and didn’t speak for hours. (It may have been twenty minutes, but it felt like hours.) I felt like a miracle had occurred in my body – the body with the faulty pancreas – and if I spoke, it would all fall apart. Of course, I couldn’t contain myself forever; I called Gary at work and shouted through the phone, GUESS WHAT? Gary was thrilled and said we’d celebrate that night.

Next I called my mom, but she didn’t pick up, so I sat with my news and started daydreaming. My mind took me back to 1996, the year of my diagnosis. I was twelve years old, sitting in my parents’ den, eating graham crackers with Grandma Miriam. As Grandma watched me draw my insulin shot, she casually mentioned that pregnancy cured diabetes. (Yes, you read that right.) She had heard this from one of her ladyfriends at the Y.

My eyes bulged and I said, “Grandma, that’s crazy!”

But a part of me wanted to believe her.

Grandma just shook her head. She was the type of woman who knew her stuff, and if you disagreed, she’d say, “Psh,” or, in her heavy Yiddish accent, ask, “What’sa metter wit you?”

I had no choice but to tell her we’d wait and see. She was pleased.

In case you’re sitting on the edge of your seat, wondering if pregnancy cured my type 1 diabetes, the answer is no. Grandma was wrong on this one; but don’t hold it against her, she meant well.

Since I wasn’t cured, my biggest priority when I found out I was pregnant was keeping my blood sugar in excellent control. You know, because of the whole High Blood Sugar Harms Your Baby thing. I’d never be able to forgive myself if High Blood Sugar Harmed My Baby. So in order to keep my A1C  in the fives, I’ve been testing fifteen times a day because that’s what the combination of pregnancy and type 1 diabetes demands.  And I avoid restaurants whenever possible so there are no surprises.

But diabetes is unpredictable, especially with pregnancy hormones swirling around and even if I tested every hour it wouldn’t guarantee perfection. Sometimes I have to remind myself that a blood sugar of 147 is just a moment.  It doesn’t make me a criminal.

I got through the first trimester and I’m sorry to report that aside from the knowledge that I was pregnant, which kept me going, I was fairly miserable. No unicorns, butterflies, and rainbows were present.  There was no pregnancy glow. Instead, I had extreme morning sickness which lasted all day and all night. I could hardly eat or drink, which caused low blood sugar, weight loss, dehydration, and dizziness. There was talk in my doctor’s office of admitting me to the hospital because of dehydration, but my mother assured them that I’d get more fluids. For the next few weeks, I sipped electrolyte enhanced water, and munched on toddler portions of cheerios that I counted out in a plastic measuring cup. Gary and I were supposed to go on vacation, but I couldn’t get out of bed.  I recall the entire three months as a blur of nausea, naps, and worry.

Somehow, the little baby in my womb survived this difficult time. I am in my fourth month now, and starting to gain an appetite. My diet has completely changed. I used to be the low carb queen, like, one cup of lettuce equals 6 carbs, and yes, you had better count that. But salads no longer appeal to me, nor does meat. Instead I prefer to eat things like peanut butter crackers and chocolate covered rice cakes. The interesting part is that my blood sugars are holding up to the snacky foods I used to avoid. I have read, and also experienced first-hand, that pregnancy causes low blood sugar, which makes insulin requirements go down at least in the first trimester.  (It seems to be persisting for me, though I don’t know if this will be true for everyone.) While it’s nice to enjoy carby snacks with good blood sugar readings to follow, I’ve also had to deal with severe hypoglycemia and hypoglycemia unawareness. I don’t always detect my lows in the 70s or 60s; I feel them when I’m in the 30s or 20s and am about to pass out. This has been alarming, especially when I’m at work.

I emailed my endocrinologist my numbers and she told me to come in the following day. She said that my numbers were dangerously low. And how was I functioning? She said they might have to admit me to the hospital.

For the second time in my young pregnancy someone was telling me I might have to be hospitalized.  Was this always the case with pregnancy and type 1 diabetes?  As a person with diabetes, I try to avoid hospitals at all costs because I don’t need a sugar drip for 48 hours, thank you very much.

I said, “Please, no! I’m trying so hard, I’ll do anything!”

She said “Okay.”

She graciously sat with me for two and a half hours and we drastically changed my insulin to carb ratios and cut my basal rates by almost half. Then she told me to stay out of work for at least a week because being nauseated and low all the time must have been exhausting – for my body and my brain, and I needed time for my blood sugars to stabilize.

I said “Okay.” But I was really thinking, Doctor, when can I expect a pregnancy glow? What’s happening to me?!

I’m usually Ms. Independent. A diabetes expert. But I felt like I was twelve again, newly diagnosed, weak, and needy.

I realize now that pregnancy is a game changer and it is new to me. If that makes me less able for a short while, that’s okay. My priority is the health of my baby and I’ll do anything to ensure that.

So this is where I stand (sit), creeping my way through the second trimester.  Everyone says it will be a breeze.  I am hopeful.  In the meantime when my blood sugar is misbehaving and I’m feeling lousy, I just pop open my album of ultrasound pictures, and that cures everything.

Jennifer Jacobs

Jennifer Jacobs grew up in Long Island, New York. She was diagnosed with type 1 diabetes at age twelve. The challenges of living with diabetes have inspired Jen to be creative. She makes “diabetes art,” which can be viewed on her website, www.diabetesart.com. Work from Jen’s Diabetes Revealed series has been exhibited at various events in the NY-metro area. She also writes about diabetes and is putting together an essay collection.

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