Managing diabetes – type 1, type 2, gestational, or any other form – can be tricky by itself. When you add in the enormous changes that the female body goes through during pregnancy, diabetes management can seem downright impossible – but it is not, and I hope I can help put your mind at ease about what’s in store.
I am currently 20 weeks pregnant with my first child, and I’ve also been living with type 1 diabetes for over 26 years. Like so many others, I have concerns about the possible risks (and rewards!) associated with pregnancy and diabetes, but I also know that so many other women before me have experienced healthy pregnancies while managing their diabetes. Careful planning and the diligent care of a competent health team can help minimize the potential risks.
Having diabetes does not mean that a healthy pregnancy isn’t possible. And even though your pregnancy may be very healthy and uneventful, so to speak, pregnancies with pre-existing diabetes are considered “high risk”. Don’t let that label get you down – while you may be “high risk”, it also means that you will get lots of extra attention!
Your medical team will be very important to you throughout your pregnancy (and beyond), so if you are planning a pregnancy, you will want to start assembling your A-Team well before conception. Your team may include:
- An endocrinologist who is familiar with pregnancy and diabetes, and is willing to help you manage the drastic changes in medication you may need, as well as monitor things like thyroid levels, blood pressure, cholesterol, and kidney function
- An obstetrician familiar with managing high-risk pregnancies
- A Maternal Fetal Medicine doctor (specializes in high-risk pregnancies) whom you may see for higher level ultrasounds and screenings
- An ophthalmologist who can monitor your eyes for any changes that may occur during pregnancy
Pregnancy with diabetes will mean some (okay, a lot) of hard work on your part. It’s totally possible, though – you can do this! Some changes you can expect:
- checking your blood glucose more often
- aiming for numbers post-prandial and fasting glucose numbers that are lower than you are accustomed to
- HbA1c goals of under 6.5% or 6.0% (your doctor will help set individual goals for you, which may differ from what I’ve listed here)
- lower insulin needs in the first half of pregnancy, while the second half of pregnancy generally increases insulin resistance (and therefore increases insulin requirements by two, three, or even four times as much as you are used to taking)
- changes to other medications, such as thyroid medication, vitamins, blood pressure medications or anti-depressants
- all of the expectations for non-diabetic pregnant women: balanced diet, pre-natal vitamins along with increased folic acid, regular (but not strenuous) exercise, increased fluid intake, and plenty of sleep.
There are many women in the diabetes online community who have shared their personal stories of pregnancy while living with diabetes, and organizations who have put together resources specifically for people like us – be sure to check out the list of resources below.
JDRF’s Pregnancy Toolkit:
From JDRF, “Take care! Pregnancy or planning a pregnancy with type 1 diabetes (T1D) requires special consideration to help ensure a healthy outcome for mother and child. This guide provides information for parents-to-be or future parents-to-be with T1D—explaining the disease management goals for pregnancy and reviewing how to obtain the best possible support from healthcare providers at every stage.”
Diabetes Forecast’s Guide to Pregnancy:
[blog] Six Until Me: http://sixuntilme.com/blog2/diabetes_and_pregnancy/
[blog] Managing the Sweetness Within: http://www.thesweetnesswithin.blogspot.com/
[book] Balancing Pregnancy With Diabetes: Healthy Mom, Healthy Baby: http://www.amazon.com/Balancing-Pregnancy-Pre-existing-Diabetes-Healthy/dp/1932603328/ref=cm_cr_pr_product_top
[blog] Sweetly Voiced: http://www.sweetlyvoiced.com/2011/11/tell-me-sweet-little-lies.html, http://www.sweetlyvoiced.com/2012/02/this-time.html, http://www.sweetlyvoiced.com/2012/02/so-how-did-we-do.html
Guest posts on DiabetesMine
[blog] http://www.diabetesmine.com/2012/08/gina-capone-how-pregnancy-with-diabetes-saved-my-life.html, http://www.diabetesmine.com/2012/01/c-sections-vs-natural-birth-in-diabetic-moms.html
Jane Dickinson, RN, PhD, CDE
Holly at “Arnold and Me”
[guest post] WhatToExpect.com: http://www.whattoexpect.com/wom/pregnancy/it-s-always-complicated.aspx
[blog] Typical Type 1: http://typicaltype1.com/tag/pregnancy/
Christel Marchand Aprigliano
[blog] theperfectd: http://theperfectd.com/2013/03/21/fall-down-seven-stand-up-eight/
[Yahoo Group] http://health.groups.yahoo.com/group/positivediabeticpregnancies/